You've got the right oxygen therapy equipment...  and it sounds like you're using it properly...  

Re-attacks are very common for many of us using oxygen therapy during the first 3 to 5 weeks of using it at flow rates that support hyperventilation...  They are even more pronounced for folks using higher oxygen flow rates and hyperventilating all the way to an abort as this results in a rapid abort of the cluster headache pain, but not necessarily an abort of the triggering mechanism.  

Based on data from over 650 aborts we've collected over the last two years in the pilot study of oxygen therapy flow rates that support hyperventilation, the occurrence re-attacks tends to peak by week 3 to week 4 of this method of therapy and then drop to zero by week 8.  You'll still have attacks after that, but at a much reduced frequency.

It's just a theory at this point, but all the data collected so far suggests vascular toning not only prevents the occurrence of re-attacks but also lowers the overall frequency, intensity, and time to abort for cluster headache attacks by week 8.

Vascular toning is no different than if you took a dumb bell and worked out with it doing curls for 5 minutes per session, 6 to 8 times a day.  At the end of 8 weeks, your biceps would be larger, stronger, and toned up...  The same thing happens to the smooth muscles lining the arteries and capillaries in and around your trigeminal nerve.  Once these arteries and capillaries are toned up, they tend to be more resistant to the dilation signaled by the cluster headache triggering mechanism.

A disciplined approach of using oxygen therapy on each and every cluster headache attack up to 6 or 8 sessions a day using flow rates that support hyperventilation and each lasting a minimum of 5 minutes will cause enough repeated vasoconstriction to strengthen and tone the smooth muscles lining these arteries and capillaries.

If you've been using this method of oxygen therapy on every attack and it's been less than 4 weeks with no change in the frequency then patience grasshopper...  

If it's been over 4 weeks with no decline in the frequency of re-attacks, then it's possible you have another condition that's interfering with the vasoconstrictive effects of this method of oxygen therapy.

A lower than normal serum/arterial pH (high acid level) will interfere with oxygen therapy no matter how it's administered.  Normal arterial pH is 7.4 (7.35 to 7.45).  An arterial pH below this range can be caused by a number of medical conditions that are best diagnosed by your doctor.  Just be aware that a single pH measurement made during a lab test will not accurately reflect your actual pH as is varies from day to day and throughout each day.  

You can pick up some pH test strips from pH ION over the Internet and test your saliva pH three times a day.  If you do this using the same procedure before breakfast, before lunch, and prior to bedtime before you brush your teeth for a week you'll have a better pH level profile...

If you also take a saliva pH reading as soon as you feel an attack approaching, or as soon as you wake up with an attack, you should see a reading below your daily pH average for that day.  If you take a second saliva pH reading 5 minutes after you complete oxygen therapy with an abort, you should see a pH reading that is equal to or slightly higher than your daily average.  

The following chart illustrates the relationship between the pH at the start of my cluster headache attacks that woke me up from sleep and my daily pH average levels.

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The green line was the daily average pH of my saliva.  The red line is the pH measurement taken as soon as I woke up with an attack and the blue line, my saliva pH taken 5 minutes after the abort and completion of oxygen therapy.  As you can see, oxygen therapy at flow rates that support hyperventilation were able to raise my pH by an average of 0.4 during each session.

If you're still having re-attacks and have difficulty in getting enough good sleep, ask your doctor for a prescription for generic imitrex 50mg tabs a last resort.  I used a pill splitter to split the 50 mg tabs in half and took one at the start of my oxygen therapy.  I got the fast abort with the oxygen and as the half life of the 25mg imitrex tablet is 2 hours, this regimen kept the beast away for at least 4 hours and I was able to get some real sleep.

Hope this helps.

Take care,

V/R, Batch