High-Flow Oxygen Therapy as Effective as Sumatriptan for Cluster Headaches

oxygen tank
oxygen tank
The effectiveness, tolerability, and use of inhaled oxygen compared with injectable sumatriptan was examined by utilizing a patient reported survey.

Inhalation of high-flow oxygen may be as effective as injectable sumatriptan in the treatment of cluster headaches, according to survey results published in Headache.

Researchers culled 493 participants from the online Clusterbusters Medication Use survey. The survey contained 41 questions that requested information regarding demographics, headache characteristics, medications, and oxygen use. Medication effectiveness was measured using a 4-tier rating scale: not effective, partially effective, moderately effective, or completely effective. Text messaging was an option for responding to questions not easily answered or unavailable on the survey.

Of the participants who used oxygen with a flow rate higher than 10 L/min (n=270), 64.4% had tried both oxygen therapy and injectable sumatriptan, and similar percentages reported response to only one medication: oxygen for 15.5% and sumatriptan for 14.9%. Response to inhaled oxygen was again almost the same whether participants responded to injectable sumatriptan (81.4%) or not (79.4%). Participants who had only tried injectable sumatriptan or inhaled oxygen at rates higher than 10 L/min (but not both) reported similar results: an 82.6% response to oxygen compared with 82.3%, respectively.

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Investigators conclude that “therapeutic response to inhaled oxygen at sufficiently high flow rates (>10 L/min) had comparable efficacy to that of injectable sumatriptan for the acute treatment of cluster headache.” Researchers counted Internet bias and diagnostic validity as study limitations, but survey results suggest that oxygen therapy for cluster headaches may help in triptan overuse.

Disclosures: Multiple authors declare affiliations with Clusterbusters. Please refer to original reference for a full list of authors’ disclosures. 


Schindler EAD, Wright DA, Weil MJ, Gottschalk CH, Pittman BP, Sico JJ. Survey analysis of the use, effectiveness, and patient-reported tolerability of inhaled oxygen compared with injectable sumatriptan for the acute treatment of cluster headache [published online September 17, 2018]. Headache. doi: 10.1111/head.13405