Despite its dramatic name, exploding head syndrome isn’t a painful or dangerous condition, and it can be managed.
Sleep disorders can be disruptive in general, but exploding head syndrome can be frightening for those who experience it.
Symptoms of this condition include hearing very loud noises in your head as you transition in or out of sleep. This is why, although not painful, exploding head syndrome can be distressing and alarming.
Not everyone describes these noises in the same way. Some people say the sound is like crashing cymbals, while others may say it sounds more like a lightning strike or fireworks going off.
It’s possible to reduce the likelihood of an episode, although there’s no formal treatment for the condition.
No. Exploding head syndrome, also known as episodic cranial sensory shock, isn’t considered a mental health illness. It’s a sleep disorder.
Specifically, the condition is a type of parasomnia — that’s any condition that involves undesirable or involuntary physical events during the sleep cycle. Sleepwalking and sleep talking, for example, are two common parasomnias.
In exploding head syndrome, the undesirable event is an extremely loud noise you perceive in your head that happens while falling asleep or waking up.
The noise can resemble an explosion, gunshot, lightning strike, or any similar exploding sound.
Loud noises can sometimes be accompanied by other sensations like a flash of light or a feeling of being electrically shocked.
An episode of exploding head syndrome usually lasts a few seconds, but it can be a frightening and draining experience that could lead to symptoms of anxiety, including panic attacks.
Exploding head syndrome isn’t a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). However, this reference handbook for mental health professionals does recognize non-specified parasomnias under sleep-wake disorders.
The International Classification of Sleep Disorders, 3rd edition (ICSD-3) includes the condition under “other parasomnias.”
Five events are typically considered when reaching a diagnosis of exploding head syndrome:
- hearing a short, sudden, and loud sound when falling asleep or waking up
- experiencing muscle spasms or electric-like sensations at the same time the noise is heard
- waking up with rapid heart rate or difficulty breathing
- experiencing intense fear or agitation after the event
- not feeling significant pain
Episodes of exploding head syndrome usually come without warning, which makes them hard to predict.
You can go without experiencing episodes for a long time, and often, the condition resolves on its own.
Primary health professionals, neurologists, and sleep medicine doctors can diagnose exploding head syndrome, based on your description of the symptoms. There are no diagnostic tests available for this condition.
The causes of exploding head syndrome aren’t yet established, and research on the condition is limited.
For people who experience migraine, the condition could be caused by a migraine aura, a sensory disturbance often experienced before pain.
It’s also possible that the loud noises are a side effect of stopping some medications for depression and anxiety.
Exploding head syndrome is more common in people who’ve received a sleep paralysis diagnosis. A history of insomnia, or increased stress, may also make it more likely to experience an episode of this condition.
Because exploding head syndrome is such a rare condition and episodes are hard to predict, there are no formal treatment guidelines.
If an underlying condition such as sleep paralysis or chronic migraine is suspected as the cause, addressing that condition directly could also bring some relief.
If these strategies don’t offer the expected results, anecdotal reports indicate that some health professionals may also include the
- Clomipramine: a tricyclic antidepressant typically used to treat obsessive-compulsive disorder (OCD)
- Amitriptyline: another tricyclic antidepressant used to treat major depressive disorder
- Topiramate: an anticonvulsant prescribed to treat seizures
- Duloxetine hydrochloride: an antidepressant
- Nifedipine: an antihypertensive drug used to treat high blood pressure
More research is needed to determine whether sTMS could be a treatment option for all people experiencing symptoms of exploding head syndrome.
Exploding head syndrome is a benign sleep disorder that involves hearing loud noises in your head as you fall asleep or wake up.
There are no formal tests or treatments for the condition, but learning that it isn’t life threatening or painful may help reduce the likelihood an episode repeats.
Addressing possible underlying conditions, such as other sleep disorders, may also help treat symptoms of exploding head syndrome.