Evidence of high rates of burnout symptoms in a cohort with cluster headache

Abstract Background Cluster headache is a debilitating primary headache disorder. During active bouts, headache attacks occur daily and can last up to 3 h. Besides the excruciating pain, the disorder can greatly impact a patient's mental health, sleep, and life quality. The reoccurring attacks as well as sleep problems may lead to energy depletion and burnout symptoms, which can limit a person's ability to participate in society to the extent they would like to. Objective Our aim was to investigate the extent of burnout symptoms in a Swedish cluster headache cohort using a cross‐sectional approach. We further wanted to study if burnout symptoms can be linked to disease status—and if sex, lifestyle factors, or any specific clinical characteristics may be linked to change in burnout symptoms. Methods Between January 2024 and September 2025, the Shirom‐Melamed Burnout Questionnaire was sent out via the Research Electronic Data Capture platform to 839 study participants with cluster headache. Global scores from the questionnaire were compared between study participants in active bout and remission. Likewise, the scores were analyzed between participants whose remission period had lasted longer than 5 years (long‐term) compared to less than 5 years (short‐term). Lifestyle and clinical factors were further analyzed in study participants with high Shirom‐Melamed Burnout Questionnaire scores (global score >3.75). Results The total number of individuals included in the analysis was 373/839 (44.5%). Scores above threshold (>3.75) were recorded in 65.9% (58/88) of study participants in an active bout compared to 37.5% (90/240) in the remission group (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.93–5.38; p < 0.001). Participants in short‐term remission similarly had a higher percentage of scores above threshold compared to participants in long‐term remission (42.0% [73/174] vs. 22.2% [12/54], OR = 2.53, 95% CI = 1.25–5.14; p = 0.009). Participants with burnout scores above 3.75 were more likely to be females (OR = 3.25, 95% CI = 2.04–5.19; p corrected <0.001) and report sleep deprivation as an attack trigger (OR = 2.24, 95% CI = 1.32–3.82; p corrected = 0.034). Conclusion Participants with cluster headache in our Swedish cohort reported higher scores for burnout symptoms, particularly during active bout. For participants in remission, the burnout symptoms score was inversely correlated to the number of years since their last active headache bout. When managing cluster headache in a clinical setting, it should be taken into consideration that this patient group has a substantial risk for developing burnout symptoms both in and out of an active bout. Future studies should evaluate how to best support patients with cluster headache handling exhaustion and promote recovery to improve their quality of life.