Frequently Asked Questions (FAQs)

Q. What is high flow oxygen therapy?

A. High flow oxygen therapy involves breathing medicinal oxygen at 100% purity at a rate of between 7 and 15 litres per minute. When taken quickly after the onset of a cluster headache attack it has proven effective in relieving symptoms within 15 minutes for most patients. It can be taken multiple times a day without any side-effects.

Q. Is high flow oxygen therapy safe?

A. When used in the quantities prescribed by a doctor, oxygen therapy causes no side-effects. It can be used during pregnancy and breastfeeding and can be prescribed for patients with cardiac, cerebral or peripheral vascular disease as well as patients with kidney, liver or lung disease. However, using more oxygen than prescribed can affect respiratory function and patients should always consult their doctor or specialist before using oxygen therapy.

Q. Can standard medication be taken with high flow oxygen therapy?

A. Yes. There are two types of treatment available for cluster headaches: symptomatic treatment (to abort a current attack) and prophylactic therapy (to prevent or reduce future attacks). Oxygen can be used multiple times a day, in conjunction with prophylactic therapies and alongside other forms of symptomatic treatment (e.g. sumatriptan succinate), when prescribed by a medical professional.

Q. Why is a demand valve oxygen therapy (DVOT) more effective than other types of oxygen delivery?

A. Demand valves have been proven to achieve much better pain relief after the first 15 minutes of the first cluster headache attack. Some, like the UltraflowTM, feature a special exhalation valve that makes breathing easier and avoid contamination with exhaled air as it cannot flow back into the handset. However, conventional rebreathe masks deliver less than 100% oxygen and as patients breathe harder the amount of exhaled air rebreathed increases.

Q. Where can I get a demand valve?

A. Patients should first consult a doctor or specialist. For more information about distributors of the UltraflowTM demand valve in your country, contact BPR Medical.

Q. What support is available for cluster headache sufferers?

A. There are many organisations offering advice and support for cluster headache sufferers and their families. More Information.

Q. Can a demand valve be used with an oxygen concentrator?

A. No. Oxygen concentrators are not able to deliver the high oxygen flows required for a whole patient breath. Furthermore, oxygen concentrators do not deliver oxygen at the levels of purity required by cluster headache patients. Demand valve oxygen therapy needs to be provided by gaseous oxygen, either via large static cylinders in the patients’ home or via smaller portable cylinders.


Q. What evidence is there that high flow oxygen therapy is effective?

A. The original study by Dr Lee Kudrow M.D. in 1981 established the effectiveness of high flow oxygen therapy in relieving cluster headache symptoms. This has since been supplemented by studies that have provided further evidence of oxygen therapy at higher volumes being effective among patients that did not respond to standard oxygen regimens. More information.

Q. What are the main benefits of demand valve oxygen therapy (DVOT) for my patients?

A. Demand valve oxygen therapy (DVOT) ensures that the delivery of oxygen is synchronised with the patient’s breathing and that exhaled air is directed safely away from the handset. This means 100% oxygen is delivered to the patient has they inhale, maximising the effectiveness of the therapy. DVOT is also particularly effective at delivering oxygen at the high flow rates required by cluster headache sufferers, while preserving oxygen meaning cylinders last longer.

Q. What evidence is there for the superior performance of demand valves?

A. The efficacy of demand valves in delivering oxygen therapy has been proven in several clinical trials. In a study by Anja S Petersen et al the UltraflowTM oxygen demand valve system reduced attack durations more than any other oxygen delivery method and resulted in a significant decrease in the need for rescue medication when compared with conventional simple oxygen masks. The study also found that most patients prefer the UltraflowTM to other delivery systems.