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Exploding head syndrome

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

This group contains additional names: - EHS

General

Exploding head syndrome is a type of sleep disorder in which a person hear a loud noise or explosive crashing sound in the head. The sound isn't real or heard by anyone else. The episode typically happens suddenly either in the beginning to fall asleep or when wake up during the night. Along with the loud sound, EHS can occur along with flashes of light and muscle jerks (myoclonic jerks). Unlike its painful-sounding name, the episode is painless. EHS is a parasomnia, which is an undesired event that happens while sleeping. It’s also called episodic cranial sensory shocks.

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Signs & symptoms

Signs and symptoms of exploding head syndrome include: * Feeling frightened or anxious after the episode. * Experiencing a sudden muscle jerk at the time of the episode. * Having difficulty falling back to sleep. * Waking up sweating, having a rapid heartbeat and/or trouble breathing. You don’t experience physical pain with EHS.

Diagnosis

The doctor, usually a sleep disorder specialist, will ask you or your sleep partner about the episode. Criteria from the International Classification of Sleep Disorders help the doctor make the diagnosis. These criteria are: * You wake up suddenly to a loud noise or an explosion in your head. * Your experience is intense and you feel frightened after the episode. * You don’t experience any physical pain during or after the episode. Your sleep specialist will also ask: * If you saw any flashes of light during your episode (some people experience this). * If you had any muscle twitches during the episode. Your sleep specialist may want to order certain tests to rule out other conditions. These tests may include: * Polysomnogram- This test measures brain and body activity during sleep. It records your brain waves, heart rate, eye movements and breathing while you sleep. * Magnetic resonance imaging- This scan uses a large magnet, radio waves and a computer to produce detailed images of your brain and body. * Electroencephalogram (EEG)- This test records the electrical activity of your brain. It’s useful for detecting nocturnal (nighttime) epilepsy. The doctor will also rule out other conditions by taking your full medical history and asking: * If you or other family members have any other known sleep disorders, such as insomnia or sleep apnea. * If you have a history of headaches or psychiatric disorders, such as post-traumatic stress disorder.

Treatment

Exploding head syndrome typically doesn’t need to be treated. The doctor will talk with you and reassure you that this condition isn't dangerous or a sign of any other serious condition. The Food and Drug Administration hasn't approved any medications to treat exploding head syndrome specifically. However, if needed, The doctor may choose to prescribe a medication used to treat other conditions. Medications that have been found helpful for EHS include the antiseizure medicine topiramate, the heart disease drug nifedipine, the antidepressant amitriptyline and a drug for obsessive-compulsive disorder, clomipramine.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

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