What Is Exploding Head Syndrome And How Is It Treated?

What Is Exploding Head Syndrome (EHS)?

Exploding head syndrome (EHS) is an uncommon and rather undocumented event of parasomnia, in which a person feels a loud bang in their head. This may be similar to an earthquake, bomb exploding, another type of loud sound, the clash of cymbals or indecipherable loud sound that seemingly originates from the head interiors.

What is Exploding Head Syndrome (EHS)

This type of noise appears when a person falls asleep for an hour or two but is not a part of the dream. Such episodes may last for a few seconds or may end up for a few minutes. Exploding head syndrome is a rare and a type of parasomnia that appears at night and occurs when the mind transitions from one sleep stage to the other. The sound may appear to be extensively loud, but is not followed by any pain in the head. The appearance of attacks may change over time, but several attacks may happen within a shorter time span.

Any pre-attack or post-attack of Exploding head syndrome (EHS) often elevates the heart rate in the patient and he or she can develop a sense of anxiety or fear. This may also be associated with a heavy breathing and superficial light flashes. This condition is called as “auditory sleep starts.” The symptoms that are associated may vary and those that are benign in nature can be emphasized extensively. However, treatment or cure for Exploding head syndrome (EHS) has not been indicated. Some might also lack the ability to vocalize the surrounding sounds, or undergo a mild paralysis when the attack commences. This can be denoted in the following ways:

  • A bomb explosion
  • A painless loud bang
  • A clash of cymbals.

Stress and Exploding Head Syndrome

Some patients only witness the noise appearing in an ear while others find its appearance in both the ears. There are other cases where the sound seemingly appears from the interior part of the head.

Exploding Head Syndrome

Researchers have speculated that the exploding head syndrome commonly affects those people who are subjected to increased levels of physical and metal fatigue or stress. The condition is observed in males and females, but is prominent in the latter gender. This appears to affect the people who are above 50 years of age or older, but some children have also registered the symptoms associated with the syndrome.

As a little research has been done about this condition, the exact cause is not determined. Some experts suggest that the syndrome appears due to minor seizure attacks in the temporal lobe while others show that it might be associated with hearing disorders.

What Are The Causes Of Exploding Head Syndrome?

Although the exact cause of exploding head syndrome is not speculated, extreme fatigue might be a major cause of its occurrence.

  • Its attack is common amidst those who are in their late fifties; however, even the ten year old have been registered with this attack.
  • Exploding head syndrome attacks can occur once or several times. At times, there are no incidences linked with it and they can recur as well. Although the attack does not cause any pain or is not fatal, yet it can be distressing and can terrify the patients.
  • Patients show an increased heart rate along with the associated level of increased fear or anxiety.
  • Certain drugs like SSRIs and benzodiazepines have been linked with the exploding head syndrome as its withdrawal may trigger the symptoms significantly.
  • Exploding head syndrome may generate at any time in life and is commonly seen in women as compared to men.

The mechanism of exploding head syndrome is not known and the possibilities have been suggested out of which one may be due to the catastrophic transition of the Eustachian tube. Another thing may be due to the appearance of minor seizure that is associated with the temporal lobe. This is the place where the cochlear nerves are located. Recording of Electroencephalograms (EEG) has shown that the attacks are associated with strange activities commonly observed in patients.

Risk Factors For Exploding Head Syndrome (EHS)

People who are in the late fifties have an increased tendency of being affected by the exploding head syndrome. Women are subjected to the increased risk of experiencing the syndrome and many children have also registered with the same problem.

Exploding head syndrome is not alarming; neither does it have any severe effect on sleep. Yet, many people often seek medical assistance to get rid of the symptoms at the earliest. You will have to consult a physician initially and present the entire detail of medical history to avoid any complications in the diagnosis of exploding head syndrome.

Signs and Symptoms of Exploding Head Syndrome (EHS)

You may suffer from Exploding Head Syndrome if you are:

  • Imagining a catastrophic noise or explosion inside the head prior to waking up at night or when you fall asleep.
  • Finding that the sounds do not cause any unusual pain.
  • If you wake up with a sense of fear after the attack.

The imagined sound can also be a result of various other things other than the exploding head syndrome. They are:

  • Substance abuse
  • Another sleep disorder or a medical condition
  • A mental health disorder
  • Medication use.

Tests to Diagnose Exploding Head Syndrome (EHS)

It is advisable to visit a sleep specialist if the syndrome results in a peak anxiety level and interferes with your sleep. The doctor will try to understand the occurrence of the pain and inspect your medical history. He or she may also try to know about the duration of such an attack and their frequency of occurrence. At such times, be sure to educate the doctor about past drug use or any specific medication.

Acknowledge the doctor about the sleeping disorder if you have experienced any in the past. Find out whether any of your family members have been suffering from a similar disorder. It will also prove to be helpful if you note down all the instances in a diary. This way; the doctor can speculate your sleeping patterns and connect the dots that relate to the occurrence of such syndrome. The doctor will also find a permanent cure for correcting the problem.

Diagnosis of exploding head syndrome does not require carrying out any tests. The doctor may sometimes have to do an overnight sleep study on you to see the patterns that appear in relation to the sleeping disorder. This is called as polysomnogram. This depicts the heartbeat, breathing and the brain waves that your body experiences. It also records the pattern of your limb movements. The study will help in revealing that the occurrence of sound is triggering your sleep disorder or no.

Treatment for Exploding Head Syndrome (EHS)

Clomipramine (an anti-depressant) may be helpful in treating the symptoms associated with exploding head syndrome. Sedatives also help in easing the troubles that relate to exploding head syndrome. Surprisingly, the stimulants have also worked in a few cases. In some, the exploding head syndrome may take time to recede and the time span can range from week to years.

Lifestyle Changes for Exploding Head Syndrome (EHS)

  • Relaxation: People are often asked to relax for reducing the frequency of exploding head syndrome occurrence. Relaxing the body and mind often helps in reducing the level of symptoms of exploding head syndrome.
  • Get Sufficient Sleep For 8 Long Hours: A good amount of sound sleep can help in maintain stability between the body and mind. People, who sleep for less than six hours, often suffer from various sleep disorders or myoclonus.
  • Follow a Balanced and Healthy Diet: Exploding head syndrome sufferers are often encouraged to maintain a healthy eating habit. Fruits and vegetables can provide the essential minerals and vitamins in abundance which helps in relieving the stress from the body.
  • Seek Support and Encouragement: A person who is suffering from exploding head syndrome should be reassured that the syndrome is not grave and can be healed in an amount of time. This will help in bringing down the anxiety levels in some patients.
  • Minimal Stress Levels: Every person is subjected to some amount of stress on a daily basis. These stress levels can be kept at a minimum by indulging in various activities and doing some yoga or meditation. This way, the body is free from stress by the time you go to sleep.
  • Consult A Physician: When you notice increased frequency of this disorder, it is necessary to consult a doctor. Even though there are specific medications for exploding head syndrome, some drugs can prove to be helpful.

Prevention of Exploding Head Syndrome (EHS)

When fatigue or stress is related to the exploding head syndrome (EHS), experts suggest practicing mind relaxing techniques like meditation, yoga or a combination or both. You may also take a hot shower before going to bed. Physicians have also speculated that sleep disturbances like exploding head syndrome are associated with the use of various drugs or medication. Bringing down the levels or altering the consumption of such drugs may help in alleviating the exploding head syndrome symptoms.

Tinnitus and Exploding Head Syndrome (EHS)

The occurrence of tinnitus may be similar to the exploding head syndrome (EHS). This often causes a ringing sensation in the ear and the sufferer experiences whistling, hissing, ringing, buzzing and chirping. The noise can be irregular or continuous and can vary in their intensity as well. The sounds appear even worse when the background noise is minimal and you are trying to sleep in a silent surrounding.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 13, 2019

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