Decoding Exploding Head Syndrome


It is quite normal to hear the phrase “My head is exploding” when someone is talking about a bad headache. But, did you know ‘Exploding Head Syndrome’ is a real thing?

Exploding Head Syndrome, also called Head Blast Syndrome, is a rare, under-diagnosed parasomnia in which, the affected person awakens from sleep with the sensation of loud noise. A parasomnia involves undesired events while being asleep.

Some of the most common symptoms observed in exploding head Syndrome is a painless loud bang, a clash of cymbals, a bomb exploding in the head, etc.,  which can cause a high level of distress to the individual. In a few cases, a flash of light may appear with the sound or a muscle twitch or jerk may also occur.

Though these events may be painless, a sudden stab of pain in the head has always been reported. Infact, most people presume the pain in the head to be a head stroke. The timing of the attacks in Exploding Head Syndrome may vary but and usually tend to occur at night. Due to this, these episodes alter the individual’s sleep pattern and may be accompanied by a cluster of attacks at several nights. It is also common to see a few weeks or months pass before these attacks recur.

The cause of exploding head Syndrome is unknown but it may occur mostly due to stress or being excessively tired. In many people, such episodes occur less often over a period of years.


Signs, Symptoms and Risk Factors to Watch Out For

Image source: Cleveland Clinic

Due to overlapping symptoms, Exploding Head Syndrome can be confused with headache syndromes and migraine. However, waking up in the night due to a sudden loud noise or an explosion in the head and hearing these sounds without any kind of pain are two of the most commonly observed events in people with Exploding Head Syndrome. Other additional symptoms of this condition include:

  • Tachycardia
  • Fear or distress
  • Twitching of muscles

It’s unknown how many people have or are suffering from Exploding Head Syndrome. It has been found to be more common in women than in men and can begin or occur at any age. Though the average age when it first appears is around 58 years, it has even been reported as early as less than 10 years of age.

Differential diagnoses of Exploding Head Syndrome include:

  • Sleep disorders
  • Secondary to a medical condition
  • Medication use
  • Mental health disorder
  • Substance abuse


How is Exploding Head Syndrome Diagnosed?

In most cases, a patient visits their doctor with symptoms of anxiety or sleeplessness when they are suffering from Exploding Head Syndrome. For any medical practitioner, diagnosing a case of Exploding Head Syndrome can be challenging. The diagnosis usually begins with a thorough medical history of the patient, followed by the history of events that may have led to the triggering factors. A complete history of the medications that a patient is taking or has taken is essential in the diagnosis to rule out side effects of medication and/or overdose or abuse of these medications, which may be causing the symptoms.

Other interventions that may be prescribed to patients with suspected Exploding Head Syndrome include maintaining a sleep journal or diary where they are required to document any dreams they had, hours of sleep, quality of sleep, etc., for two to three weeks. Polysomnography (sleep analysis) may be performed if a sleep disorder is suspected.


How is Exploding Head Syndrome Treated?

The treatment for Exploding Head Syndrome depends upon the trigger or causative factor.

  • Improving sleep quality and duration

If the cause of a patient’s Exploding Head Syndrome is lack of sleep, their symptoms can be alleviated by getting a minimum of 7-8 hours of sleep every day.

  • Stress-busting

If the patient’s condition is triggered by factors like stress, they are usually recommended to use relaxation techniques like yoga, meditation, mindfulness, short walks, reading before bed, listening to soothing music, etc. Patients are also advised to avoid alcohol as it is known to cause sleep disruptions.

  • Medication

In some patients, medications like Clomipramine, a tricyclic anti-depressant, may help in treating Exploding Head Syndrome.

Key Takeaway!

Though most patients get scared hearing the name of the condition, Exploding Head Syndrome is not a serious or life-threatening condition. It is also natural for patients with the condition to fear the condition, especially after having experienced initial symptoms. For healthcare professionals, understanding this rare condition is important while treating the patient for other conditions.


Featured image source: Pexels
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About the author

Dr.Nikita Pawar is a General Practitioner by profession and has completed her (MBBS PGDCR). She has previously worked in GMC Hospital Dubai & is currently attached to a hospital, corporate company and Clinics in Mumbai. She is passionate about medical article writing and always strives to maintain commitment towards achieving professional growth as she transitions from one phase of her career to the next.



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