I agree about reading the oxygen info tab, on the left edge of your screen.

I would be willing to bet, if you switched to a higher flow rate, and a better mask, you would get more consistent, and quicker results.

Chuck

Mike,

It sounds like you may need a higher oxygen flow rate and a better breathing technique.  25 liters/minute is the minimum flow rate that supports hyperventilation and higher flow rates above that are even more effective in achieving an abort in less time.

You're having re-attacks if the cluster headache returns in less than 45 minutes after a successful abort with oxygen therapy.  These are common for many of us and will go away around week 3 to 4 after starting oxygen therapy if you maintain a disciplined use of this therapy on every attack including shadows.  

You've indicated your subsequent attacks (re-attacks) take longer to abort...  Unless your serum pH is lower than normal due to another condition, this is usually an indication your oxygen flow rate is too low.  You should be able to achieve the effects of respiratory akalosis after as little as 1 to 2 minutes of hyperventilation.  

This condition is characterized by paresthesia - the tingling or prickling sensation in your fingertips, feet, face, and lips also accompanied with a slight feeling of dizziness as you reduce your CO2 levels below normal.  This is the best indication you're hyperventilating correctly and that you're on your way to a fast abort.  It's also very safe.  I've been using this technique for years and have yet to fall on my backside.

I've done a lot of coaching with folks using a demand valve or high flow rate regulator and found the common mistake most tend to make is to think they're breathing fast enough...  In reality they may have a higher than normal respiration rate but they're usually not breathing deeply enough.  A little CO2 buildup can totally negate 100% oxygen as an abortive for our cluster headache attack.

The best technique is to stand during oxygen therapy... or sit leaned back in a recliner to take pressure off the diaphragm for better lung ventilation.  Try to inhale and exhale as completely and deeply as possible.  I've found squeezing as much exhaled breath out as possible with an abdominal crunch works best.

If you're using a face mask, try using a mouthpiece.  This configuration traps less exhaled breath and keeps the inhaled oxygen at the highest concentration possible.  A good non-rebreathing mask should also have a 3-liter reservoir bag.  This is particularly important as the average adult lungs hold 5 liters and the maximum tidal volume on the inhale cycle is 3 liters if your work at it.  What you're trying to achieve with hyperventilation on 100% oxygen is to cast of CO2 faster than your body is generating it.

It's hard work if you're using this procedure correctly and you will get tired.  Look at it this way, the more effectively you hyperventilate and push your system into respiratory alkalosis, the faster you abort the pain of your attacks.  Shoot me a PM if you have questions.

Take care,

V/R, Batch