What Is Exploding Head Syndrome?

Causes and diagnosis of this unique sleep—not headache—disorder

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No one wants to experience a very loud, distressing noise, like a bomb exploding in their brain, as they fall into a deep slumber. But this is the very disturbance experienced by those who suffer from a syndrome known as exploding head syndrome.

Symptoms

Exploding Head Syndrome, or EHS, is a sleep disorder that causes a person to sense sudden, loud noises when falling asleep or waking up. This syndrome is accompanied by intense fear and anxiety.

It's not classified as a headache disorder by the International Headache Society because it causes no head pain. That being said, people with EHS do sometimes visit headache specialists for a diagnosis.

Causes and Risk Factors

EHS may be rare, or it may just be under reported. In one study of 36 participants, published in Somnologie, the prevalence of EHS was found to be 11 percent. But, there is still too little scientific data to know exactly how common, or uncommon, it really is.

It's also unclear what actually causes this unusual sleep disorder. Some theories include:

  • Ear problems
  • Temporal lobe complex seizures
  • Side effects from fast withdrawal from benzodiazepines or selective serotonin re-uptake inhibitors
  • Genetic problems linked to mutation on chromosome 19
  • Delays in switching off certain nerve activity in the brainstem when transitioning from wakefulness to sleep

Research suggests that exploding head syndrome may be common in women, especially as they age over 50. EHS may also be fairly common in college-aged students, according to one study in the Journal of Sleep Research. EHS may also be more common in those who suffer from isolated sleep paralysis.

Diagnosis

There are a few tests your doctor may utilize to make the diagnosis. One is called the Duke Structured Interview Schedule for Sleep Disorders which helps doctors diagnose sleep disorders according to the DSM-IV and the International Classification of Sleep Disorders (ICSD-2).

Your doctor will also want to make sure to rule out other neurological, sleep, or psychiatric disorders that can mimic EHS like:

Treatment

At this time, it's hard to say what treatments are effective for EHS. Treatments that do not involve medications, like education and reassurance, may be all that a person needs. Treatment of other underlying sleep disorders, like sleep apnea, may also be helpful.

Medications that have also been tried include the tricyclic antidepressant, clomipramine, or the calcium-channel blocker nifedipine. An anti-seizure medication like carbamazepine or topiramate (Topamax) may also be prescribed. More scientific data is needed though to verify the true benefit of these medications.

A Word From Verywell

Exploding head syndrome is a sleep disorder that can be confused with a headache disorder, the key difference being that exploding head syndrome causes no head pain. If you do experience this syndrome, the good news is that it's a benign (harmless) condition and there are therapies your doctor can recommend if symptoms are bothersome.

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Article Sources
  • American Academy of Sleep Medicine. Exploding Head Syndrome–Overview & Facts. 2014.

  • Evans, R. W. Exploding head syndrome followed by sleep paralysis: A rare migraine aura. Headache, 2006, 46: 682–683.

  • Fulda, S., Hornyak, M., Muller, K., Cerny, L., Beitinger, P. A. and Wetter, T. C. Development and validation of the Munich Parasomnia Screening (MUPS): A questionnaire for parasomnias and nocturnal behaviors. Somnologie. 2008;12:56–65.

  • Sharpless B. Exploding head syndrome. Sleep Medicine Reviews. Dec;18(6):489-93.
  • Sharpless BA. Exploding head syndrome is common in college students. J Sleep Res. 2015 Mar 13. doi: 10.1111/jsr.12292. [Epub ahead of print]