Causes of cluster headache at night

Cluster headache is a neurological condition involving severe pain around one eye or one side of the head. Attacks can arrive in bouts, with some people noticing a regular time of night. The hypothalamus, a brain area involved in sleep and circadian timing, may contribute to this pattern. Alcohol can trigger an attack during an active bout, while strong smells or changes in sleep may also be relevant for some people. A nighttime headache is not automatically a cluster headache; migraine, sinus-related pain and other causes can feel similar.

During an attack, one-sided facial pain may occur with a watery or red eye, blocked or runny nose, eyelid swelling, or marked restlessness. Keeping a record of timing, duration, symptoms and possible triggers can help a clinician distinguish patterns.

Arrange a GP assessment if attacks repeat, wake you from sleep, or cause severe pain. Record when each episode starts, how long it lasts, which side is affected, and whether eye or nose symptoms appear. Note alcohol, sleep disruption, heat, strong odours and medicines taken before an attack. Avoid alcohol while a cluster period is suspected, and use prescribed treatments exactly as directed. A clinician may discuss an urgent attack treatment and a plan to reduce further episodes; ordinary painkillers may not act quickly enough for cluster headache.

Seek emergency help for a sudden, explosive headache, new weakness or numbness, confusion, fainting, a seizure, fever with a stiff neck, or new vision loss. Get urgent medical advice for a first severe headache, a clear change in an established pattern, or pain after a head injury. Do not drive yourself if severe pain, visual symptoms or neurological changes make travel unsafe.

Could this pattern fit cluster headache or another headache disorder? Which symptoms should prompt emergency help? What should I do during a nighttime attack, and which treatments are suitable for me?