It’s estimated that 95% of people have experienced headaches at least once in their lifetime…and over 42% get headaches regularly. Yet despite the prevalence of head pain, that pain and its causes often go undiagnosed or misdiagnosed, preventing affected persons from getting proper treatment.
Cluster headaches and migraines are both considered primary headache disorders — in other words, not symptomatic of another medication condition. But they are, in fact, separate and different.
First, a few basics:
- Migraines are much more common than cluster headaches, with about 12-25% of the population experiencing migraine compared to just 0.5% for cluster headaches.
- Migraine is predominant in females at a 3:1 ratio, while cluster headaches are primarily seen in men also at a 3:1 ratio.
Migraines and Cluster Headaches: Similarities and Differences
How They’re Similar
Although migraine and cluster headache differ considerably in diagnosis, they do share some like symptoms:
- Location: Cluster headaches occur exclusively on one side of the head. Migraine headaches are felt on one side of the head in 60-70% of adult patients (although they may also occur on both sides).
- Nausea: In migraine cases, nausea is a prevalent symptom — up to 90% of people with migraine experience nausea, and up to 70%, vomiting. Cluster headaches cause 23-29% of people to experience nausea, making it a less frequent but noteworthy potential symptom.
- Sensitivity to Light and Sound: During a migraine episode, up to 80% of people experience light sensitivity, and 70-80% report elevated sensitivity to sound. People with cluster headaches report light and sound sensitivity 47-52% of the time.
How They’re Different
- Duration: Cluster headaches usually last for 15-180 minutes and peak within minutes. Migraines, on the other hand, generally last anywhere from 4 to 72 hours.
- Intensity: Reported to be one of the most painful medical conditions, cluster headaches are very severe and have even been called more painful than labor. Migraine headaches can be intense but feature a range of pain between episodic and chronic cases.
- Type of Pain: Although both cluster headaches and migraine cause severe pain, the former is typically described as “excruciating, throbbing and stabbing,” while migraine is reported to be “deep and pulsating.”
- Frequency: Cluster headaches generally occur more frequently than migraines — on the average of once every other day, up to 8 times a day, as compared to every other day for people living with migraine (and with significant differences between episodic and chronic migraine). Cluster headaches also appear to follow rhythmic cycles, with episodes occurring at similar times each day.
Some 24 to 48 hours before the onset of migraine, about 77% of people begin to notice prodromal symptoms, commonly including irritability, depression, increased yawning, neck stiffness, and a craving for specific foods.
Some studies show that cluster headaches may exhibit ”pre-attack” symptoms similar to those of migraine. However, cluster headaches do display certain symptoms unlike those of migraine, including:
- Agitation and restlessness: During an attack, people with cluster headaches may prefer to pace in an agitated state, for which neither position nor rest offers relief. This contrasts with people experiencing migraine, who find comfort in a more quiescent state.
- Cranial autonomic symptoms: Uncomfortable ‘rest-and-digest’ symptoms occur in up to 97% of people with cluster headaches, including tear production and conjunctival infection (pink eye), nasal congestion, and facial sweating.
- Seasonal/daily periodicity: Dr. Wei at the Swedish Neuroscience Institute explains that 82% of people with cluster headaches have them at the same time every day. Peak time for these headaches is between 1 and 3 am. Also, their frequency tends to be “clustered” during certain times of the year. This rhythmicity may be due to action of the hypothalamus, the part of the brain known to control our biological clock and circadian sleep/wake cycles.
Triggers for Migraines and Cluster Headaches
Migraine and cluster headaches can be caused by many of the same triggers; however, some triggers are specific to each disorder.
- Stress. Stress is the most common trigger of migraines, indicated in around 46% of people with migraine.
- Sleep fluctuations. In an extensive clinical study of people living with migraine, half indicated that sleep disturbances aggravate their headaches.
- Odors. Specific odors have long been thought to be a trigger of migraine, found in up to 46% of people with migraine.
Cluster Headache Triggers
- Daytime naps. 1/3 of people living with cluster headaches say napping during the daytime can trigger attacks. This is linked to the rhythmic nature of the condition and the hypothalamus.
- Alcoholic beverages. For some people, cluster headaches may onset almost directly after alcohol is consumed.
- Vasodilating medications, such as nitroglycerin.
- Smoking. Some evidence suggests a link between smoking and cluster headache attacks.
Can the potential for both migraines and cluster headaches be present in the same individual? Perhaps. In a recent genetic study, only one gene was found similar for both migraine and cluster headache. But more studies with additional participants are needed, before any possible links between the two types of head pain can be understood.
Are you ready to uncover the cause of your migraine episodes? One very effective approach is through a DNA-guided treatment program that gives you a clearer picture of why and how your migraines occur. DNA-informed treatments can help you find a tailored approach that works quickly to identify, treat, and potentially halt your migraines.