Symptoms & Treatment Of Exploding Head Syndrome

Exploding head syndrome (EHS) is a parasomnia, a rare sleep disorder that causes people to hear a loud noise, like an explosion, when someone is falling asleep or just waking up. The sound isn't real or painful, but it's intense enough to startle people awake. for most undiagnosed people, the noise attacks can cause great fear, anxiety, confusion, and distress.

Now redefined as an episodic cranial sensory shock, EHS is a strange phenomenon that does not happen to many people as it is unusual and rare.

The frequency and severity of attacks can vary from person to person. It can occur regularly during a period of time or occasionally and then just as mysteriously go away. Some people may only experience a few attacks in their lifetime, while others may have them consecutively for a few nights.

The occurrence of EHS episodes is varied across all the patients. Some patients experience multiple episodes over the course of one night, while others have reported experiencing repeated episodes for several consecutive nights following weeks or months without activity.

Some people suffering from exploding head syndrome also experience brief flashes of light or feelings of pressure in their heads. The condition usually doesn't cause any other symptoms and goes away on its own after a few minutes or hours.

man with exploding head

The first documented EHS description.

... of the exploding-head syndrome dates back to 1876. Silas Weir Mitchell, a Philadelphia physician, published his paper "On Some of the Disorders of Sleep" in the Virginia Medical Monthly.

In 1920, psychiatrist Sir Robert Armstrong-Jones described several psychiatric patients whose symptoms included terrifying experiences. These victims' symptoms ]

in 1988 British neurologist ohn M.S. Pearce also published an article covering more about EHS in the medical journal Lancet.

Since then, there has been more peer-reviewed research conducted on the condition.

Causes of exploding head syndrome

EHS has been in existence for decades, but it hasn't been well studied.

People over the age of 50 most often have this sleep disorder that is thought to be brought on by stress or extreme fatigue, although it has been known to occur in teenagers and even as young as ten years of age.

Researchers don't know exactly what causes it, but there are some possible explanations:

Fear, emotional stress, or anxiety can trigger an attack.

When we experience fear, emotional stress, or anxiety, our brains secrete chemicals such as cortisol, which can trigger an Exploding Head Syndrome attack.

Sleep conditions such as obstructive sleep apnea and sleep paralysis.

Both obstructive sleep apnea and sleep paralysis are known to cause brief awakenings during which individuals might experience a loud noise. This could explain why some people who suffer from exploding head syndrome also experience other parasomnias like sleep paralysis or night terrors.

Sleep deprivation and poor sleep quality.

Sleep is a vital part of our lives. If someone is not getting enough sleep or if their sleep is constantly interrupted, it could increase the chances of experiencing the exploding head syndrome.

It's been suggested that people who experience exploding head syndrome are more likely to have poor sleep quality and be sleep deprived.

Overactive imagination.

This is the most speculative explanation, but some experts have suggested that people who experience exploding head syndrome may be more imaginative and creative than the average person. It's thought that these people might be more likely to vividly visualize sounds in their minds which could lead to experiencing an exploding head syndrome episode.

This could explain why some people only experience the condition occasionally and why children are more likely to experience it than adults.

Certain medications.

It's also possible that some medications could trigger an episode of exploding head syndrome. This is mainly caused by the side effects of the medication. If you're taking any new medications and you start experiencing episodes/symptoms of EHS, it's essential to talk to your doctor about it.

Temporary changes in the brain's electrical activity during sleep

Theories about how the brain's activity causes exploding head syndrome are speculative. But one possibility that has been studied suggests that temporary bursts of neural activity in the brain occur concurrently with episodes of the reported EHS.

During deep sleep, the body shuts down and becomes partially paralyzed to prevent us from acting out our dreams. The studies suggest that in exploding head syndrome, the brain responsible for overseeing the body's general shut-down experiences a hiccup which delays switching off some areas. Once the neurons fire up once again to resume normal function, they cause the sensation of an explosion in your head.

Sudden shifts in the parts of the middle ear

Another theory suggests that the experience of EHS may be caused by sudden shifts in the parts of the middle ear. The tiny bones in your middle ear help transmit sound waves to the inner ear, and when these bones move suddenly, it can create the sensation of an explosion.

Minor seizures in the temporal lobe

Another theory suggests minor seizures may cause EHS in the temporal lobe. The temporal lobe is responsible for some of our auditory processing, and seizures in this area could lead to the experience of EHS.

Genetic disposition

It's also been suggested that some people may be more genetically disposed to experiencing the exploding head syndrome. If this is the case, then there may not be any specific trigger that will cause an episode.

Who gets Exploding Head Syndrome?

Exploding head syndrome is a rare condition that affects about 10 percent of the population. It's more prevalent in women than men, and it is usually more common in people aged around 50-60 years. However, there are reported cases of EHS in 10 years old kids and the elderly 70 years and above.

Although not scientifically established, there is thought to be a genetic link as some cases of EHS have been found in two or more members of the same family.

Not ALL the loud noises are a result of EHS. Similar symptoms could be caused by drug abuse, sleep disorders, mental condition, medicine side effects, or a medical condition.

How Is Exploding Head Syndrome Diagnosed?

If you are experiencing any of the symptoms of exploding head syndrome, it is important to see a doctor for evaluation. There may be an underlying condition causing your symptoms and it is important to get the correct diagnosis.

NOTE that there is no specific test for diagnosing exploding head syndrome. It is usually diagnosed based on a person's symptoms and medical history. If the doctor suspects that EHS may be responsible for a person's symptoms, they may refer them to a specialist in sleep disorders for further evaluation.

Other conditions EHS patients may be evaluated for include;

  • post-traumatic stress disorder.

  • nocturnal epilepsy

  • hypnic headaches

Sleep specialists use a diagnostic criterion to distinguish EHS from other conditions that can lead to similar symptoms.

For example, sudden onset-headache syndromes, like thunderclap headaches and idiopathic stabbing headaches, could cause EHS episodes to occur. Such episodes, which usually occur when someone is about to wake up, are sometimes accompanied by slight pain.

Although EHS seems not to affect sleep duration or architecture, some patients may have to undergo polysomnography tests and magnetic resonance imaging to check for any underlying conditions. They may also do a physical exam and order some tests, such as EEG, to rule out other causes of your symptoms.

  • Polysomnogram - A Polysomnogram is a test that measures the electrical activity of the brain and body during sleep. It records the heart rate, brain wave activity, eye movements, and breathing rate while you sleep. This test can help doctors determine if a person has EHS rule out other causes of your symptoms that could be related to sleep disorders and obstructive sleep apnea.

  • Magnetic resonance imaging(MRI) - A magnetic resonance imaging (MRI) is a test that uses a strong magnetic field and radio waves to produce detailed images of your brain and body. This test is used to diagnose various conditions, including sleep disorders, epilepsy, and tumors. It can also help rule out other causes of your symptoms.

  • Electroencephalogram (EEG) - An electroencephalogram (EEG) is a test that measures the electrical activity of your brain. This test can help doctors diagnose various conditions, including nocturnal (nighttime) epilepsy and sleep disorders.

Be sure to tell your doctor about any medications you are currently using or any known sleep problems you have.

Exploding head syndrome symptoms.

If you have an exploding head syndrome, you may experience hypnogogic hallucination, hypnopompic hallucination, or both.

According to the sleep foundation, hypnogogic hallucination occurs when you are in consciousness just when you are about to fall asleep. The hallucinations create realistic, intricate visual disturbances in the mind causing you to wake up in extreme confusion or fear that your hallucination was real. Hypnogogic hallucinations are relatively common, and about 37% of people experience these nighttime hallucinations. 

On the other hand, hypnopompic hallucination occurs when someone wakes up in the morning and is between a state that falls somewhere between dreaming and being fully awake. They are less common and have only been recorded to occur in over 12% of people. 

These hallucinations cause you to believe there are noises flashing lights and may jolt you awake and keep you from falling back to sleep. Other characteristic symptoms include:

  • elevated heart rate

  • muscle twitches

  • a sense of pressure in your head

  • a feeling of dizziness or vertigo

  • sense of fear or distress

  • sweating, shortness of breath

What Is the Treatment for Exploding Head Syndrome?

There is no specific cure for exploding head syndrome and the condition simply fades with time. If the condition is causing you distress or disrupting your sleep, your doctor may recommend treatment options to help lessen the symptoms.

Healthy Diet

A healthy diet and lifestyle are always important, especially when trying to manage any condition. Eating a balanced diet consisting of nutrient-rich whole foods can help your body function at its best both physically and mentally. EHS patients who had a positive change in their diets reported a decrease in the frequency and severity of their symptoms.

More specifically, eating foods that are known to help with sleep, such as bananas, yogurt, turkey, chamomile tea, and honey, may also help to relieve some of the symptoms and help treat the exploding head syndrome. Avoid spicy or fatty foods, caffeine, and alcohol right before bed.

Reduce Stress

Stress can be a significant contributor to symptoms of exploding head syndrome. When you are feeling stressed, your body is in a state of fight or flight, which can negatively affect your sleep. Techniques that can help reduce stress include yoga, meditation, journaling, and deep breathing exercises.

other methods like using aromatherapy essential oils help promote relaxation and well-being. The use of lavender oil is especially helpful in reducing stress and promoting sleep.

Since there's a documented link between EHS and stress, learning how to manage and cope with stress and anxiety emotions may help reduce or stop the episodes.

Good Sleep Hygiene

Good sleep habits and practices can also help improve sleep quality and reduce the likelihood of experiencing EHS. This includes maintaining a regular sleep schedule, avoiding caffeine and alcohol before bed, and using relaxation techniques before bed. If you are struggling with insomnia, see a sleep specialist to help identify and treat the underlying cause.

Read more about best sleeping practices here.

Medications & Antidepressants

If lifestyle changes and stress-relieving techniques do not help to reduce the symptoms of EHS, your doctor may prescribe medications or antidepressants. Clomipramine and Tricyclic antidepressants (TCAs) are often prescribed for people with EHS as they have been shown to be effective in reducing the occurrence of exploding head syndrome.

Sleep experts believe that selective serotonin reuptake inhibitors (SSRI) effectively manage brain pathways that regulate mood, among other essential functions, thereby helping alleviate symptoms of EHS.


One of the best treatments for exploding head syndrome is reassurance from friends, family, and doctors that you are not experiencing a mental health disorder and that your symptoms are harmless. This can help to reduce the fear and anxiety that often accompanies these hallucinations.

A Word From Vitalsleep

Although Exploding Head Syndrome may seem startling and disruptive, it is manageable with the right information. By understanding what causes EHS and what you can do to lessen its effects, you can take control of this condition and live an everyday life.

Since exploding head syndrome is still relatively unknown, there is not a lot of information available on how to treat it directly. There is no one-size-fits-all answer to managing exploding head syndrome, as the best approach may vary from person to person. However, by making healthy lifestyle changes, reducing stress, and practicing good sleep hygiene, you can often reduce or eliminate the symptoms of EHS. If your symptoms persist or are causing significant distress, talk to your doctor about possible medications or antidepressants that may help.

Frequently Asked Questions

What is parasomnia?

Parasomnia refers to a group of disorders that are characterized by abnormal behavior or experiences during sleep. This includes conditions like disorientation, sleep eating, sleepwalking, night terrors, teeth grinding, talking while asleep, and restless legs syndrome.

Is Exploding Head Syndrome Dangerous?

No, exploding head syndrome is not a dangerous condition. It is considered partially harmless as it does not pose an immediate risk to one's health. It is not associated with any consequential additional conditions. EHS, however, could lead to chronic sleep deprivation if left untreated.

Is exploding head syndrome a mental illness?

No, exploding head syndrome is not a mental illness. It is considered a sleep disorder and falls under the category of parasomnia. However, it can cause distress and anxiety, leading to or worsening mental health conditions.

Can exploding head syndrome happen while awake?

No, exploding head syndrome is not associated with hallucinations that occur while awake is a condition that is associated with the transition from wakefulness to sleep, when you are just beginning to fall asleep, or just when you are about to work.

Can exploding head syndrome be cured?

Currently, there is no specific treatment for exploding head syndrome. However, most people find relief from their symptoms with some combination of treatments. If you are struggling with EHS, see a doctor to help find the best treatment plan for you.

Can sleep apnea cause exploding head syndrome?

There is no clear evidence that sleep apnea causes the exploding head syndrome. However, some people with EHS report experiencing more severe symptoms when they have a  history of insomnia, untreated apnea, and high-stress levels.

Is exploding head syndrome related to sleep paralysis?

Sleep paralysis and exploding head syndrome are two different conditions. However, they both fall under the category of parasomnia and can share some common symptoms, which could also signal the onset of EHS. If you experience sleep paralysis, it is crucial to get treatment as soon as possible, as it can lead to other more severe sleep disorders.

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