A review of the current and potential oxygen delivery systems and techniques utilized in cluster headache attacks

Background Despite oxygen therapy being one of the foremost acute treatments for cluster headache (CH) attacks, little is known about the different techniques and systems. Objectives In this review we will examine the efficacy of the standard non-rebreather mask (NRM) with room temperature oxygen in relieving pain in CH, and try to compare it with the diversity of other oxygen gas conditions and interfaces like partial rebreathers, simple masks, nasal cannulas, tusk masks, demand valve oxygen, hyperbaric and cooled oxygen. Method We searched non-structured Pubmed, Medline, the Cochrane online database and instruction protocols from various oxygen delivery devices. Conclusions and implications Interfaces like demand valves and tusk masks are already proving to be superior or at least similar to the standard NRM in terms of fraction of inspired oxygen (FiO2), though the demand valve only showed better results than the NRM in a single study in only four participants. Furthermore, new research shows how lower temperatures of the gas may be an essential part of effective pain relief and hyperbaric treatments show potential in preventing night time attacks.