Common cluster headache triggers include drinking alcohol, smoking, and eating certain foods. Identifying your triggers may help reduce the frequency and severity of your headache attacks.

Many people with cluster headache find that certain actions and circumstances tend to trigger an attack. Identifying and avoiding these triggers can be useful and help complement your treatment plan.

Cluster headache is a primary headache disorder that causes severe pain on one side of your head. It also causes other symptoms such as tearing and a runny nose. Cluster headache is a rare condition, affecting only about 0.1% of the population.

Attacks occur cyclically. You may have a series of severe headaches for several days, weeks, or months in a row. But the attacks usually stop when the cluster period ends. They may not return for several months or years.

During cluster periods, you may benefit from avoiding your triggers as much as possible. The first step is identifying them.

Graphic presentation of cluster headache triggers.Share on Pinterest
Illustrations by Alyssa Kiefer. Design by Maya Chastain and Andrew Nguyen

Some triggers common among people with cluster headaches include:

1. Alcohol

Drinking is one of the most common cluster headache triggers. Many people identify this trigger early on and avoid alcohol because of it.

There’s no evidence that any specific type of alcohol is worse than others.

2. Smoking

Although the connection isn’t entirely understood, there’s a known relationship between cluster headache and tobacco. As many as 88% of all people with cluster headache smoke cigarettes. Smoking or spending too much time in a smokey environment might also trigger an attack.

3. Time of day

Cluster headache attacks frequently occur on a set schedule, most often at night. Many people are awakened by excruciating pain at the same time every night. This is so common that cluster headache attacks are sometimes called alarm clock headaches.

Research shows that cluster headache originates in or involves the hypothalamus, an area in your brain involved in the circadian rhythm.

4. Time of year

Cluster headache gets its name from the pattern in which attacks arrive. People experience frequent attacks over a period of weeks or months, and then they typically experience a remission period.

Symptom clusters tend to appear in a seasonal pattern, with the first attack in a cluster occurring around the same time of the year. This might happen every year or every few years.

5. Diet

Certain foods are more likely than others to trigger cluster headache attacks. Fasting, missing a meal, and dehydration can also trigger attacks.

Common trigger foods include:

  • monosodium glutamates (MSG), such as in soy sauce or meat tenderizer
  • nitrites or other preservatives, such as in sausage and bacon
  • caffeine, such as in coffee or tea
  • aged cheese, such as cheddar or Parmesan
  • tyramine, such as in citrus fruits or beans
  • aspartame and other artificial sweeteners
  • processed foods, such as deli meats

6. Bright lights

During cluster headaches, some people experience sensitivity to bright or flashing lights. This type of light sensitivity is actually a neurological issue called photophobia.

The light activates specific nerve cells in your brain that can trigger an attack or increase its severity. Because these nerve cells work independently from the eyes, this condition can even occur in blind people.

Specific color wavelengths, such as blue-green, also play a role in photophobia.

7. Sleep problems (including sleep apnea)

Cluster headache appears to be affected by circadian rhythms and may be related to sleep cycles. If you aren’t getting enough sleep or you experience a change in your typical sleep schedule, this could trigger a cluster headache attack.

Research has also shown a connection between cluster headache and sleep apnea, which causes constant sleep interruptions. Between 30% and 80% of people with cluster headache also have sleep apnea.

Decreased melatonin levels are also associated with cluster headache.

8. Strong smells

Some people say strong smells such as nail polish can trigger an attack. But there’s no definitive research that proves particular scents trigger headaches.

9. High altitudes

High altitudes could trigger or worsen a cluster headache attack by increasing blood vessel dilation in your brain. This theory is supported by the fact that oxygen, which narrows blood vessels, is a well-known treatment for attacks. Higher altitudes naturally have lower levels of oxygen.

10. Weather changes

Many people say the weather triggers or worsens cluster headache. Case studies have also mentioned weather changes as possible triggers.

One study on all headache types states that several aspects of the weather can have an impact, including:

  • changes in barometric pressure
  • low barometric pressure
  • seasonal changes
  • high humidity
  • rainfall

11. Exercise

Exercise or physical exertion may trigger cluster attacks in a small percentage of people with cluster headache. But more research needs to be done to clarify and expand on this topic.

12. Stress

The association between pain and stress is well known. Stress and anxiety can increase the impact of cluster headache on your day-to-day life.

Knowing your triggers and avoiding them as much as possible may help reduce the frequency of your cluster attacks.

There are several things you can do to treat or manage cluster headache, including the following:

Keep a headache diary

Use a diary, journal, or headache diary template to track symptoms and identify possible triggers. Note your symptoms, when they occur, and how severe they are.

You can also use your diary to record your diet and exercise routine for several weeks or months. This may help you identify foods or activities to avoid or cut out altogether.

You can also keep track of the treatments you have tried and how well they worked.

Talk with a doctor about medication

Talk with a doctor about your symptoms. They may recommend medication to prevent attacks before they start, stop them before they progress too far, or lessen the symptoms. These medications may include:

  • melatonin supplements
  • capsaicin nasal spray
  • lidocaine nasal spray
  • corticosteroids
  • valproic acid
  • verapamil
  • triptans
  • lithium

Oxygen is the most well-known cluster headache treatment and is effective for most people. But keep in mind that insurance won’t always pay for oxygen therapy for cluster headache.

Try alternative therapies

Some people have had good results with alternative therapies, such as:

Talk with a doctor before adding alternative therapies to your treatments. Some supplements and herbs can interfere with your other medications or health conditions.

Cluster headache is a neurological problem that can be affected by several different factors, including:

  • Cluster headache is a neurological condition that causes severe headache attacks on one side of your head and other accompanying symptoms.
  • It’s a rare condition, and research into causes and triggers is limited and sporadic.
  • Identifying and avoiding triggers may help reduce the pain and stress caused by cluster headache.
  • Talk with a doctor about what treatments, medications, and therapies are right for you.