Waking up with cluster headache: what to know

Cluster headache attacks are often intense and may centre around one eye or one side of the head. The affected eye can water or look red, and the nose on that side may feel blocked or run. Restlessness is common during an attack. Some people notice attacks at a similar time of night, but a new or changing pattern should not be self-diagnosed.

A headache diary can record when you woke, which side hurt, how long the pain lasted, eye or nose changes, possible triggers, and any medicine used. This gives a clinician useful detail when distinguishing cluster headache from migraine or another cause.

Sit upright in a safe, quiet place and avoid driving while the pain or visual symptoms are active. Use only a treatment already recommended for you and follow its instructions; ordinary painkillers may not act quickly enough for cluster attacks. Arrange a prompt [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) if this is your first suspected episode or attacks are recurring.

Keeping a record of the timing and associated [Headache](/symptoms/headache/) features can help the clinician choose an acute plan and consider prevention.

Seek emergency help for a sudden, extremely severe headache, new weakness or numbness, confusion, fainting, a seizure, a stiff neck with fever, or new trouble speaking or seeing. Get urgent advice if severe pain follows a head injury, occurs during pregnancy, or feels clearly different from previous attacks.

Pain with marked eye swelling, loss of vision, or severe [Facial Pain and Pressure](/symptoms/facial-pain-and-pressure/) also needs urgent assessment.

Ask whether the timing and one-sided symptoms fit cluster headache, which treatment should be used at the start of an attack, and what warning signs should send you to emergency care. Mention smoking, alcohol exposure, sleep disruption, medicines, and any recent change in frequency.