Meta-analysis finds strong links between cluster headaches, migraines and circadian rhythm (Abnormally low melatonin)

Medical Xpress / American Academy of Neurology / Neurology ^ | March 30, 2023 | Mark Joseph Burish, MD, Ph.D.l. et al

[ConservativeMind]

Both cluster headache and migraine have strong links to the circadian system, the internal clock that regulates body processes, according to a meta-analysis.

The meta-analysis included all available studies on cluster headache and migraine that included circadian features.

The researchers also looked at studies on cluster headache and migraine and hormones related to the circadian system, including cortisol and melatonin.

"The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache," said Mark Joseph Burish, MD, Ph.D.l. "It raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body's circadian rhythm."

For cluster headache, the meta-analysis found a circadian pattern of headache attacks in 71% of people. Attacks peaked in the late hours of night to early hours of morning. During the year, people had more attacks in the spring and fall. On the genetic level, cluster headache was associated with two main circadian genes, and five of the nine genes that increase the likelihood of having cluster headache are genes with a circadian pattern of expression.

People with cluster headache also had higher cortisol levels and lower melatonin levels than people without cluster headache.

For migraine, the meta-analysis showed a circadian pattern of attacks in 50% of people. While the peak for attacks during the day was broad, ranging from late morning until early evening, there was a circadian low point during the night when few attacks happened. Migraine was also associated with two core circadian genes, and 110 of the 168 genes associated with migraine were genes with a circadian pattern of expression.

People with migraine had lower levels of melatonin in their urine than people without migraine. In addition, melatonin levels were lower during a migraine attack.

[ConservativeMind]

They noted melatonin levels were lowest during a cluster headache.

As this was a meta-study, I’m not sure how any novel “anything” comes out of it, as no primary research is done, but I don’t think many people caught the prior study’s reference to low melatonin during cluster headaches, so I’m glad they regurgitated that, for us.

It might point to such persons trying a small amount of melatonin, to see if it can help them.

[ConservativeMind]

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[pepsionice]

I’ll just say at least one night a week, to get a deeper sleep...I’ll use melatonin. If you read through the literature....you don’t want to get hooked to a regular nightly use.

[Bullish]

I’ve had a lifetime brutally rife with Cluster headache disorder. This study makes sense to me since I’ve heard this years ago, that it was related to the sleep cycle. I remember they mentioned the pituitary gland which is located near the center of the brain and has to do with sleep cycle regulation, at least that’s what my neurologist told me 20 or so years ago.

When I was in Cluster periods, my headache attacks came at practically the exact same time every day for weeks, even months at a time. They are indescribably excruciating in the level of pain. I was a case study for many doctors I’d seen back in the 70s and 80s because most doctors in those days had no idea what it was and didn’t even have a name for the disorder. I went to alot of doctors looking for help. They tried literally everything on me. Nothing worked, until a neurologist put me on a steroid called prednizone, which seemed to prevent most headaches while I was in cluster.

The clusters finally started to wane about 10 or so years ago and now I don’t get many Cluster attacks, thank God.

My heart goes out to anyone who has Cluster headache, doctors have told me that clusters are probably the worst pain a body can produce on its own. I believe that, cause I’ve been there.

[Dac59]

My Husband suffered with cluster headaches for years until a massage therapist helped get rid of them. He has not got one since. If I remember right. The therapist concentrates on a neck muscle while my husband was sitting in a chair. it was daily for a week then once every week for 1 month. It worked. She was taught by a man specifically for the cluster headaches. My husband could not take prednisone because it would cause him to get pancreatitis. Thank God he found that therapist.

[nicollo]

Whatever prednisone helps, acupuncture can help as well. And without the problems of steroids.

[budda1954]

I had cluster headaches as well. Talk about PAIN. Nothing worked for me except oxygen.

[Bullish]

I had 24/7 oxygen for a while too. They tell you to take the oxygen full strength when you start to feel a cluster coming on. It worked for me about 30% of the time. The only thing that worked for prevention was the steroid prednizone but I was told to take massive doses, even to dangerous levels monitored by my neurologist. But at least it was finally something that worked. I had a nerve block injection where they stick 3 inch long needle into the back of your neck to block pain for a while, for some well needed relief. Problem was, that didn't really work on me. I was at the final stage where they were considering doing a nerve removal surgery when we discovered that steroids would work. I'm so glad because of the known side effects of the nerve removal, including possible facial drooping from the lack of those nerves. I consider myself very blessed that I didn't have to have the nerve surgery, and got through to the point that I no longer have massive clusters, but still little short cluster periods with comparatively minor headaches.

I have been taken to emergency rooms with massive clusters in the past too. All they could do for me is a knock out injection, but it was needed to stop the damn marathon cluster.

Sorry to hear you had to suffer with that too. I've been told it's a pretty rare condition that only effects certain people, I guess we're among those who were stricken with it.

Clusters destroyed a lot of my life.

[Bullish]

I have heard about the nerves in the neck and massaging that area does help. My case was an extremely bad one and it would come on like clockwork and completely debilitate me.