What Is Exploding Head Syndrome?

Exploding head syndrome, or EHS, is a sleep disorder in which persons falling asleep or waking up hear loud noises variously described as explosions, gunshots, thunder, crashes, or something similar. These noises are imaginary and can’t be heard by anyone else. Despite the gruesome name, EHS is painless and causes no physical harm. It can, however, be a source of anxiety, and therefore sleeplessness, for persons who experience it on a regular basis. EHS is categorized as a parasomnia by medical researchers.

Exploding head syndrome can strike at any age and has a range of potential causes. Medical researchers are unsure of how common it is, though EHS appears to affect women more often than men. One study found that more than three out of every 20 college students included in the survey had experienced EHS. If you or a loved one is suffering from a parasomnia condition, the sleep specialists at Baptist Health can help.

What Are Exploding Head Syndrome Symptoms?

EHS is characterized by the following symptoms:

• Hearing loud but imaginary noises when transitioning between waking and sleeping states
• Feeling startled, anxious, or frightened on arousal
• Responding with an elevated heart rate, labored breathing, and/or heavy sweating but without a sensation of pain
• Difficulty returning to sleep

Some individuals with EHS have also reported seeing bright flashes of light or experiencing involuntary muscle twitching, a condition known as myoclonus.

What Causes Exploding Head Syndrome?

The causes of EHS are unclear. A number of potential causes are currently being investigated, including:

• Improperly operating inner-ear structures
• A temporary surge in electrochemical activity among the sensory neurons
• Unusual brain activity during the transitory state between sleeping and waking
• A side effect for individuals who have stopped taking certain antianxiety or antidepressant medications

EHS symptoms parallel, to a partial extent, those associated with auras, the premonitory phase of migraine headaches. Researchers are evaluating if migraines and EHS share some degree of cause.

What Are the Risk Factors for Exploding Head Syndrome?

• Gender: Women appear to experience EHS more than men.
• Sleep disorders: Evidence suggests that individuals already troubled by insomnia, or another sleep disorder, are also susceptible to exploding head syndrome.
• Stress: Persons with high stress levels seem more likely to develop EHS than individuals without.

Age does not appear to be a factor. EHS has been reported in young, adolescent, middle-aged, and older patients, with an average age of onset in the late fifties.

How Is Exploding Head Syndrome Diagnosed?

If you’re experiencing symptoms of EHS on a regular basis, you should consult a physician who specializes in sleep disorders. He or she will diagnose your condition by:

• Asking about your EHS episodes and the circumstances surrounding them
• Recording a complete list of symptoms, including less-common ones, such as muscle tremors and bright flashes of light
• Reviewing your medical history, including any sleep disorders that you’ve experienced
• Documenting what, if any, medications that you’re taking

The major medical concern with EHS is the impact it has on your ability to achieve sustained, healthful levels of sleep. Depending on the situation, your doctor may ask you to keep a sleep diary, or a written record of your sleep experiences, typically for a period of two weeks. In more serious circumstances, he or she may order a sleep study.

A sleep study involves sleeping overnight at a healthcare facility attached to monitoring technology, the data from which is used to determine any deeper, underlying medical causes for EHS. Other possible diagnostic tests include an electroencephalogram (EEG) or an imaging test, such as a magnetic resonance imaging (MRI) scan.

How Is Exploding Head Syndrome Treated?

EHS rarely requires medical intervention. It is no more harmful than the occasional nightmare – unpleasant, yes, but not a threat to your health. In those cases, however, where regular episodes of EHS deprive the patient of needed sleep, a number of medications with other uses have proven helpful in reducing recurrence. These include:

• Amitriptyline: an antidepressant
• Clomipramine: a drug for treating obsessive-compulsive disorder
• Nifedipine: a heart-disease medication
• Topiramate: an antiseizure drug

Because EHS sometimes fades with time and is not a source of pain or physiological damage, the prognosis for persons with this condition is generally positive.

Can Exploding Head Syndrome be Prevented?

There are no certain forms of prevention for EHS, but there are some common-sense steps that you can take to reduce its likelihood:

• Adopt and maintain good sleep habits (at least 7 to 8 hours of rest every night)
• Combat stress in your life by developing relaxation techniques (e.g., practicing yoga, reading, taking a warm bath before bed, etc.)

Learn More About Exploding Head Syndrome at Baptist Health. You can also find more information about sleep disorders or schedule an appointment with one of our physicians.