Exploding head syndrome (EHS) is a sleep disorder. Although it sounds painful, you feel no pain. You hear a loud noise or explosion in your head. The sound isn't real or heard by others. It happens as you’re falling asleep or when waking up during the night. EHS is harmless and not a sign of another serious health condition. It usually doesn’t require treatment.
Exploding head syndrome (EHS) is a type of sleep disorder in which you hear a loud noise or explosive crashing sound in your head. The sound isn't real or heard by anyone else. The episode typically happens suddenly either when you're beginning to fall asleep or when you 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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Researchers don’t know how many people have had exploding head syndrome (EHS). It’s more common in females.
EHS can happen to persons of all ages. Some 16% of college students report EHS according to the results of one study.
How often an EHS episode occurs varies from person to person. Some people have several episodes in a single night. Others have episodes several nights in a row followed by weeks or months without episodes.
In most cases, researchers don’t know what might trigger exploding head syndrome episodes. Some people report that feeling stressed or tired might have led to their episodes.
An episode typically lasts less than a second.
Exploding head syndrome isn't dangerous and doesn’t harm your overall health.
Signs and symptoms of exploding head syndrome (EHS) include:
You don’t experience physical pain with EHS.
Most individuals who experience exploding head syndrome describe it as an explosion in their head or hearing sounds like gunshots, thunder or another very loud noise.
Researchers don’t know the exact cause of exploding head syndrome. Most published medical reports on this topic are based only on a few patients.
However, there are some current theories about causes. These include:
Your healthcare provider, usually a sleep disorder specialist, will ask you or your sleep partner about your episode(s). Criteria from the International Classification of Sleep Disorders help your provider make the diagnosis. These criteria are:
Your sleep specialist will also ask:
Your sleep specialist may want to order certain tests to rule out other conditions. These tests may include:
Your provider will also rule out other conditions by taking your full medical history and asking:
Exploding head syndrome typically doesn’t need to be treated. Your provider 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, your provider 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.
If you and your healthcare provider think certain factors might trigger an episode, work on those triggers. For example:
Your outlook is good. Exploding head syndrome isn't dangerous and isn't a sign of another serious health condition. With some reassurance from your health care provider, education about this condition and control of any triggers or other sleep problems, your episodes should completely disappear with time.
If you have disrupted sleep or are anxious about these episodes, see your healthcare provider or a sleep specialist.
Be sure to tell your healthcare provider:
Your sleep specialist may have asked you to keep a sleep diary to keep track of your sleeping patterns and any episodes of EHS. Bring your journal with you to your appointment and share your findings with your provider.
A note from Cleveland Clinic
Waking up suddenly from sleep because you’ve heard a loud noise or an explosion in your head can certainly be frightening. You’re not alone if you think this is a symptom of a serious health condition, such as a brain tumor or stroke. However, rest assured that there's nothing to worry about if you do have exploding head syndrome. Your condition isn’t harmful and should completely go away with time.
Last reviewed by a Cleveland Clinic medical professional on 10/19/2021.
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