Both migraines and cluster headaches cause intense pain in the head, often centered around the forehead, temples, or sinuses.
Migraines are characterized by severe pain or throbbing, typically on one side of the head. In contrast, cluster headaches are shorter in duration but can recur over a period of a few months, followed by a remission period that can last up to a few years.
Those who experience cluster headaches often notice that they occur during the same season each year.
Migraine is a prevalent condition, impacting over 37 million Americans, whereas cluster headaches are much rarer and only affect around 1 million individuals.
A new meta-analysis published in the medical journal Neurology has found strong links between cluster headaches, migraines, and the circadian system.
The study analyzed all available research on the two types of headaches that included circadian features, such as the timing of headache attacks throughout the day and year, and investigated whether circadian genes were more prevalent in people with these conditions.
The findings suggest that both cluster headaches and migraine are highly circadian at multiple levels, highlighting the importance of the body’s internal clock in these disorders.
According to the study’s lead author, Dr. Mark Joseph Burish of the University of Texas Health Science Center at Houston, the researchers also examined the relationship between cluster headaches and migraine and hormones associated with the circadian system, including cortisol and melatonin. The findings suggest that both types of headaches are highly influenced by the body’s internal clock, particularly in the case of cluster headaches.
“This reinforces the importance of the hypothalamus—the area of the brain that houses the primary biological clock—and its role in cluster headaches and migraine. It also 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.”
The meta-analysis found that 71% of individuals with cluster headaches experienced a circadian pattern of headache attacks, with peak occurrences in the late hours of the night to early morning. During the year, individuals had more attacks in the spring and fall. On the genetic level, cluster headaches were associated with two main circadian genes, with five of the nine genes that increase the likelihood of having cluster headaches showing a circadian pattern of expression. Additionally, people with cluster headaches had higher cortisol levels and lower melatonin levels than those without.
For migraines, the study showed a circadian pattern of attacks in 50% of individuals, with the peak occurrence ranging from late morning to early evening. However, there was a circadian low point during the night when a few attacks happened. Migraine was also associated with two core circadian genes, with 110 out of 168 genes linked to migraines exhibiting a circadian pattern of expression.
The study revealed that individuals with migraines had lower levels of melatonin in their urine compared to those without migraines. Additionally, melatonin levels were found to be lower during a migraine attack.
The findings “raise the potential for using circadian-based treatments for headache disorders,” Burish added. “This could include both treatments based on the circadian rhythm – such as taking medications at certain times of the day – and treatments that cause circadian changes, which certain medications can do.”
The study was limited by the lack of information on factors that could affect the circadian cycle, including medications, other conditions like bipolar disorder, and issues related to circadian rhythm, such as working night shifts.
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