What is Exploding Head Syndrome?

Causes and Diagnosis of this Unique Sleep (not Headache) Disorder

What is Exploding Head Syndrome?. Tara Moore/Getty Images

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.

What is Exploding Head Syndrome?

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.

Is Exploding Head Syndrome Rare?

It may be rare or it may be under-reported. In one 2008 study in Somnologie of 36 participants, 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.

What Causes Exploding Head Syndrome?

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

  • Ear Problem
  • Temporal lobe complex seizures
  • Side effect from fast withdrawal from benzodiazepines or selective serotonin reuptake inhibitors
  • Genetic problem – linked to mutation on chromosome 19
  • Delays in switching off certain nerve activity in the brainstem when transitioning from wakefulness to sleep

    Who is at More Risk of Developing Exploding Head Syndrome?

    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.

    How is Exploding Head Syndrome Diagnosed?

    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 he rules out other neurological, sleep, or psychiatric disorders that can mimic EHS like :

    How is Exploding Head Syndrome Treated?

    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.

    Bottom Line

    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 suffer from 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.

    Sources:

    American Academy of Sleep Medicine (2014). Exploding Head Syndrome–Overview & Facts. Retrieved May 15th 2015.

    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]

    DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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