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Everything You Need to Know About Exploding Head Syndrome

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Written By Alex Petrović

Sleep Consultant

Featured image for Exploding Head Syndrome

7 November 2023 4 min read

Although it might sound like the worst migraine ever, Exploding Head Syndrome (EHS) is actually a sleep disorder! Here's everything you need to know about this scary-sounding condition.

When you hear “Exploding Head Syndrome”, we wouldn't blame you for imagining a scene out of a horror movie or remembering a specifically bad hangover you've had. However, this condition is a lot more complex and actually affects a completely different part of your life – your sleep.

So, we're going to go over the symptoms, possible treatments, and cover what is known about this sleep disorder currently. However, do note that this is just a general overview based on research we could find and that seeing your GP will always be the best thing to do.

What is Exploding Head Syndrome (EHS)?

An image of a woman covering her ears with her pillow

Exploding Head Syndrome is classified as a parasomnia, which is an umbrella term for many sleep disorders and just means that your sleep is negatively affected. Some of the more popular parasomnias include sleep paralysis, night terrors, and sleepwalking.

However, while these sleep disorders do have some similarities, they can also be distinguished based on a few factors – like in which sleep phase they typically occur, whether there's recollection of the event, and the physical symptoms.

Exploding Head Syndrome for example takes place in the transition period between N1 sleep and wakefulness. This means that you're likely to experience symptoms as you're drifting off to sleep or just as you're waking up. If you'd like to know more about sleep cycles, we recommend reading our article on the topic.

People suffering from this syndrome typically report hearing an explosion, gunshots, or some other loud noise. However, there are other possible symptoms as well – such as seeing flashing lights and/or colours or even feeling like there's electricity going through your body. So, just like with other sleep disorders, the experience may vary from person to person.

What are the symptoms of Exploding Head Syndrome?

An image of a woman in bed at night holding her face in pain

Although this condition doesn't cause actual pain, it can still be a rather unpleasant experience. It comes with a few characteristic symptoms, the most common of which is hearing loud noises, and it can still dramatically influence your sleep quality.

According to the Cleveland Clinic, people suffering from Exploding Head Syndrome typically experience the following symptoms:

However, as you can see, and as we'll now discuss, these symptoms overlap with many other sleep disorders and conditions. Even something like sleep apnea can be mistaken for Exploding Head Syndrome without careful consideration and the presence of a professional.

How is this condition different from other sleep disorders?

An image of a man in bed worried and unable to sleep

In the absence of a sleep specialist, it can be somewhat difficult to distinguish Exploding Head Syndrome from some other sleep disorders. This is especially true for conditions such as night terrors, nocturnal epilepsy, hypnic headaches, PTSD, and nocturnal panic attacks.

However, you can still tell them apart to a degree based on three main factors – when it happens, whether you remember it and whether you're in pain. First off, although it sounds extremely painful, this condition doesn't actually hurt. So, if your head is throbbing with pain, it's most likely a hypnic headache or migraine.

Secondly, if you suddenly wake up in the middle of the night, it's also unlikely that you're experiencing Exploding Head Syndrome. As we've mentioned, this condition typically takes place as you're falling asleep or waking up in the morning. On the other hand, things like nocturnal panic attacks typically occur during the night.

Lastly, if you can recall the sound that you heard, you can probably rule out night terrors and panic attacks. This is because these conditions usually leave a general imprint or feeling but rarely have an associated narrative to go along with it. But with all of that being said, symptoms do vary, so consult your GP to be safe.

What causes Exploding Head Syndrome

An image of a woman in bed holding her face with her eyes closed

A factor that makes this condition somewhat difficult to treat and diagnose, as we'll talk about in the following two sections, is that doctors aren't sure what the exact cause is. However, there are a few theories.

According to the NIH, Exploding Head Syndrome can be attributed to a few different factors:

As you can see, these theories vary quite a bit and as of writing this article, there doesn't seem to be a clear consensus. In fact, certain experts even argue that the name of the condition should be changed to episodic cranial sensory shock, as to better describe the condition since there is no significant pain involved.

However, there do seem to be a few common triggers (although these can vary as well). From what we've found, stress triggers are rather common as well as reactions to certain medications. It should also be noted that the condition is more common among women, notably prior to their menstrual cycle.

How to diagnose Exploding Head Syndrome

As you've seen in the previous paragraph, there's still a lot we don't know about this condition. However, this doesn't mean that medical professionals are completely helpless!

For one, some doctors can advise keeping a sleep diary, so that they could potentially figure out a pattern and determine whether you're suffering from the condition. You might also be asked to stay for an overnight study, as this could provide further evidence.

But it's important to reemphasise – don't self-diagnose. The diagnostic criteria might seem simple enough but having a professional present is essential. This article should simply serve as a guide for what to look out for and keep track of so that you can inform your GP. Plus, Exploding Head Syndrome, although it is a sleep disorder, doesn't strictly rely on sleep medicine when it comes to treatment. So, it's not something you can or should do by yourself.

How to treat this sleep disorder

An image of a comic pannel depicting exploding head syndrome

We know it might seem repetitive at this point however, it's still true – there doesn't seem to be a 100% surefire way to treat Exploding Head Syndrome. However, there have been a few sleep medicine reviews that point to a possible solution.

In the experiment “Topiramate responsive exploding head syndrome“, the use of Topiramate has decreased the intensity of this condition in one middle-aged woman. And Duloxetine Hydrochloride has been successful in reducing the frequency and duration of episodes in one of the two patients.

As you can see, the solution isn't as easy as “get this sleep med and you're cured forever”, however, certain medications do seem to help out. Plus, getting a diagnosis can help out quite a bit. While doing research, we stumbled upon the artist Planetmclulu and would like to share this panel from their comic.

They then go on to say that finally getting diagnosed made a difference, as it eased some of the fear and anxiety associated with going to sleep. And this is something we've talked about when discussing nocturnal panic attacks as well. Sometimes simply having a label for what you're going through can make the whole ordeal a lot easier to come to grips with.

How common is Exploding Head Syndrome

An image of a woman in bed unable to go to sleep

Lastly, we'd like to discuss a rather interesting fact – Exploding Head Syndrome arguably isn't among the most rare psychological disorders. In fact, according to the Mayo Clinic, around 10% of the population has at least one episode during their life.

And other sources even claim that this number can reach 16% if strictly looking at students. So, if you do happen to suffer from this condition, know that you're not alone. In fact, you can find more artists such as Planetmclulu and even a decently-sized subreddit. And being part of a community of people all going through the same struggles might just be that little comfort you needed in order to get through this.

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