Do You Wake Up With A Bang? It Could Be “Exploding Head Syndrome”

Have you ever fallen asleep and then been jolted out of bed by the sound of a bomb exploding in your head? If so, you have probably experienced exploding head syndrome, a mysterious and poorly understood sleep disorder. Exploding head syndrome (EHS) belongs to a family of sleep disorders known as parasomnias. Other parasomnias include sleep paralysis and hypnotic jerks – the cause of the unpleasant feeling of falling that we sometimes experience when falling asleep.

EHS has been known to healthcare workers for at least 1876and apparently a French philosopher and scientist René Descartes I have experienced this. Despite this, we know surprisingly little about this condition.

A typical episode is characterized by the experience of a sudden noisy noise or a sense of explosion inside the head that occurs during the transition from wakefulness to sleep. Sounds heard during EHS are variableand include perceptions of gunshots, slamming doors, or unspecified screams. Importantly, the sounds that are heard are always brief (a few seconds or less), very noisy, and without any obvious external source in the environment.

Next to the sounds, some people experience accompanied by brief visual hallucinations, such as brilliant flashes. Others have also reported a feeling of intense heat or a sensation of an electric charge flowing through the upper body.

It is challenging to accurately estimate how many people experience EHS. One reason is simply the lack of available data. Only a few studies have attempted to examine the prevalence of EHS in the general population.

One early study found that 11% of healthy adults experienced EHS, while another test in undergraduate students, 17% of participants were found to have experienced multiple episodes in their lives. In my own, more recent study, also with undergraduate students, my colleagues and I found that one third in our sample experienced at least one episode of EHS in their lifetime, with approximately 6% experiencing at least one episode per month.

These studies show that EHS is a relatively common experience, at least in juvenile adults. However, it seems to be less common than other parasomnias, such as hypnotic jerks, which occur in 70% of people.

Triggers

The exact cause of EHS is unknown. While many theories have been put forward about the root cause of EHS, most popular implies natural brain processes that occur during the transition from wakefulness to sleep. On a typical night, as we transition from wakefulness to sleep, activity in the reticular structure of the brain is reduced.

This reticular formation is a set of brain structures located primarily in the brain stem and hypothalamus that acts as an “on-off” switch for the brain. As reticular activity slows in the transition to sleep, our sensory cortex, which controls vision, sound, and motor movement, begins turn off.

It has been proposed that the experience of EHS is caused by a disruption of this normal shutdown process, which results in a delayed and disjoint boost in neural activation in sensory networks in the absence of any external stimuli. These brief increases in activation are then perceived as the noisy, nonspecific sounds that characterize EHS.

Although the exact neural basis of EHS remains speculative, we are beginning to learn more about other factors that make an episode of EHS more likely. In one of the first studies to look at the factors involved, my colleagues and I discovered that well-being variables, such as life stress, were associated with experiencing EHS. This association was mediated by insomnia symptoms. In other words, life stress was not directly associated with EHS, but was indirectly associated by first disrupting normal sleep patterns.

Is EHS risky?

Despite its provocative name, EHS is harmless. However, it is significant to distinguish an episode of EHS from other conditions, in particular from various types of headaches. EHS episodes are very brief (a few seconds) and usually do not involve any pain. If there is pain, it is soft and transient. In contrast, many headaches last longer and involve much higher levels of pain.

This does not mean that EHS cannot be a terrifying experience. last examination Of the more than 3,000 participants who experienced EHS, we found that 45% of respondents reported moderate to severe levels of fear related to their EHS. A quarter of participants also reported high levels of stress in response to experiencing EHS, with increased levels of stress being associated with more habitual episodes.

Unfortunately, no systematic studies have been conducted to investigate potential treatments and coping strategies for people struggling with EHS-related distress. In our studyparticipants reported that changing sleeping position to avoid sleeping on their backs, adjusting sleep patterns, and using mindfulness techniques were effective strategies to prevent EHS. Whether any of these techniques will prove effective in clinical trials remains to be tested.

Encouragingly, just learning that EHS is a common and harmless condition can go a long way. patient case studyreassurance and education about the experience have been reported to prevent episodes from occurring. At least for now, the best advice seems to be to try to understand that these experiences are natural and do not indicate that anything is wrong. Elementary techniques, such as improving sleep habits, can go a long way toward preventing stressful episodes from occurring.