Exploding Head Syndrome

Learn about this surprisingly painless parasomnia that could be affecting your sleep.

By Ashley Little

Jan 6th, 2021

Though it sounds excruciatingly painful (and potentially lethal), exploding head syndrome is nearly harmless. In fact, you may be experiencing it and not even realize it’s a condition.

What is Exploding Head Syndrome?

Exploding head syndrome (EHS) is a type of parasomnia that is an auditory hallucination. Those who experience EHS describe it as a loud noise they hear when falling asleep or waking up in the night.

This loud sound people report hearing is a hallucination that can sound like a bomb exploding, a gunshot, fireworks, a lightning strike, or cymbals crashing. Sometimes, this noise may be accompanied by perceiving bright flashes of light, muscle twitches, or shortness of breath, though this is likely due to an increased heart rate.

EHS is not painful or necessarily dangerous, but it can be frightening for people to experience. Some people wake up believing the noise they heard was a real event and become confused. The noise occurs most often prior to reaching deep sleep and sometimes occurs after coming out of deep sleep.

Frequency varies by the individual. A person may have several attacks a week, long periods of remission, or spontaneous patterns of attacks. The experiences reported are irregular and sporadic, showing no consistent pattern for the condition.

What Causes Exploding Head Syndrome?

Little is known about the exact causes of exploding head syndrome, though some scientists believe it may be associated with minor temporal lobe seizures. These minor seizures could be caused by traumatic brain injury, infections, brain tumors, blood vessel malformations, or genetic syndromes.

Others believe EHS may be caused by sudden shifts of middle ear components, impairments in calcium signaling, nerve dysfunction, or stress and anxiety. EHS may also be a side effect on another condition such as a different sleep disorder, a mental health condition, drug or alcohol abuse, or a side effect from certain medicines.

Findings from Research

Some studies have been conducted to research the causes of EHS. One group of studies suggests that the “explosion” may be caused by a burst of neural activity in the brain. As we fall asleep, our body shuts down and goes into sleep paralysis to prevent us from acting out our dreams.

During the in-between period from wakefulness to sleep, the shut-down process is usually a slow, gradual transition. Occasionally, there may be a hiccup in the reticular formation—a part of the brain responsible for this shut down—that delays the turning off of some parts of the brain.

This delay causes two reactions: a suppression of the alpha brain waves which make us drowsy, and a burst of neural activity in the parts of the brain connected to sound processing. The combination of these activities could be the cause of exploding head syndrome, though more research is required to fully understand the condition.

Researchers have found that about 10% of the population experiences EHS and females tend to be more at risk than males. People over the age of 50 are also more likely to experience EHS, though it has been reported in children as young as 10.

Treatment Options

Because exploding head syndrome is fairly harmless, many people do not seek or require treatment. In some cases, EHS can lead to considerable distress or disturb sleep patterns and lead to sleep deprivation, in which case treatment is highly recommended.

To ensure the best treatment plan for your condition, speak with a doctor about your symptoms. You should first be sure what you are experiencing is EHS. Your doctor may ask you questions about how often you hear the noise, what it sounds like, and your sleeping patterns. There are no specific tests for EHS, but a sleep specialist may encourage you to do an overnight sleep study to detect potential sleeping problems.

Some doctors have prescribed tricyclic antidepressants to treat EHS. Others have used calcium channel blockers for successful treatment. Non-drug treatments can also be successful in reducing EHS attacks. This can include reducing stress by increasing relaxation periods before bed, improving your sleep hygiene, or seeking counseling.

For a better night’s sleep, be sure you avoid putting yourself at risk of sleep deprivation and other avoidable sleep conditions. Keep up with a consistent seven to nine hours of sleep each night and maintain a healthy lifestyle with frequent exercise and a well-balanced diet. If you have concerns about your sleep, contact a doctor or a sleep specialist to create a treatment plan that’s right for you.