Why We Sleep

Feel Like Your Brain Exploding? Exploding Head Syndrome

Feel Like Your Brain Exploding? Exploding Head Syndrome

Exploding Head Syndrome (EHS) is a relatively uncommon but distressing sleep disorder that affects individuals during the transitional stages of sleep. It is characterized by a loud noise or explosion in the head that is not actually occurring, which can cause anxiety and distress. Although EHS is not life-threatening, it can have a significant impact on a person's quality of life, making it important to understand its symptoms and causes.

Brief history of EHS

In 1988, JMS Pearce, a British neurologist, first coined the term Exploding Head Syndrome, describing it as a rare auditory hallucination. However, it was not until 2005 that EHS was officially recognized as a sleep disorder when it was included in the International Classification of Sleep Disorders (ICSD). Despite being recognized as a sleep disorder, limited research has been conducted on EHS, and much about the condition remains unknown. However, studies suggest that EHS is more prevalent than previously thought and may affect up to 10% of the population.

Symptoms of Exploding Head Syndrome

The hallmark symptom of EHS is a loud, explosive noise that seems to originate within the head but is not actually occurring in reality. The sound is often compared to a gunshot, thunderclap, or fireworks and may be accompanied by a flash of light. These episodes can be disturbing and distressing, causing anxiety and disorientation. EHS typically occurs during the hypnagogic or hypnopompic stages of sleep, and it can happen once or multiple times per night, either sporadically or on a chronic basis. Along with the auditory hallucinations, some individuals with EHS may also experience hypnagogic or hypnopompic hallucinations that involve seeing people or objects that are not present, feeling as though they are floating, or experiencing a sense of dread or fear. Anxiety and sleep difficulties are also common in individuals with EHS.

Causes of Exploding Head Syndrome

The exact causes of EHS are still unknown, but there are several factors that may contribute to its development. These include:

  • Lack of sleep or disrupted sleep patterns: EHS may have a higher risk of occurrence in individuals with insufficient sleep or disrupted sleep patterns, including irregular sleep schedules and sleep deprivation. Additionally, episodes of EHS may become more frequent during stressful periods or when an individual is experiencing anxiety.
  • Side effect of medication: Although it is rare and typically affects individuals who are already susceptible to the condition, certain medications like antidepressants may heighten the likelihood of EHS.
  • Brain chemistry imbalances: The occurrence of EHS may be associated with imbalances in neurotransmitters, which are responsible for regulating various functions in the brain, including sleep.

Diagnosing Exploding Head Syndrome

To diagnose EHS, the initial step is to seek an appointment with a healthcare provider who has expertise in diagnosing sleep disorders to identify the condition and establish a treatment plan that targets the root causes and alleviates symptoms. During this assessment, the healthcare provider will conduct a comprehensive evaluation of the patient's medical history, sleep habits, and symptoms. This may involve inquiring about the frequency and intensity of EHS occurrences, current medication usage, and any other medical conditions that may be contributing to their symptoms.

After collecting the necessary information, the healthcare professional may suggest a sleep study test for the patient. This test requires spending a night at a sleep laboratory, where specialists will observe the patient's brain waves, eye movements, and other physiological indicators to detect any underlying sleep disorders or neurological conditions. Additionally, other diagnostic tests like an MRI or CT scan may be recommended in some cases to eliminate any underlying neurological disorders that could be responsible for the patient's symptoms.

Treatment Options for Exploding Head Syndrome

After an EHS diagnosis, healthcare professionals will collaborate with the patient to devise a treatment plan that tackles the root causes of their symptoms and minimizes their effect on their daily life. Some typical EHS treatment options include:

1. Address underlying sleep issues and ensure sufficient sleep

This may entail making modifications to the patient's sleep environment, such as using earplugs or a white noise machine, or practicing good sleep hygiene, such as adhering to a consistent sleep schedule and avoiding stimulating activities before bedtime.

2. Stress-reducing techniques such as meditation, yoga, or therapy

These techniques help patients learn to manage their stress levels and reduce anxiety, which can reduce the frequency and severity of EHS episodes.

3. Discontinuing medication that may be causing the condition

If a patient's EHS symptoms are caused by a medication they are taking, healthcare professionals may recommend discontinuing or reducing the dosage of the medication. This should only be done under the guidance of a healthcare professional, as abruptly discontinuing certain medications can have serious side effects.

4. Medication to address imbalanced brain chemistry

In some cases, healthcare professionals may prescribe medication to address imbalances in neurotransmitters, the chemicals in the brain that regulate sleep and other functions. These medications can help reduce the frequency and severity of EHS episodes, but should only be used under the guidance of a healthcare professional.

Coping Mechanisms for Dealing with Exploding Head Syndrome

There are various coping mechanisms that individuals with EHS can adopt to minimize the impact of their symptoms and improve their overall quality of life, in addition to medical treatment.

1. Relaxation techniques such as deep breathing or progressive muscle relaxation

To alleviate stress and anxiety and induce relaxation, deep breathing and progressive muscle relaxation techniques can be employed. These techniques involve slowly inhaling and exhaling while concentrating on relaxing specific muscle groups in the body.

2. Creating a consistent sleep routine

Consistency in sleep routine is a vital coping mechanism for people with Exploding Head Syndrome (EHS). Maintaining a regular sleep schedule can regulate the body's natural sleep-wake cycle, thereby reducing the frequency and severity of EHS episodes. Individuals with EHS are advised to adhere to a fixed sleep schedule by sleeping and waking up at the same time every day, including weekends, and avoiding daytime naps. Additionally, creating a calming bedtime routine, such as reading or taking a warm bath, can help prepare the body and mind for sleep. Establishing a consistent sleep routine can improve the overall quality of sleep and minimize the impact of EHS symptoms


Exploding Head Syndrome (EHS) is a condition characterized by loud noises or explosions in the head that are not actually occurring. It often occurs during periods of disrupted sleep and can be triggered by stress, anxiety, and certain medications. While EHS can be distressing, it is important to remember that the condition is not life-threatening and there are various treatment options available. Seeking help from a healthcare professional and addressing underlying sleep issues, reducing stress, and discontinuing medication can all help manage symptoms. Additionally, creating a consistent sleep routine and practicing relaxation techniques can also be helpful coping mechanisms. If you are experiencing symptoms of EHS, it is important to seek help and support from a healthcare professional or support group. Remember, EHS is a manageable condition, and with the right treatment and support, individuals can improve their quality of life and reduce the impact of their symptoms.

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