Patients with chronic cluster headache (CCH) suffer from poor sleep, which may affect brain microstructure and waste clearance. In 11 CCH patients, subjective sleep quality—measured by the Pittsburgh Sleep Quality Index—improved one week after three doses of psilocybin (0.14 mg/kg) given one week apart, with a mean PSQI change of -2.50 points. Before treatment, CCH patients had poorer sleep and differences in brain microstructure and water diffusivity compared to 24 healthy controls, primarily in grey matter. Psilocybin intervention was not associated with statistically significant changes in brain microstructure or water diffusivity on average, though most patients showed lower white matter diffusivity and neurite volume. Subjective sleep quality showed borderline significant correlations of moderate effect size with brain microstructure and water diffusivity.
Many people with cluster headache lack effective treatments. An online survey of 202 Australian adults with cluster headache found that 35% rated their treatments as not at all or somewhat ineffective, and 27% reported only partial effectiveness. The main treatment challenges were ineffectiveness (74%), side effects (54%), cost (53%), and access difficulties (39%). Among participants, 62% expressed interest in joining future clinical trials, with psilocybin being the highest-ranked treatment (66% very interested), followed by combination therapies (84% very interested or interested). The findings highlight inadequate treatment options and a strong patient interest in research, particularly on psilocybin and combination therapies.