Exploding Head Syndrome (EHS)

What is exploding head syndrome?

Exploding head syndrome (EHS) is a sleep disorder that makes you hear a loud noise or explosive crashing sound in your head. Healthcare providers also call it episodic cranial sensory shocks.

EHS is a parasomnia. The sound isn’t real and nobody else can hear it. But it can still be a scary, frustrating interruption.

Exploding head syndrome isn’t dangerous, but talk to a healthcare provider if you’re experiencing any new symptoms that affect your sleep.

What causes exploding head syndrome?

Experts aren’t sure what causes exploding head syndrome. Researchers are still studying EHS and its causes. Some theories about why it happens include:

• Sudden, unexpected electrical activity in the parts of your brain that process and create your senses (your sensory neurons).
• Damage or issues in your inner ear.
• Tiny, quick seizures in your brain’s temporal lobe.
• Your brain mistakenly wakes you up when it shouldn’t (an abnormal sleep-wake transition).
• An aura that occurs before a migraine headache.
• Side effects from suddenly stopping SSRIs (selective serotonin reuptake inhibitors), or benzodiazepines that you take to treat depression and/or anxiety disorders.

Is exploding head syndrome genetic?

We don’t know if exploding head syndrome is a genetic condition. It’s possible that genetic variations passed through generations in your biological family can increase your risk. But experts haven’t identified any exact genes or variations that may cause EHS.

What are exploding head syndrome symptoms?

The loud noise you hear is the most obvious exploding head syndrome symptom. The noise might sound like:

• An explosion.
• Gunshots.
• Thunder or a storm.
• Loud musical instruments like cymbals or drums.
• Shattering glass.
• Another sudden loud bang, like a car accident.

Even though the exploding noise sounds incredibly real, it’s not caused by actual sound waves. It won’t damage your ears or cause pain.

You might experience other EHS symptoms during an episode, including:

• Seeing flashes of light (photopsia).
• Muscle jerks (myoclonus).
• Having trouble getting back to sleep.
• Waking up sweating.
• Feeling like your heart is racing (heart palpitations).
• Shortness of breath (dyspnea).
• Feeling anxious or frightened.

How frequent are episodes of exploding head syndrome?

How often you experience symptoms can vary. You might have several episodes in one night or for several nights in a row. Some people go weeks or even months between episodes.

Exploding head syndrome triggers

In most cases, researchers don’t know what might trigger exploding head syndrome episodes. Some people report feeling stressed or unusually tired right before having symptoms. It might help to keep a journal of when you experience symptoms. This can help you identify patterns or changes to your routine that may trigger EHS that you might not have noticed otherwise.

How is exploding head syndrome diagnosed?

A healthcare provider will diagnose EHS by discussing the symptoms you’ve experienced and running some tests. You might need to visit a sleep specialist (a somnologist).

Tell your provider which symptoms you’ve experienced, how often they happen and when they first started. Let them know if you’ve been feeling more stressed or anxious lately, or if you’ve ever had trouble sleeping before.

Some people experience symptoms or wake up without knowing it. If you sleep with a partner, your provider may ask them if they’ve noticed any changes in your sleep habits.

Which tests will be done to diagnose exploding head syndrome?

Your provider may use a few tests to rule out other conditions that can cause similar symptoms. You might need:

• A sleep study (polysomnography).
• An EEG.
• An MRI.

What is exploding head syndrome treatment?

There isn’t any specific treatment for exploding head syndrome. Your provider can help you manage symptoms like stress, anxiety or trouble sleeping.

The U.S. Food and Drug Administration (FDA) hasn’t approved any medications to treat exploding head syndrome. But your provider may suggest some medications used to treat other parasomnias, including:

• Topiramate (an antiseizure drug)
• Nifedipine (a medication that usually treats heart disease)
• Amitriptyline (an antidepressant)
• Clomipramine (an obsessive-compulsive disorder medication)

Can you prevent exploding head syndrome?

Because experts aren’t sure what causes it, you may not be able to prevent EHS. But you may be able to reduce symptoms from coming back (recurring) by managing factors that might trigger episodes. For example:

• Practice good sleep hygiene.
• Try relaxation techniques like meditation, gentle yoga stretches or breathing exercises right before bedtime.
• Manage other health conditions, especially if they affect your sleep.
• Talk to a mental health provider if you feel stressed or anxious.

Is exploding head syndrome dangerous?

No, exploding head syndrome isn’t dangerous. It can be shocking to hear an explosion or experience other symptoms (especially when they wake you up). Learning to live with symptoms can be frustrating and annoying. But it may be easier to adjust to having EHS once you know you’re not in any danger. It will never cause pain and doesn’t mean something is harming your brain.

Having EHS may increase your risk of having other parasomnia conditions. Talk to your provider if you notice any other symptoms or changes that affect your sleep.

When should I see my healthcare provider?

Talk to your provider if it feels like you’re having more EHS episodes or if you’re having a harder time than usual getting a good night’s sleep.

Even if we don’t know what causes it, your provider will help you find ways to manage the symptoms so you can get a healthy amount of sleep again.

Which questions should I ask my provider?

• How can I manage EHS symptoms?
• Which tests will I need?
• Do you suggest any medications?
• Which changes in my sleep or the symptoms I experience should I watch out for?

Is exploding head syndrome a seizure?

Exploding head syndrome isn’t a seizure. Seizures are unusual electrical activity in your brain that affect how you can control your body. Some experts think the same kind of abnormal electrical activity may cause EHS, but that hasn’t been proven yet.

Because they can have some similar symptoms, your provider may test you for conditions that can cause seizures before they diagnose EHS.