Now, it might sound like something from a children’s cartoon, computer game, or horror movie, but exploding head syndrome is something quite different from what the name suggests.
Have you ever been jolted awake by a loud noise, feeling as if your head is about to explode, only to discover you’ve completely imagined it? If so, you may have a sleep disorder called exploding head syndrome (EHS).
Despite its dramatic name, EHS is a harmless sleep disorder. During an EHS episode, the resting person thinks they hear a sudden loud noise when falling asleep or waking up. Which sounds like a bit of a nightmare, right?
In this article, we'll go into more detail about what causes exploding head syndrome, its symptoms, and how this perplexing condition can be managed.
Understanding Exploding Head Syndrome
EHS is a sleep disorder that falls under the category of hypnagogic or hypnopompic hallucinations. Individuals who have experienced EHS describe sudden, loud noises that seem to originate from within their head. This usually occurs just before falling asleep or upon waking.
Thankfully, the sounds are not accompanied by pain. However, they do have the ability to significantly disrupt sleep and lead to feelings of distress. The sounds may include:
- Thunder
- Gunshots
- A bomb exploding
- The crack of a whip
- Loud bells
- Cymbals crashing together
These sounds also may be accompanied by:
- Muscle jerks
- Sweating
- Rapid heartbeat
- Flashes of light
- Difficulty breathing
- Feeling frightened
“There’s this sudden crescendo of noise, then a profound and jarring explosion of sound, electrical fizzing and a bright flash in my vision, like someone has lit a spotlight in front of my face.”
Niels Nielsen, exploding head syndrome sufferer
How Common is it, and Who is Affected?
EHS is usually described as being quite rare, affecting a small percentage of the population. Estimates suggest that 1 in 10 people have experienced it, though it’s not known exactly how many do. Those who do experience may have one EHS episode in a lifetime, or they may have several in one night.
However, one 2015 study of college students found that 18% of the 211 asked said they had experienced the condition—almost one in five. However, this was likely to be because students often get less sleep than the rest of the population, so would be more prone to experiencing EHS.
Adults more commonly report symptoms than children, and it’s more common in females. There are no specific risk factors identified, but stress and fatigue are believed to exacerbate the condition.
Causes of Exploding Head Syndrome
Scientists aren’t sure where exploding head syndrome comes from, and there haven’t been enough studies to find definitive answers. The condition only entered medical classification systems in 2005, so there hasn’t been sufficient time to research it properly yet.
However, there are several theories about what causes the sleep disorder, such as:
- Sudden neural activity in the areas of the brain responsible for processing sound and sleep regulation (elsewhere described as “problems with the brain shutting down”)
- Minor seizures in the temporal lobe or dysfunction in the middle ear
- Other sleep conditions such as sleep apnea, insomnia and sleep paralysis
- High stress levels
Diagnosing Exploding Head Syndrome
Because the symptoms of EHS are often mistaken for other sleep disorders or medical conditions, diagnosing EHS can be challenging. What’s more, diagnosis may be complicated futher due to a lack of widespread knowledge about EHS.
Typical Diagnostic Process
There are no specific tests for EHS, but doctors will usually take a detailed patient history and get the individual having sleep problems to describe their symptoms. Physicians will often focus on ruling out other conditions that could cause symptoms similar to EHS, such as ear disorders or neurological issues.
Managing and Treating Exploding Head Syndrome
Lifestyle Changes and Coping Strategies
As with most sleep disorders, managing exploding head syndrome involves making lifestyle changes that aim to reduce stress, improve sleep hygiene, and encourage better sleep. Here are some recommendations:
- Establish a regular sleep schedule: This may include going to bed at the same time each night and getting the same number of hours sleep each night (7-9 hours is recommended)
- Practice pre-bed relaxation techniques: Guided meditation, yoga, stretching, and breathing exercises can all help prepare the mind and body for sleep
- Reduce caffeine intake: Stop drinking tea and coffee around eight hours before bed so it’s out of your system when you go to sleep
- Optimize your sleep environment: Pillow recommends ensuring you have the right mattress and fine-tuning noise, temperature, and lighting to make sure you’re fully comfortable during the night
- Limit screen time: Try to avoid looking at the TV, your smartphone, laptops, and other light sources in the evening
When a 2020 study of over 3,200 people with EHS asked respondents how they prevented episodes, they suggested some strategies and gave a percentage to indicate the effectiveness of each:
- Avoiding sleeping on the back (80%)
- Going to bed earlier (50%)
- Getting more sleep (52%)
- Trying to wake up (81%)
- Using mindfulness (63%)
Medical Treatments for Exploding Head Syndrome
There isn’t any specific treatment for EHS, but medications used to treat other conditions have been found to help symptoms. These include the anti-seizure medications topiramate and the antidepressant amitriptyline.
Before taking any medication, please remember that it’s vital to consult your physician.
Living with Exploding Head Syndrome
Exploding Head Syndrome (EHS) might strike as a frightening phenomenon, but it's a largely benign condition that manifests through startling auditory hallucinations at the cusp of sleep. While the exact causes remain under investigation, stress and sleep disturbances have been identified as potential exacerbators.
For those experiencing EHS, adopting lifestyle modifications aimed at enhancing sleep hygiene and reducing stress can be beneficial. It's also encouraging to note the emerging strategies and treatments that offer relief to sufferers. As awareness grows and research advances, understanding and managing EHS will hopefully become more straightforward, offering solace to those disturbed by this perplexing sleep disorder.
