Exploding Head Syndrome Symptoms, Causes, and Treatments

BLAM! CRASH! When such a loud and disturbing noise occurs surrounding sleep, you might think you are dreaming even though you are awake. You might even think a gunshot or car crash has occurred outside your bedroom and get up to check it out. Sudden loud noises around sleep transitions may also occur as part of a condition called exploding head syndrome. What is exploding head syndrome? Learn about the most common symptoms, the causes and why it occurs, and consider effective treatments if it is bothersome.

Symptoms

Exploding head syndrome may almost sound like a made-up name. You might envision a head popping like a balloon as you might see on a cartoon. But for the people who have this rare and unusual sleep disorder, the drama that name conjures up is very real. Those with exploding head syndrome may hear loud noises during sleep transition—so loud that they may parallel something you'd imagine coming from a special effects sound stage.

This parasomnia involves the experience of hearing a loud bang within one's head. The specific noise type may vary, sometimes sounding like a bomb explosion, gunshot, car crash, or even a clash of cymbals; on occasion, some may also experience a bright flash of light associated with the noise. The condition can be greatly upsetting and distressing, especially if it is not initially understood. It may cause confusion and concern about a serious underlying cause. Fortunately, there is no pain or other physical symptoms associated with it.

Causes

Exploding head syndrome, or "sensory starts" as it is sometimes known, commonly occurs in the transition period around deep sleep. Deep sleep is also known as slow-wave or stage 3 (N3) sleep. It occurs more in the first third of the night and naturally decreases with age, beginning to decline after the teenage years. It is during this phase of sleep that growth hormone is released.

It seems to occur more often in women, especially after age 50, but it has been reported in a child as young as 10. Its precise cause is not known. It may be similar to other phenomena such as sleep paralysis that occur in the transitions between states of sleep and consciousness. These overlap states can lead to bizarre sensory experiences.

Exploding head syndrome often occurs in association with extreme fatigue or high levels of stress. The attacks may vary over time, and sometimes abruptly cease for long periods. It may occur once and never again.

Disorders that fragment sleep may also play a role. For example, obstructive sleep apnea may cause sudden awakenings from sleep to restore breathing. This may fragment sleep stages, and lead to an abrupt transition from deep sleep to wakefulness. Though less common, narcolepsy may also lead to these sudden transitions in consciousness. It is also possible for environmental disturbances to fragment sleep. Noise may lead to sleep fragmentation and this might precipitate an episode.

Effective Treatments

The condition is not dangerous, and treatment is generally limited to reassurance and stress management. It sometimes helps to simply know what it is and that it is nothing serious. Following general sleep guidelines can be helpful as well, ensuring that rest is of sufficient length and quality. 

If a contributing sleep disorder is suspected, it may be important to undergo a diagnostic sleep study. Sleep apnea may be treated with continuous positive airway pressure (CPAP) therapy or oral appliance use. Narcolepsy may be treated with medications, including the use of sodium oxybate.

In some cases, the tricyclic antidepressant called clomipramine may be a useful option. Fortunately, this is usually not necessary.

A Word From Verywell

If you think this may be affecting you, and it is bothersome, speak to your healthcare provider about your options. It may be helpful to arrange a sleep study to ensure there are not other disorders like sleep apnea contributing to your sleep fragmentation.