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Exploding Head Syndrome

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.

What Causes Exploding Head Syndrome

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.

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.

Sources

Frese, A., Summ, O. & Evers, S. 2014. Exploding head syndrome: Six new cases and review of the literature, Cephalalgia, 1468-2982

Brian A.S. 2014. Exploding head syndrome, Sleep Medicine Reviews, 6: 489-493

Author: Dr. Emma Mitchell, PhD, UK – Reviewer

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More on Exploding Head Syndrome (older content) :

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. 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.

Who Gets Exploding Head Syndrome

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.

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.

How to Treat Exploding Head Syndrome

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.

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.

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  • I just experienced this for the first time last night. I had woken up and had a diffult time shutting down to go back to sleep. Thinking too much. Finally I tried to go to sleep, still feeling unsettled, I driffted off, then bang. Like a thunder clap, so loud, but I knew instantly it was in my head. It felt like every neuron fired at once. My fear was if I had a stoke or seizure. I even tested myself to make sure my face wasn't drooping and if my speech and memory were still okay. Very powerful, brought me to search and was shocked to find this syndrome describing my exact experience. Very scary but am glad to know it should be relatively harmless. I am a 45 yo female, hoping it does not reoccur.

  • This is very interesting.

    My only concern is that this has recently become a nightly occurrence for me, usually just as I start to fall asleep. It keeps me alert and awake for hours after it happens. Last night I was so convinced in the sound and brightness that I turned on all fours in bed as if I were looking for something. This information is a step in the right direction. As a 26 y/o male, I just want more than 3-4 hours of sleep a night and I'm not touching that.

  • I started having episodes of this phenomenon around 13 years ago after having my first child. It would happen more frequently during times of high stress and sleep deprivation. However last year, each instance became more intense and would be happening every night several times, often accompanied by sleep paralysis. The noises would vary, but would be very loud, and accompanied by a flash of bright light and a jolt of electricity from my toes to my head.

    During the times that these symptoms increased, I found out that I was very low in b12 and folate. It took months of supplementation to get my numbers up, but what I have now noticed is that my episodes of ‘eps’ have decreased to the point that they are very rare.

    I noticed that someone had mentioned vitamin deficiency in the comments above, and just wanted to add my account in the hope that it spurs others on have their bloods taken. If your b12 is less tha 500, and you are experiencing eps, I would suggest speaking your doctor about it.

  • I've had these episodes for 40 years. I always have them during the day never associated with sleep and I can go years in between episodes.

  • I've had this episode in my early 20's when I was working the midnight shift for at least 10 hrs and missed missing a meal before going to bed. It occurred almost every day and feels like a blood vessel just popped in your head. After almost 7 years working the night shift I have switched to day shift and the episodes disappeared but I didn't know if working night shift or bec of the episodes I had a hard time memorizing books after reading since I took some classes thereafter. A year ago I've had one episode but it was minor compared to what I've had before.

  • I hear knives clashing and a door being unlocked this stems from me looking at conspiracy theories and my anxiety kicking in

    • I’ve been hearing things like people screaming and I feel like it’s like a future telling sign I know that sounds completely crazy but. It sounds so real

  • I experienced this a couple of years ago, and since then the EHS comes and goes. I had an EHS constant occurrence a few weeks ago and I documented all my symptoms. I’m an MS pt and I wonder if that put me at larger risk.
    I’m looking to participate in a study for this because of the value I can offer researchers. My internist was surprised to see EHS listed as a sleep disorder, although there’s a high level of fatigue associated with mine. 3 weeks ago, the 3 hour duration of explosions every few minutes caused me to send an email to my neuro, detaining every sx. When I saw my internist that week, my Eustachian tubes were both blocked, giving me the sense that some “explosions” were in stereo/bilateral.

    • I’m an MS patient too. I was diagnosed with EHS years after my MS. I’m wondering if one of my MS flare ups caused the EHS.

  • I am 49 and have had this happen intermittently for several years. Mine are slightly different in that I don't always have the light flash or the bang but almost always have a sensation of intense blackness...in which I wonder if I have died. Very alarming. I haven't heard of anyone else with that symptom. Surely I'm not the only one?

  • I have had EHS for over 2 years now and it’s getting worse. I’m having them more often and they are causing pain in my head. Everyone says they are not harmful but I believe they are wrong. Something is happening within the brain that is NOT normal. Have there been any further research into this issue?

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