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Sleep Health

Exploding Head Syndrome Is Real: Here’s What To Do if You Have It 

As I was falling asleep the other night, I heard an enormous crash. When I sat up, startled, the sound faded — it wasn’t real. A few weeks before that, just as I laid my head on my pillow, I heard a woman scream at the top of her lungs. And a month earlier, I woke up to the sound of a brass band blasting through my bedroom. These noises all sounded very real, flooding my head for a second or two before I opened my eyes. Curious, I looked up the phenomenon online and found out I may have something called “exploding head syndrome.”

What is exploding head syndrome? 

“Exploding head syndrome is the distressing sensation of hearing or feeling an explosion or very loud sound,” says Elisabeth James, PhD, clinical instructor at The University of Toledo College of Medicine and Life Sciences, and board-certified psychologist specializing in behavioral sleep medicine with The University of Toledo Physicians group. “People can experience it while falling asleep, waking up, or sometimes during sleep.” 

According to Yalda Safai, MD, MPH, and board-certified psychiatrist, the term is rather colloquial. “Exploding head syndrome is not exactly an official clinical term,” she tells First for Women. “It is medically referred to as episodic cranial sensory shock. It is a type of sleep disorder which is characterized by the perception of a loud sound while asleep that usually lasts a second.” 

Dr. James adds that researchers have been documenting the phenomenon for centuries. “Exploding head syndrome was identified centuries ago by description and is presently classified as a sleep disorder, specifically as ‘parasomnia,’ which is a category that includes a variety of behaviors and experiences, such as sleepwalking or having nightmares, that occur during sleep, or while one is falling asleep or waking up,” she says.  

What do people with exploding head syndrome usually hear? 

Sounds vary from person to person with this condition — as you can tell by the strange noises I’ve heard! However, Dr. Safai points out that some sounds are very common, including explosions, gunshots, and thunder. 

“It can be frightening because of the nature of the ‘sound,’ which has been described as a gunshot, cymbals clashing, or explosion such as a bomb going off,” adds James. “It also can be upsetting because of the feeling that it is occurring as a sensation in one’s own head, and of course, that would be a very unusual and frightening experience.”  

As for other symptoms, there aren’t many at all. “Exploding head syndrome is not accompanied by pain or headache, but it can make it hard to go back to sleep or even create some fear of sleeping if it occurs frequently,” James says.  

What causes exploding head syndrome? 

At this point, members of the scientific community can only theorize the causes of exploding head syndrome. “This is usually a benign phenomenon,” says Safai. “The exact cause remains unclear. However emotional stress or anxiety may contribute to the condition. To date, nothing has been proven in the literature regarding its cause.” 

The condition isn’t serious, either. “It is not known to be a dangerous condition, but it can set off concerns about sleeping,” says James. “It can be a bit of a signal to the individual that they may need to sleep on a more regular schedule or get more sleep … In those who experience exploding head syndrome, it may be one time only in their entire lives. Or there may be a cluster, such as every night for a week, or maybe once every few years.”  

What should you do if you have exploding head syndrome?  

Depending on how much you are affected by exploding head syndrome, there may be very little to do. “While this is benign and should not be cause for panic, it does create distress and fear,” Safai says. “New research has been focusing on using transcranial magnetic stimulation (TMS) which has shown some promise. However, there are no empirically supported interventions yet, and little is known about prevention strategies.” 

If you suspect that you have exploding head syndrome, a practical first step is to speak with your doctor. According to James, “Someone who experiences the sensation of a loud sound should contact their primary care physician and describe the symptom.” James says that a doctor will likely schedule a routine appointment and ask about sleep habits and recent lifestyle changes. A doctor may take further action if you have other medical issues, such as headaches or neurological problems.  

For right now, you might want to keep track of your episodes and how you’re sleeping. “Pay attention to how much sleep you are getting and the sleep environment,” James says. “Do not use sleep aides, such as over-the-counter medications, without having a discussion with your health provider and a plan for their use, including how long you’ll use them.”  

While I’ve never had a proper diagnosis and haven’t had an episode in the past few weeks, I’ll certainly keep a sleep diary from now on! I’ll also focus on getting to sleep earlier and improving my sleep quality in different ways, from strength training to wearing socks to bed.  

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