Cluster headache at night: what should you know?

Night-time attacks can occur around the same part of the sleep period and may be linked with the body’s sleep rhythm. The pain is usually severe and one-sided, often around an eye or temple, with tearing, redness, nasal blockage, or agitation on that side. Waking with head pain does not identify the cause by itself: migraine, sleep-related problems, medication effects, and other conditions can also disturb sleep. Compare your symptoms with the Headache and Facial Pain and Pressure information pages.

Keep a bedside record of bedtime, awakening time, attack duration, side, eye or nose symptoms, alcohol exposure, snoring, witnessed breathing pauses, and medicines. Keep prescribed rescue treatment accessible as directed, and avoid taking extra doses simply because sleep was interrupted. Arrange a GP Consultation if attacks recur, disturb sleep, or have not been diagnosed. A clinician may need the timing pattern to guide next steps.

Call emergency services for sudden maximal pain, weakness, trouble speaking, confusion, seizure, fainting, fever with neck stiffness, or persistent visual loss. Seek prompt review for a new night-time headache, a rapidly changing pattern, repeated vomiting, or headaches associated with breathing pauses or severe daytime sleepiness.

What pattern should I record overnight? Could sleep apnoea, medicines, or another headache disorder be contributing? What can I use safely when an attack wakes me? Should I have a prevention plan, and which warning signs require emergency help?