Exploding Head Syndrome

Last updated: May 31, 2019

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Exploding Head Syndrome is a type of parasomnia. Parasomnias involve undesirable events that accompany sleep. The exploding head syndrome may sound painful and even gruesome, but it is not. This is a disorder where a person hears a loud noise right before they fall asleep. The noise that the patient hears is imaginary. Patients describe the noise as akin to a violent explosion. It sounds as if this loud bang occurred in the patient’s head. Although it often happens while a person is about to fall asleep it can also occur as a person wakes up in the middle of the night.

What to People with EHS Hear?

Some patients describe the sound that they hear as similar to that of a clash of cymbals. There are also those who compare the sound to that of an exploding bomb. Sometimes the sound is not as loud and less alarming. There are instances when a flash of light accompanies the sound. Some patients experience a twitch together with the loud sound. An episode of EHS is often painless. There are some patients though who reported feeling sudden painful stabs in the head during an episode.

The intensity of the sound makes some patients think that they are having a stroke. An episode of exploding head syndrome may vary in frequency. It can occur very rarely. There are also instances when a patient experiences multiple episodes in just one night. Some patients experience multiple attacks over a period of several nights. A few weeks or months without a single episode may follow before episodes of EHS occurs again.

What are the symptoms of Exploding Head Syndrome?

A person may have Exploding Head Syndrome if that person:

  • Imagines a loud noise or explosion in his head. A patient might hear the noise before he falls asleep. Some patients hear it immediately after waking up in the middle of the night.
  • The loud explosion that the patient hears is not painful. Although the sound of the explosion is really loud it doesn’t result in harm. The sound associated with EHS can be quite startling though.
  • An episode of EHS suddenly wakes up a patient. It is also common for a patient to experience a sense of fright together with any of the episodes listed above.

Aside from the symptoms listed above an episode of exploding head syndrome might also cause:

  • An elevated heart rates as a result of getting startled by the loud explosive sound.
  • A sense of distress or fear. People often associate loud explosive sounds with danger. This might explain why the patient may show a sense of fear upon hearing the loud explosion sound caused by EHS.
  • Muscle twitches

What causes Exploding Head Syndrome?

Researchers haven’t determined yet what is the exact cause of exploding head syndrome. Some researchers believe that it is a neurological issue. There are some doctors who believe that this disorder is a result of fear, stress, and anxiety. Another possible source of this disorder is minor seizures in the temporal lobe of the patient’s brain. Some believe that the loud explosions are results of sudden shifts in the parts of the middle ear of the patient.

There is also the possibility that the loud noise that the patient hears is not a result of exploding head syndrome. It might be the result of another disorder or health condition. There is a possibility that the loud explosion that a patient hears is a side effect of a medication that the patient is taking. It might also be the result of drug or alcohol abuse. There is also no discounting the possibility that this disorder stems from another sleep disorder.

There is no hard data that indicates how many people suffer from exploding head syndrome. This parasomnia may be more common in women than in men. There is no indication that it is more common in a particular age group. Exploding head syndrome can begin at all ages. There are reports that it can show up in children as young as 10 years old. The average age when it first shows up in patients is 58 years.

How is this disorder diagnosed?

A thorough review of a patient’s medical history can help determine if the patient really suffers from exploding head syndrome. It can also eliminate the possibility that the symptoms, even if they point to EHS, are for another sleep disorder.

Before going to a medical professional for consultation the patient can start a sleep diary. A sleep diary can help chart the patient’s sleeping patterns. It can also help the doctor determine if a part of the patient’s sleep routine is what’s causing the problem. When taking down notes on a sleep diary, it is important for the patient to be as detailed as possible. This can help guide the doctor during diagnosis.

There are no tests for exploding head syndrome. The attending physician may recommend an overnight sleep study or a polysomnogram. During a sleep study the doctor or a medical technician monitors the patient while he sleeps. The polysomnogram uses other diagnostic tools that can track the patient’s heart rate, rate of breathing, and brainwaves during sleep. There are also sleep studies where a doctor uses a video camera to record the patient’s movements while the patient sleeps. A sleep study can help a doctor determine if another sleep disorder is causing the loud explosions that the patient hears.

How is Exploding Head Syndrome treated?

There are several ways to treat an Exploding Head Syndrome. These treatments are more focused towards treating the possible cause of the loud noises. An example are patients who experience symptoms of EHS while sleep deprived. If that is the case then the right course of action is to try to get adequate sleep each night. The ideal length of sleep for an adult is between 6 and 8 hours of sleep.

There are instances when Exploding Head Syndrome is a result of stress or anxiety. If this is the case the patient should try other means of relaxation. Relaxation techniques can help relieve stress. There are also everyday activities that can help relieve stress. Examples are short walks, light exercise, or reading before bedtime. Taking a warm bath before going to bed can also help relieve the symptoms of EHS.

A medication might also help relieve the symptoms of EHS. Medications that influence neurological activity might help the patient. Clomipramine – an antidepressant – is useful in relieving the symptoms of EHS.   

Anticonvulsants and tricyclic antidepressants might help a patient. There are also indications that using calcium blockers might help relieve the symptoms of EHS. If a patient believes that a medication can help prevent an episode the doctor and the patient should carefully discuss a possible treatment.

There are cases wherein the disorder is a result of another medication. When EHS is a result of another health issue the patient should not immediately stop taking the prescribed medication. There are medications with side effects. If the patient needs to stop taking a particular medication the patient should gradually stop taking the medication. It is also important to consult the prescribing physician before you stop taking a drug. The doctor can help set-up a plan that will allow the patient to slowly decrease the dosage and frequency of a particular medication.

Exploding Head Syndrome is a parasomnia connected to the patient’s sense of hearing. The loud noise is only heard by the patient. This can result in sleep deprivation. A person might be anxious to go back to sleep for the fear of another loud explosion. This can result in sleep deprivation. There are many modes of treatment available depending on what is causing the Exploding Head Syndrome.  

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