Exploding head syndrome (EHS) is a disorder characterized by the perception of loud noises (e.g. a bomb explosion, gunshot or cymbal crash) when going to sleep or awakening. Contrary to the name, ENS is not associated with pain. However the noise attacks can elicit a great deal of fear, confusion and distress in sufferers. Reports of tachycardia and palpitations are also common. Despite the distressing nature of EHS, relatively little is known about the prevalence and underlying cause of the condition. Some scientists have estimated that EHS may affect 10% of the population. Females tend to be more at risk than males and the average age of onset is 50 years old.
There are various theories as to what might cause Exploding Head Syndrome. For instance, some scientists have speculated that Exploding Head Syndrome may be associated with minor temporal lobe seizures. Another theory is that EHS is caused by sudden shifts of middle ear components. Other possible causes include stress/anxiety, impairments in calcium signalling and brainstem neuronal dysfunction. (1)
Because of the benign nature of Exploding Head Syndrome, many individuals do not require medical treatment. However if an individual is suffering from disturbed sleep or considerable distress as a consequence of EHS, then treatment may be necessary. Tricyclic antidepressants have been proven useful in some individuals. Calcium channel blockers may also be beneficial. Non-pharmacological strategies such as relaxation, improved sleep hygiene and counseling may also help to alleviate symptoms.
Exploding head syndrome is a rare and relatively undocumented parasomnia event in which the subject experiences a loud bang similar to a bomb exploding, a gun going off, a clash of cymbals or any other form of loud, indecipherable noise that seems to originate from inside the head. Contrary to the name, exploding head syndrome has no elements of pain, swelling or any other physical trait associated with it. They may be perceived as having bright flashes of light accompanying them, or result in shortness of breath, though this is likely caused by the increased heart rate of the subject after experiencing it. (2) It most often occurs just before deep sleep, and sometimes upon coming out of deep sleep.
Attacks can increase or decrease with time, and can disappear for long stretches at a time, or entirely, of their own volition. Subjects often feel fear or distress after the incident.
People over the age of 50 are most likely to experience exploding head syndrome. Women are at a higher rate of experiencing it than men. It has been reported in people as young as 10 years old. (3)
Exploding head syndrome is thought to be highly connected with stress and extreme fatigue in most individuals. What actually causes the sensation in individuals is still unknown, though speculation of possible sources includes minor seizures affecting the temporal lobe, or sudden shifts in middle ear components.
As exploding head syndrome is not dangerous, and does not have a drastic effect on sleep, many individuals do seek help for their symptoms. It will first be necessary to consult with a sleep doctor regarding your sleep and medical history to ensure that what the individual is experiencing is actually exploding head syndrome and not something else. Similar experiences have been known to be brought on by certain medications or drugs. Exploding Head Syndrome may lead to secondary insomnia.
One medication that has been used to treat exploding head syndrome is clomipramine, a tricyclic antidepressant. (4)
If stress is causing the episodes, it is advised to either seek to clear the problem. This could include reading, yoga, relaxing music or a hot bath before bed. These steps have also demonstrated to have positive effects in achieving quality sleep in general.
If the disturbances are the result of sleep deprivation, it is recommended to institute a more balanced routine that includes a minimum of 6 hours of sleep per night. If sleep deprivation is being caused by other sleep related disorders, these should be evaluated.
© 2021 American Sleep Association.