Sleep Education
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Exploding Head Syndrome

What is it?

Exploding head syndrome is a parasomnia. A parasomnia involves undesired events that come along with sleep. Exploding head consists of a loud noise that you suddenly imagine just before you fall asleep. It can seem like a violent explosion has gone off in your head. It can also occur as you wake up in the night.

It has also been described in the following ways:

  • A painless loud bang
  • A clash of cymbals
  • A bomb exploding

At times it may seem like a less alarming sound. Episodes can cause a high level of distress and fear. Many people think that they are having a stroke. The number of attacks varies. They can happen very rarely. They can also occur many times in one night. Having many episodes can greatly disturb your sleep. Some people report having a cluster of attacks over several nights. Then a few weeks or months will pass before it occurs again.

A flash of light may come along with the sound. A muscle twitch or jerk may also occur. The event is normally painless. A sudden stab of pain in the head has at times been reported.

The cause of exploding head is not known. It may occur more often when you are very tired or under stress. In many people the episodes occur less often over a period of years.

Exploding head syndrome can be confused with other headache syndromes. But exploding head is normally painless. Headache syndromes can cause great pain.

Who gets it?

It is not known how many people have exploding head syndrome. It may be more common in women than in men. It can begin at all ages. It has even been reported as early as less than 10 years of age. The average age when it first appears is 58 years.

How do I know if I have it?

  1. Do you imagine a sudden loud noise or explosion in your head just before falling asleep or just after waking up in the night?
  2. Are these sounds normally free of any sense of pain?
  3. Do these events wake you suddenly with a sense of fright?

If you answered yes to these questions, then you might have exploding head syndrome.

It is also important to know if there is something else that is causing the imagined sound. Instead of being exploding head syndrome, it may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Do I need to see a sleep specialist?

You should see a sleep specialist if exploding head causes you great anxiety or often disrupts your sleep.

What will the doctor need to know?

The doctor will need to know when the imagined sounds began. He or she will want to know how often they occur and how long they last. The doctor will need to know your complete medical history. Be sure to inform him or her of any past or present drug and medication use.

Also tell your doctor if you have ever had any other sleep disorder. Find out if you have any family members with sleep problems. It will also be helpful if you fill out a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This data gives the doctor clues about what is causing your problem and how to correct it.

Will I need to take any tests?

Tests are not normally needed for someone who has exploding head syndrome. Your doctor may have you do an overnight sleep study if your problem is severely disturbing your sleep. This study is called a polysomnogram. It charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This study will help reveal if the imagined sounds are related to any other sleep disorder.

How is it treated?

If you notice exploding head symptoms while you are sleep deprived, then try to get more sleep every night. Most people need between six and eight hours of sleep per night.

If stress triggers exploding head symptoms, then you should consider some form of relaxation. This will help prevent stress and exploding head events. Stress relief could include short walks, reading before bed, yoga, or whatever works for you. Alcohol is a poor form of stress relief and causes sleep disruptions.

There is some evidence that the medicine clomipramine may help in treating exploding head symptoms. If you feel you need medications, then it is best to see a sleep specialist or your doctor.

Updated October 21, 2005

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