Cluster headache has the very appropriate name “suicide headache”. It’s rare enough that we haven’t studied it nearly enough, and yet common enough to affect our communities in a big way, and individuals in a huge way.
With a shortage of good treatments, you would think that doctors would prescribe whatever will work that’s not a huge risk. So why is one treatment often overlooked?
That treatment is oxygen therapy.
Oxygen therapy for headache was first mentioned in literature almost 80 years ago, so this is not a new therapy. It’s also considered to be a fairly safe, stable option. As the Migraine Trust says:
Oxygen is one of the safest ways to treat cluster headache. You need to breathe the oxygen in at a rate of between 7 and 12 litres per minute. The treatment usually starts to work within 15 to 20 minute. For some people the attack is delayed rather than stopped altogether. [source]
An article from the National Headache Foundation last month lamented the fact that oxygen therapy is still underutilized for cluster headache:
Despite treatment guidelines recommending the use of oxygen for the acute therapy of cluster headache, oxygen remains underutilized. A recent study looking at the cost of oxygen for cluster headache found the reason for its lack of use may be because of poor physician awareness of the treatment, as well as the lack of understanding for how to write and fill a prescription for high-flow oxygen.
According to a recent study, the price of oxygen therapy varies quite a bit, but averages out at around $1000 per year in the USA. Most private insurance plans will cover it. So – why not make use of it?
It’s time for an update on our discussion of pillows for migraines. You may remember, this was the topic of a podcast six years ago – The Practical Pillow Podcast. Since then, there has been a lot more written on the topic.
Unfortunately, if you’re simply looking for the “best pillow for migraine” you’re going to be disappointed. Yes, there is a lot of advice out there. But a pillow is a very personal thing. And a pillow that works for your friend may not work for you. You don’t sleep the same way, your headache condition may be different, even simple things like room temperature, or your weight, could make a difference.
So here are some of the most popular pillows for migraines today, and some quick facts about them.
Memory Foam Pillows: Let’s start with the simple memory foam pillow. These have gained in popularity over the past few year, and have helped a lot of people. There are variations on the memory foam pillow, which we’ll see below.
If you haven’t looked at pillows for a few years, you’ll see that things have changed. The technology has improved quite a bit, and there is much more variety. One of the most popular today is the Z Zoned Memory Foam Pillow, which is supposed to be a lot softer than similar pillows from past years. They also make a travel pillow.
A common complaint of these pillows is that they tend to have a manufacture-chemical smell at first. The smell does fade, but migraine patients find they need to leave the pillow out for a while before using it.
Still, many migraine patients used them. One reviewer writes:
I suffer with regular migraines and I quickly learned that the pillow I slept with was a huge factor on whether or not I was going to wake up with a migraine or not so I am very picky, so lets say, used to suffer with regular migraines! Basically I need my head to feel it is floating on a cloud of nothing or I will be miserable when I wake up. I chose the high loft so my head doesn’t “bottom out” and kinda just suspends in this middle of cloudy softness… call me weird in the comments if you want but once you try an amazing high loft pillow you’ll understand what I mean 🙂 [source]
Countoured Neck Support Pillows: Many looking for pillows for migraines immediately think of contoured pillows. Many of these are memory foam as well (which is why I spent extra time talking about memory foam above). A typical example is the inexpensive MEJOY Memory Foam Pillow. If you’re looking to avoid memory foam, check out the Snuz Neck Support Pillow (there is an extra-firm option).
Buckwheat Pillows: Buckwheat pillows have a number of advantages. They provide premium support, being very firm. They have no chemical-smell. They adjust to the shape of your head. And they’re cool. You can even put them in the freezer for an hour before you use them to really cool your throbbing head.
I’ve often talked about buckwheat pillows for migraines. If there is a downside, it’s that they are very firm. It really depends on how you sleep. Also, if you move around a lot, you can hear the shifting of the buckwheat hulls.
“Cooling” Pillows: Because of the pulsing, hot headaches that many of us get, “cooling” pillows are a great option. Now, just a caveat here. Cooling does not necessarily mean that the pillow continually cools you all night. That may be the case if there is constant water flow. But generally it means it doesn’t hold heat in like many traditional pillows do.
One well-known brand is Chillow, but Chillow has changed. Generally what you get today is a “cooling pad” which you can use by itself or with a pillow underneath. You actually put water in the pad. Although some people swear by them, the hassle of adding water and possible leaks have hurt the popularity of Chillow (on the other hand, the price is right if you want to try it!).
A popular and inexpensive example of today’s cooling pillows is the Bluewave Bedding Gel-Infused Memory Foam Pillow. It’s ventilated, and gel-infused, to keep the temperature from rising while you sleep. You can also get very slim versions.
You can also get a pad to put on your favourite pillow, like the Penguin Cooling Pillow Mat. But before you just get a pad, remember you should be changing your pillow every year or two.
As you have probably guessed, there are also combinations of the above. Take for example the ViscoSoft ARCTIC GEL CONTOUR Pillow, which is a hypoallergenic, memory foam, contoured neck pillow!
Changing your pillow can make a huge difference in your health. Many people have found pillows for migraines – that is, pillows that fight migraine, as you’ll see in the reviews for the products above. But sleep remains very personal. You’ll have to try the pillow for yourself to see which one works best.
Final advice? Keep your head cool. If you buy memory foam, be prepared to leave it out of the box for a week or two before you use it. And make sure you make a good pillow a priority. You’ll be spending a lot of time on it!
Some doctors have recommended lipoic acid as a supplement treatment for migraine. So what exactly is it?
Alpha-lipoic acid (also known as thioctic acid or ALA, or there is also RLA, the naturally-occurring version) is a chemical that is found in some plants, and actually is made by your own body. It’s an antioxidant, and so helps keep your body healthy while it fights inflammation. It also helps your body maintain proper levels of vitamin C and vitamin E. Both of these may play a major role in fighting migraine and headache.
Now, we’re all for antioxidants and healthy foods, but why ALA in particular? And why haven’t you heard about it from your doctor?
The evidence for ALA for migraine is still fairly sparse, just because there haven’t been many studies on it. A study in 2007 suffered because not enough patients were recruited for the study. However, the study seemed to show fewer headache days, and less intense headaches, with ALA. This was over 3 months (see A randomized double-blind placebo-controlled trial of thioctic acid in migraine prophylaxis..
600mg was also the amount used in the migraine study.
Because lipoic acid comes from food, your best bet is probably to eat more ALA-rich foods. Broccoli is one of the best all-round foods for a migraine patient. Also try organ meat (liver, heart), spinach, and tomatoes.
So here are some things to consider:
Get ALA from food. This is almost a no-brainer, since we already know that foods like broccoli have so many benefits. Also try adding peas, brussel sprouts, carrots and beets to your diet.
ALA can be taken as a supplement for general health. You could try 50-100mg per day.
If you would like to try ALA specifically for migraine prevention, talk to your doctor about a 600mg dose.
Which supplement? An excellent version of thioctic acid is Country Life R-Lipoic Acid. It contains no gluten or milk or preservatives and is vegetarian. It’s also one of the less-expensive versions of RLA, and was tested and approved by Consumer Lab.
If you’re taking a higher dosage, an even less expensive version (also tested by Consumer Labs) is Vitacost Alpha Lipoic Acid. This would be a good option if you’re going the 600mg route, because you can take it in two doses.
Finally, if you’re looking for one of the highest rated brands on Amazon, Doctor’s Best has a whole series of lipoic acid products to choose from. The reviews themselves are an interesting read, if you want to hear about how this supplement is actually helping people.
A report at this year’s annual meeting of The American Society of Anesthesiologists focused on whether or not onabotulinumtoxinA, often sold under the brand name of Botox, is useful in treating migraine in children. As we know, there are a limited number of treatments that have been properly tested for the under-18 crowd.
The report simply reviewed charts of people ages 8-17 who had received Botox treatment to treat chronic migraine. Patients received 2-3 injections each.
There are at least two significant caveats with this report. First, there is a high “placebo effect” with the younger crowd. It would be helpful to compare onabotulinumtoxinA treatments with similar treatments to see if it’s really a lot better or not. One key here is to see what kinds of side effects could be avoided by using Botox instead of another treatment, such as Topamax.
This was also a very small study, only 9 patients. So when we have a study like this, we basically say,”Ok, that sounds significant. Let’s start up a larger study so we can see if these results are real, or just a blip on the chart.”
Even a small study like this should get specialists thinking seriously about using onabotulinumtoxinA for their chronic migraine patients.
When people think of light therapy, they often think of seasonal affective disorder, a type of depression that seems to hit some people during seasons when the days are shorter. And that kind of therapy makes sense to us – maybe some people just have trouble adjusting to seasons with less light.
But what is less known is that light therapy is something that is growing much broader. It includes various types of light, and various types of diseases and disorders.
For example, did you know what light therapy is being widely used to treat acne? Yup. And how about other types of depression? And psoriasis. And pain conditions. And, of course, migraine.
Light therapy is an important frontier in medicine because of the possibility of making it available to paitients at a very low cost, in their own homes.
Read more about the possibilities of light therapy, including the story of Donna, who has found relief from her migraine attacks through a certain type of light therapy: Testing the Healing Potential of Light
That treatment is oxygen therapy.
Now, we’re all for antioxidants and healthy foods, but why ALA in particular? And why haven’t you heard about it from your doctor?
The report simply reviewed charts of people ages 8-17 who had received Botox treatment to treat chronic migraine. Patients received 2-3 injections each.