The implications of these comments are interesting to consider:

Interesting to note that he is saying that the primary mode of action is NOT as a vasoconstrictor but on its effect on the central nervous system. Doesn't change our appreciation of this class of meds but suggests we need to change how we think about the nature of CH.
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Handb Exp Pharmacol. 2007;(177):129-43.   


Serotonin receptor ligands: treatments of acute migraine and cluster headache.

Goadsby PJ.

Institute of Neurology, Queen Square, London WC1N 3BG, UK. peterg@ion.ucl.ac.uk

Fuelled by the development of the serotonin 5-HT(1B/1D) receptor agonists, the triptans, the last 15 years has seen an explosion of interest in the treatment of acute migraine and cluster headache. Sumatriptan was the first of these agonists, and it launched a wave of therapeutic advances. These medicines are effective and safe. Triptans were developed as cranial vasoconstrictors to mimic the desirable effects of serotonin, while avoiding its side-effects. IT HAS SUBSEQUENTLY BEEN SHOWN THAT THE TRIPTANS' MAJOR ACTION IS NEURONAL, WITH BOTH PERIPHERAL AND CENTRAL TRIGEMINAL INHIBITORY EFFECTS, AS WELL AS ACTIONS IN THE THALAMUS AND AT CENTRAL MODULATORY SITES, SUCH AS THE PERIAQUEDUCTAL GREY MATTER. Further refinements may be possible as the 5-HT(1D) and 5-HT(1F) receptor agonists are explored. Serotonin receptor pharmacology has contributed much to the better management of patients with primary headache disorders.

PMID: 17087122 [PubMed]

My neuro agrees that REM sleep is not where a CH sufferers should be and has for many years prescribed CH sufferers medications for sleep that quickly get you past REM into a deeper sleep pattern than REM which is not restful.  It is theorised that many CH begin during REM sleep....now maybe your expanation explains why.

Coach Bill:

Before answering your question, I think it is REALLY important to note that

1) the mechanism of action in cluster headaches is not known
2) All primary headaches had been thought to be caused by chemical factors alone ("The dogma is that primary headache, like cluster headaches and migraine, are due to abnormal brain function with completely normal brain structure," Dr. Goadsby), BUT
3) using a new scanning technique (in 1999) Dr. Goadsby has shown that cluster headaches are likely to be caused by excessive growth of grey cells in one part of the brain (the hypothalamus),
4) "Professor Goadsby said, 'We also found that the area of the brain where these structural abnormalities were seen, the hypothalamus, is the same area of the brain where the functional studies show that activity is abnormal during the headache state.  This complete correlation of functional and structural abnormality is striking.' "  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

When it comes to the functional abnormalities, most of the cluster headache treatments are actually treatments developed for Migraines: most of those act on serotonin receptors.

"The precise cause of migraine headaches is still not fully understood [either], but it is generally believed that the key element in understanding them has to do with the blood flow changes in the brain," ...which Rosa was addressing.

Here's how that works:  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

[Some trigger] "creates a spasm in the nerve-rich arteries at the base of the brain.  This spasm closes down or constricts several arteries supplying blood to the brain, thus reducing blood flow to the brain.  Simultaneously, platelets clump together and are believed to release a chemical called serotonin.  (The trigeminal [5th cranial] nerve has been implicated.)

The serotonin causes the blood vessels in the head to contract and lowers the pain threshold.  Before a migraine episode, serotonin levels have been detected to be unusually high in the brain, lending weight to the previous explanation.  During a migraine attack, serotonin levels become very low.  The low amounts cause the blood vessels to be unusually large...."

It is this basic vasodilation that is addressed by the triptans (which cause vasoconstriction), caffeine (which causes vasoconstriction), and oxygen (which causes vasoconstriction).  Obviously each has a different mechanism of action, which is why they work for some people and not for others.

It is because the indole-ring compounds (such as LSD, LSA, psilocybin, Kudzu, &etc) have very similar chemical structure to serotonin that those researching psychedelics in the treatment of cluster headaches decided to explore that avenue. 

Rosa is pointing out that there appears to be a relationship between sleep & serotonin levels (and thus the issues of vasodilation at night) that indicates that especially those with primarily night-time hits may respond better to treatment with indole-ring type compounds than other types of treatment.  (I think).

Laurie

Laurie, Thank you for all that info and the links to the website. I do have a better understanding now of the workings of this. I get mine mostly at night untill its out of control by week 4. Once again thank you all for this info and thats for this website.. Coach Bill