People with Cluster headaches take 2X more days of sick leave
Sickness absence and disability pension days in patients with cluster headache and matched references
Christina Sjöstrand, MD, PhD, Kristina Alexanderson, PhD, Pontus Josefsson, MSc, and Anna Steinberg, MD, PhD
Neurology May 26, 2020 94 (21) e2213-e2221 https://doi.org/10.1212/WNL.0000000000009016
To determine whether patients with cluster headache have more sickness absence and disability pension days compared to matched references and possible associations with sociodemographic characteristics.
Methods
We performed a registry study of all patients who had received specialized health care for cluster headache (ICD-10 code G44.0) aged 16–64 years and living in Sweden in 2010 (n = 3,240; 34% women) and matched references from the total population (n = 16,200) regarding their sickness absence and disability pension days in 2010.
Results
Mean number of sickness absence days in 2010 was 16.13 (95% confidence interval, 14.05–18.20) among patients with cluster headache and 6.54 (5.97–7.11) among references. When combining sickness absence and disability pension days, patients with cluster headache had 63.15 (58.84–67.45) days, references 34.08 (32.59–35.57) days. Among patients, women had twice as many sickness absence days than men: 23.71 (19.36–28.06) vs 12.41 (10.19–14.63).
When adding disability pension days, those numbers were 83.71 (75.57–91.84) vs 52.56 (47.62–57.51). Patients with cluster headache had significantly more sickness absence days in all ages compared to the reference group. Patients with elementary education had more sickness absence/disability pension days (85.88 [75.34–96.42]) compared to those with high school (64.89 [58.82–70.97]) and college/university (41.42 [34.70–48.15]) education.
Conclusion
This nationwide study shows that patients with cluster headache have significantly more sickness absence and disability pension days compared to matched references. Furthermore, among patients, women had more sickness absence and disability pension days than men.
18 citations of this study as of Sept 2026
Current treatment options for cluster headache: limitations and the unmet need for better and specific treatments—a consensus article - Sept 2023 FREE PDF Neither Vitamin D nor Magnesium were mentioned
The economic and personal burden of cluster headache: a controlled cross-sectional study - May 2022 FREE PDF
- "Even in remission, nine times as many episodic patients rated their health as poor/very poor compared to controls (9% vs 1%, p = 0.002). For chronic patients, the odds of rating health as good/very good were ten times lower compared to controls (OR:10.10, 95%CI:5.29–18.79. p < 0.001) and three times lower compared to episodic patients in remission (OR:3.22, 95%CI:1.90–5.47, p < 0.001). Additionally, chronic cluster headache patients were 5 times more likely to receive disability pension compared to episodic (OR:5.0, 95%CI:2.3–10.9, p < 0.001). The mean direct annual costs amounted to 9,158€ and 2,763€ for chronic and episodic patients, respectively (p < 0.001). "
Distinguishing ‘Suicide Headache’ From Migraine: Cluster Headache’s Unusual Features - Sept 2026
Article Key Points
- Cluster headache ≈1/1000; often months of diagnostic delay. Attacks occur in daily/every-other-day clusters for weeks–months, then remit.
- Strong circadian pattern: often same time daily, frequently near bedtime.
- Severe unilateral periorbital pain + autonomic signs: tearing, redness, rhinorrhea, ptosis.
- Agitation/pacing/banging head distinguishes cluster headache from migraine.
Medscape article mentions a 2025 book by a cluster headache sufferer
The Headache: The Science of a Most Confounding Affliction—and a Search for Relief: Chronic Head Pain, the Mystery of Its Origins, and the Search for Effective Relief
"Tom Zeller, Jr, is, as you mentioned, a New York Times writer, and as he identifies in the book, he’s a cluster headache patient. He describes in great detail his own experience with cluster and also his frustrations with achieving an appropriate diagnosis, with treatment, and with the fact that very little attention has been paid to cluster headache in terms of funding or research to try and identify its cause."