Most people who have cluster headaches have 1 or 2 cycles of headaches a year, with each cycle lasting between 1 and 3 months. After the cycle has subsided, most people are in remission with no headaches for about 6 months to 2 years. This is "Episodic" Cluster Headache.
Cluster headaches may begin at night, within 2 to 3 hours of falling asleep. They may begin while you are sleeping, particularly during REM phase of sleep, so the cluster patient will awaken with a severe headache 60 to 90 min after falling asleep. but they can also occur during the daytime. You may have 1 to 8 headaches per day.
The cycle of headaches occurs on only one side of the head. Cluster headaches cause deep, stabbing pain usually in, around, or behind one eye. The pain may extend to the temple, forehead, cheek, upper teeth, or even the jaw on the same side as the pain. You may also have a stuffy or runny nose, watery eye, and drooping eyelid on the same side as the pain.
The pain of cluster headaches intensifies quickly - within 5 to 10 minutes of onset - and usually remains constant for around 30 to 45 minutes, and sometimes up to 3 hours. Active periods (bouts) of Cluster headache can continue for days, weeks, or months before symptoms completely stop (remission). You may not have another cycle of cluster headaches for months or even years. Less commonly, the headache cycles may become chronic and continuous.
During a headache cycle, you may be restless, agitated, or unable to sit still. Some people find relief by pacing, sitting, kneeling, standing, or jogging in place. Applying steady pressure to the painful area may provide relief. Lying down may make the pain feel worse.
Afterward, the pain goes away, but the headache may leave you absolutely physically and emotionally exhausted. Another headache attack may occur within a relatively short time.
Over time, cluster headache cycles may become longer, and periods without headaches (remission) may become shorter. In about 10% of Cluster Headache cases, a person may experience little or no remission. This is "Chronic" Cluster Headache. Approximately 10% of these chronic cases do not respond to medications and are deemed drug-resistant "intractable" or "refractory" cases. These cases may require surgical intervention.
Some people have a single cluster headache cycle and never have another one. During a cycle, some people have from 1 headache attack every other day, up to 8 headaches a day over a period of weeks to months, followed by headache-free periods that can last for weeks, months, or years.
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