For many years now, I have realized that my CHs can be triggered by sleeping on my left side (the same side I get the headaches on). When I'm not having a CH episode, that's actually the side I sleep best on, but during and episode I have to avoid that side entirely or I'm guaranteed to get a headache. Of course, during an episode I'll often get them anyway, no matter what I do. But even if I'm on my prophylactic meds, and wouldn't otherwise get a headache, if I sleep for a couple of hours on my left side, I can pretty much guarantee myself a headache.
I have done some searching of the site -- and of the published literature -- and I haven't been able to track down much info on whether others with CH seem to have the same effect, or whether I'm somewhat unique in this. I also know a lot of people saw Ear, Nose and Throat doctors and had multiple surgeries before finally being diagnosed with CH, and that most surgeries didn't help. I, too, saw and ENT, and CAT scans showed a bone spur that nearly closed one nostril and pushed septum off to the other side nearly closing the other. But since the ENT was convinced that didn't explain my headaches and (more importantly?) my insurance at the time wouldn't cover any nose surgeries, they sent me away saying I probably had "some sort of migraine." That was actually helpful, since my reading up on migraines led me to find a link on wikipedia to CH, which led me to finally self-diagnose, then to finally real solutions that deal with my headaches.
So, long story short, what I'm trying to figure out is if others of you have found that sleeping on one side or the other can trigger headaches? It seems like (*seems* being key here) fixing my nose might fix that, but I frankly don't know that I'd trust what and ENT would say on that count, so I thought I'd see if anyone's had experience on this. I'm not expecting surgery to fix the CH, but just maybe to cease whatever this positional triggering is. Fewer CHs would be nice, as would being able to sleep on both sides... And I now have very good insurance.
In case anyone wants more detail on my CH [warning: boring medical details to follow you can skip if you want]: Started having them in late high school as episodes of a few weeks at a time. Always on the left side, severe pain behind the left eye, 20-45 min at a time, with lots of tears produced, pain sometimes reaching a 9 or 10 on "regular" pain scales. I usually went 6 months to 2 years between episodes, and episodes are usually triggered by lack of sleep and/or stress. Finally diagnosed with CH at around age 30, and have had three episodes since (I'm currently 35). The first episode was killed with Verapamil (120 mg), using Imitrex injections for breakthrough headaches. The second time, the Verapamil wasn't doing any good, so the (very unknowledgeable) GP recommended Topomax. Research coincidentally backed her up, so I tried it, and it worked, at 50 mg/day. My current episode has been the longest ever, now going on 11+ weeks. I've had to ramp the Topomax up to 150 mg/day, and still have occasional headaches. I'm now living in the Middle East, and I can't even imagine the headache (no pun intended) of trying to get a prescription for medical Oxygen. But then, injectable Sumatriptan isn't available either. Fortunately, I work in a research lab (I'm a biochemist), so I've used the available Sumatriptan pills and formulated them as injections, which seems to work, though it makes my wife nervous

. Oddly, while on Topo, I've noticed that my breakthrough headaches are much different from "regular" CHs in that they last *much* longer, but never reach the same level of intensity as regular CH (if untreated w/ a shot).