This is an excellent post on the cost of oxygen therapy.  It's great to see so many have figured out the cost per abort with oxygen therapy is far less than any method of using triptans...  and no side effects either.

During my low cycles (3 to 4 attacks a week) and that's most of the time, I average 30 aborts with an M-size oxygen cylinder.  My copay after insurance is $6 per cylinder and I have my own regulators, so that makes my average cost per abort 20 cents.

Jim, an increase in the frequency of your cluster headaches after starting oxygen inhalation therapy is normal.  It can be due to re-attacks.  We've data on over 600 aborts with oxygen therapy with 366 aborts at flow rates that support hyperventilation that clearly indicates they go away after a few weeks. 

We defined a re-attack as another cluster headache that occurs 15 to 45 minutes after a successful abort with this method of oxygen inhalation therapy.  We think this happens because this method of oxygen therapy works so fast it aborts the pain of the cluster headache, but the oxygen time is so short, it doesn't abort the triggering mechanism. 

When the effects of hyperoxia and respiratory akalosis from using this method of oxygen inhalation therapy dissipate, (this can take from 15 to 30 minutes) and the triggering mechanism is still active, the cluster headache returns.  Fortunately, a re-attack is just another cluster headache and easily aborted in a few minutes with this method of oxygen therapy.

A simple way to avoid re-attacks is to stay on oxygen therapy long enough to bring your total oxygen time up to 15 minutes. 

In other words, if it takes 5 minutes to abort your cluster headache at flow rates ≥ 25 liters/minute, spend another 10 minutes breathing at a more normal rate of 10 to 12 liters/minute. 

Our data on folks who used a flow rate of 15 liters/minute and averaged over 15 minutes to abort their cluster headaches indicate the incidence of re-attacks was virtually zero.  Most of them did have regular cluster headaches every 2 to 4 hours during their peak 12 hour period each day, but this pattern was present before they began this method of oxygen therapy.

An increase in the frequency and intensity of your cluster headaches can also be due to a low arterial pH (too much acid).  When I go into a high cycle my arterial pH is almost always low.  I measure my saliva pH as an analog of my arterial pH with pH test strips three times a day to obtain a daily average. When I take a pH reading at the start of a cluster headache, it's always lower than my daily average.

The following chart shows the results of a two week study of my saliva pH data measured during a high cycle.  I only collected pH data on the first cluster headache that woke me up each night.

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The green line was my daily average pH.  The red dots and lines were the pH readings taken as soon as I woke up with a cluster headache.  The blue dots and lines represent the second pH reading taken 5 minutes after I had aborted the cluster headache and completed the oxygen therapy at flow rates that support hyperventilation. 

As you can also see, this method of oxygen therapy elevated my saliva pH an average of 0.4 after each oxygen therapy session back up to my daily average.  My average abort time during these sessions was 4 to 5 minutes.

I also used a finger pulse oximeter during this study.  As you can see my oxygen saturation was always low around 93% SpO2 when I woke up with a cluster headache, and near 100% after oxygen therapy.

Based on the above data, when I go into a high cycle, I take 3 to 4 calcium citrate tablets with vitamin D, magnesium and zinc washed down with fresh homemade lemonade.  This regimen acts as a buffer on the gastric juices in the stomach with the ultimate result, an elevation in arterial pH as measured with pH test strips that show my saliva pH has risen...  This regimen also breaks my high cycles in 12 to 24 hours...  Hope this helps.

Take care

V/R, Batch