Exploding head syndrome
Encyclopedia
Exploding head syndrome is a parasomnia
condition
that causes the sufferer occasionally to experience a tremendously loud noise as originating from within his or her own head
, usually described as the sound of an explosion
, roar, gunshot, loud voices or screams, a ringing noise, or the sound of electrical arcing (buzzing).
This noise usually occurs within an hour or two of falling asleep, but is not necessarily the result of a dream
and can happen while awake as well. While the sound is perceived as extremely loud, it is usually not accompanied by pain. Attacks appear to change in number over time, with several attacks occurring in a space of days or weeks followed by months of remission. Sufferers often feel a sense of fear
and anxiety
after an attack, accompanied by elevated heart
rate. Attacks are also often accompanied by perceived flashes of light (when perceived on their own, known as a "visual sleep start") or difficulty in breathing. The condition is also known as "auditory sleep starts". It is not thought to be dangerous, although it is sometimes distressing to experience. Sufferers may experience an inability to vocalize any sound, or mild forms of sleep paralysis
during an attack.
or extreme fatigue
. The condition may develop at any time during life and women suffer from it slightly more often than men. It is more common over the age of fifty, although it has been reported as young as age 10. Attacks can be one-time events, or can recur with attacks increasing or decreasing over time, sometimes with no incidents over long periods of time.
The mechanism is also not known, though possibilities have been suggested; one is that it may be the result of a sudden movement of a middle ear
component or of the eustachian tube
, another is that it may be the result of a form of minor seizure
in the temporal lobe
where the nerve
cells for hearing are located. Electroencephalograms recorded during actual attacks show unusual activity only in some sufferers, and have ruled out epileptic seizures
as a cause. But an attack must happen during an episode. If results are normal during the test, only then can epilepsy
be completely ruled out.
SSRI withdrawals have also been known to cause similar phenomena (i.e. brain zaps).
s. In surveys, as many as 85% of respondents indicate perception of them during the onset of such experiences.
. He characterized this condition as an exploding sensation in the head. Patients were awakened from their sleep by this event and the sensation persisted for several seconds. A detailed description of the syndrome was given by British neurologist John M. S. Pearce in 1989, who noted that it was most common in patients that were more than 50 years old.
Exploding head syndrome is a condition that causes the sufferer to occasionally experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, a ringing noise, the terrific bang on a tin tray, or the sound of an electrical arcing (buzzing). In some cases an instant flash of what is perceived as video "static" is reported.
This syndrome can also cause the sufferer to feel an extreme rush or adrenaline kick going through his or her head, sometimes multiple times. In most cases, it occurs when they are in a state between asleep and awake. Some sufferers report familiarization with the subsequent fear or panic element such that they no longer consciously experience it.
In some cases repeated attacks lead to the sufferer gaining a fear of sleeping or resting, as this is the most common time for attacks to take place, and this can lead to the development of sleeping disorders such as insomnia.
In some cases it is isolated on the left side of the head, and seems to come from the inner ear region.
has been used in three patients, who experienced immediate relief from this condition.
Parasomnia
For the 2008 horror film, see Parasomnia Parasomnias are a category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep...
condition
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
that causes the sufferer occasionally to experience a tremendously loud noise as originating from within his or her own head
Human head
In human anatomy, the head is the upper portion of the human body. It supports the face and is maintained by the skull, which itself encloses the brain.-Cultural importance:...
, usually described as the sound of an explosion
Explosion
An explosion is a rapid increase in volume and release of energy in an extreme manner, usually with the generation of high temperatures and the release of gases. An explosion creates a shock wave. If the shock wave is a supersonic detonation, then the source of the blast is called a "high explosive"...
, roar, gunshot, loud voices or screams, a ringing noise, or the sound of electrical arcing (buzzing).
This noise usually occurs within an hour or two of falling asleep, but is not necessarily the result of a dream
Dream
Dreams are successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep. The content and purpose of dreams are not definitively understood, though they have been a topic of scientific speculation, philosophical intrigue and religious...
and can happen while awake as well. While the sound is perceived as extremely loud, it is usually not accompanied by pain. Attacks appear to change in number over time, with several attacks occurring in a space of days or weeks followed by months of remission. Sufferers often feel a sense of fear
Fear
Fear is a distressing negative sensation induced by a perceived threat. It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of danger...
and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
after an attack, accompanied by elevated heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
rate. Attacks are also often accompanied by perceived flashes of light (when perceived on their own, known as a "visual sleep start") or difficulty in breathing. The condition is also known as "auditory sleep starts". It is not thought to be dangerous, although it is sometimes distressing to experience. Sufferers may experience an inability to vocalize any sound, or mild forms of sleep paralysis
Sleep paralysis
Sleep paralysis is paralysis associated with sleep that may occur in healthy persons or may be associated with narcolepsy, cataplexy, and hypnagogic hallucinations. The pathophysiology of this condition is closely related to the normal hypotonia that occurs during REM sleep. When considered to be a...
during an attack.
Causes
The cause of the exploding head syndrome (EHS) is not known, though some physicians have reported a correlation with stressStress (medicine)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...
or extreme fatigue
Fatigue (physical)
Fatigue is a state of awareness describing a range of afflictions, usually associated with physical and/or mental weakness, though varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles...
. The condition may develop at any time during life and women suffer from it slightly more often than men. It is more common over the age of fifty, although it has been reported as young as age 10. Attacks can be one-time events, or can recur with attacks increasing or decreasing over time, sometimes with no incidents over long periods of time.
The mechanism is also not known, though possibilities have been suggested; one is that it may be the result of a sudden movement of a middle ear
Middle ear
The middle ear is the portion of the ear internal to the eardrum, and external to the oval window of the cochlea. The mammalian middle ear contains three ossicles, which couple vibration of the eardrum into waves in the fluid and membranes of the inner ear. The hollow space of the middle ear has...
component or of the eustachian tube
Eustachian tube
The Eustachian tube is a tube that links the nasopharynx to the middle ear. It is a part of the middle ear. In adult humans the Eustachian tube is approximately 35 mm long. It is named after the sixteenth-century anatomist Bartolomeo Eustachi...
, another is that it may be the result of a form of minor seizure
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
in the temporal lobe
Temporal lobe
The temporal lobe is a region of the cerebral cortex that is located beneath the Sylvian fissure on both cerebral hemispheres of the mammalian brain....
where the nerve
Nerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
cells for hearing are located. Electroencephalograms recorded during actual attacks show unusual activity only in some sufferers, and have ruled out epileptic seizures
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
as a cause. But an attack must happen during an episode. If results are normal during the test, only then can epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
be completely ruled out.
SSRI withdrawals have also been known to cause similar phenomena (i.e. brain zaps).
Related phenomena
These loud noises are a common feature of out-of-body experienceOut-of-body experience
An out-of-body experience is an experience that typically involves a sensation of floating outside of one's body and, in some cases, perceiving one's physical body from a place outside one's body ....
s. In surveys, as many as 85% of respondents indicate perception of them during the onset of such experiences.
Symptoms
The exploding head syndrome was first described in 1920 by the Welsh physician and psychiatrist Robert Armstrong-JonesRobert Armstrong-Jones
Sir Robert Armstrong-Jones, CBE was a Welsh physician and psychiatrist. He was the grandfather of the Earl of Snowdon.He was born Robert Jones in Ynyscynhaearn, Caernarvonshire, the son of a Congregational minister...
. He characterized this condition as an exploding sensation in the head. Patients were awakened from their sleep by this event and the sensation persisted for several seconds. A detailed description of the syndrome was given by British neurologist John M. S. Pearce in 1989, who noted that it was most common in patients that were more than 50 years old.
Exploding head syndrome is a condition that causes the sufferer to occasionally experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, a ringing noise, the terrific bang on a tin tray, or the sound of an electrical arcing (buzzing). In some cases an instant flash of what is perceived as video "static" is reported.
This syndrome can also cause the sufferer to feel an extreme rush or adrenaline kick going through his or her head, sometimes multiple times. In most cases, it occurs when they are in a state between asleep and awake. Some sufferers report familiarization with the subsequent fear or panic element such that they no longer consciously experience it.
In some cases repeated attacks lead to the sufferer gaining a fear of sleeping or resting, as this is the most common time for attacks to take place, and this can lead to the development of sleeping disorders such as insomnia.
In some cases it is isolated on the left side of the head, and seems to come from the inner ear region.
Treatment
Symptoms may be resolved spontaneously over time. It may be helpful to reassure the patient that this symptom is harmless. ClomipramineClomipramine
Clomipramine is a tricyclic antidepressant . It was developed in the 1960s by the Swiss drug manufacturer Geigy and has been in clinical use worldwide ever since.- Indications :...
has been used in three patients, who experienced immediate relief from this condition.
External links
- American Academy of Sleep Medicine article on the syndrome.
- American Sleep Association article on the syndrome.
- Loud crash at 3 a.m.? It may be your exploding head, MSNBC, February 17, 2010 by Diane Mapes, contributing writer.