The pattern of the auditory hallucinations is variable. With the heightened arousal, people experience distress, confusion, myoclonic jerks, tachycardia, sweating, and the feeling that they have stopped breathing and need to make a conscious effort to breathe again. Some people may also experience heat, strange feelings in their torso, or a feeling of electrical tinglings that ascends to the head before the auditory hallucinations occur. Individuals with exploding head syndrome hear or experience loud imagined noises as they are falling asleep or waking up, have a strong, often frightened emotional reaction to the sound, and do not report significant pain around 10% of people also experience visual disturbances like perceiving visual static, lightning, or flashes of light. The condition was initially described at least as early as 1876. Women are reportedly more commonly affected. While the frequency of the condition is not well studied, some have estimated that it occurs in about 10% of people.
Clomipramine and calcium channel blockers have been tried. There is no high-quality evidence to support treatment. It is classified as a sleep disorder or headache disorder.
Potential risk factors include psychological stress. Potential organic explanations that have been investigated but ruled out include ear problems, temporal lobe seizure, nerve dysfunction, or specific genetic changes. People may also experience a flash of light. The noise may be frightening, typically occurs only occasionally, and is not a serious health concern. Reassurance, clomipramine, calcium channel blockers Įxploding head syndrome ( EHS) is an abnormal sensory perception during sleep in which a person experiences auditory hallucinations that are loud and of short duration when falling asleep or waking up. Nocturnal epilepsy, hypnic headaches, nightmare disorder, PTSD Hearing loud noises when falling asleep or waking up
Hypnagogic and hypnopompic hallucinations, nightmares, and lucid dreaming may also co-occur.Medical condition Exploding head syndromeĮpisodic cranial sensory shock, snapping of the brain, auditory sleep start Although there is no consistent precipitant, some patients have identified an association between increased frequency of events and insomnia or periods of increased stress. In one study, almost 37% of subjects with a history of sleep paralysis also reported experiencing EHS symptoms at least once. ĮHS appears to be more common in patients diagnosed with isolated sleep paralysis. Older adults are more likely to report symptoms without being prompted, likely due to anxiety surrounding age-related intracranial pathology. However, more recent research has shown that EHS may be more common than previously thought across all age groups, with up to 16% of college students reporting EHS events in one study. It was initially thought to be a rare disorder occurring predominantly in middle-aged women. There is no definitive gender predominance, although EHS reportedly occurs more often in females than males in several studies. Since the majority of journal articles about EHS are case reports, accurate prevalence rates are not available. It is an underdiagnosed and under-reported syndrome because patients may feel embarrassed about their symptoms, and healthcare providers may not be familiar with the diagnosis. These concerns are the reasons many seek medical evaluations. Patients may initially fear a more ominous cause is responsible for the sounds, such as a stroke, brain tumor, or brain hemorrhage. The phenomenon is often frightening to those who are unaware of its benign nature. More recently, the term episodic cranial shock has been proposed to describe this phenomenon. He reported a case study of two patients, who experienced the nocturnal sensation of loud sounds he described as “sensory shocks.” Despite earlier descriptions and case reports of EHS, it was not classified as a sleep disorder until 2005, when it gained inclusion in the 2nd edition of International Classification of Sleep Disorders (ICSD-2). ĮHS was first described in medical literature in 1876 by American neurologist Silas Weir Mitchell. The events occur with variable frequency, and there may be prolonged remission between episodes. The sounds have most commonly been described as explosions, gunshots, or thunder but can be almost any loud noise.
Events are often accompanied by flashes of light and patient distress, but there is no significant associated pain. These events occur during the wake-sleep/sleep-wake transition period and generally last less than a second. Exploding head syndrome (EHS) is a benign parasomnia characterized by the perception of a loud sound while asleep, which leads to abrupt awakening.
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