Exploding Head Syndrome is a rather fearsome but memorable title for the phenomenon of some people hearing loud bangs or crashes as they fall asleep.
Exploding Head Syndrome was first described by American doctor Silas Weir Mitchell in 1876. He described it as “sensory discharges’ during sleep. It was given its more lurid current name only as recently as 1989 when it was described again in more detail.
Typically people will hear the sound of an explosion or cymbals crashing as they fall asleep. Normally this is entirely pain free, despite the volume. More rarely it can be accompanied by flashes of light, a sensation of heat or tingling, or muscle jerks and twitches.
It’s actually a benign condition – it’s not the sign of some other disease or problem. Instead it’s what is called a parasomnia, an unwanted or unwelcome event that accompanies sleep. Like many other parasomnias (night terrors, sleep paralysis) it can be experienced regularly, in intermittent clusters, or even as a one-off incident.
Often though it wakes the person abruptly, and can leave them in a state of fright or panic. They may be in a cold sweat, having a racing heartbeat, or even feel a constriction in their chest that makes breathing feel difficult. This is what can make it such a disturbing and distressing experience for people.
And like many other parasomnias the cause of Exploding Head Syndrome, despite being recognized over 140 years ago, remains unclear. There does appear to be a link between it and stress and anxiety, particularly where that leads to sleep disturbance, and specifically people missing out on deep sleep.
It’s believed to be under-reported to doctors, and at the time of writing there’s no settled approach on drug treatment, with inconclusive results from antidepressants, anticonvulsants, and epilepsy treatments.
However, straightforward explanation and reassurance have been shown to reduce anxiety and so reduce the frequency of episodes. In addition, making sure that they have enough sleep, especially deep sleep, and managing their stress and anxiety are the best self-care for those affected.
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