Home » Sleep Disorders » Exploding Head Syndrome
November 2020 |  Reviewed by:  John Saito, MD and Rafael J. Sepulveda, MD

What is exploding head syndrome?

Exploding head syndrome is a rare parasomnia in which affected persons awaken from sleep with the sensation of a loud noise. A parasomnia involves undesired events that come along with sleep.

Exploding head syndrome has also been described in the following ways:

  • A painless loud bang
  • A clash of cymbals
  • A bomb exploding

Exploding head syndrome episodes can cause a high level of distress. A flash of light may come along with the sound. A muscle twitch or jerk may also occur. The event is normally painless. A sudden stab of pain in the head has at times been reported. Many people think that they are having a stroke. The number of attacks varies. They can happen very rarely. They can also occur many times in one night. Having many episodes can greatly disturb your sleep. Some people report having a cluster of attacks over several nights. Then a few weeks or months will pass before it occurs again.

The cause of exploding head syndrome is not known. It may occur more often when you are very tired or under stress. In many people, the episodes occur less often over a period of years.

Exploding head syndrome can be confused with headache syndromes. But unlike headaches, exploding head is normally a painless event without lingering pain.

What are symptoms of exploding head syndrome?

You may have exploding head syndrome if:

  • You awaken to a sudden loud noise or explosion in your head
  • These sounds are normally free of any sense of pain
  • These events wake you suddenly with a sense of fright

It is also important to know if there is something else that is causing the imagined sound. Instead of being exploding head syndrome, it may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

What are risk factors for exploding head syndrome?

It is not known how many people have exploding head syndrome. It may be more common in women than in men. It can begin at all ages. It has even been reported as early as less than 10 years of age. The average age when it first appears is 58 years.

How to diagnose exploding head syndrome?

You should see a sleep doctor if these awakenings cause you great anxiety or often disrupts your sleep.

The doctor will need to know when the events began. She will want to know how often they occur and how long they last. The doctor will need to know your complete medical history. Be sure to inform her of any past or present drug and medication use.

Tell your doctor if you have ever had any other sleep disorder. Find out if you have any family members with sleep problems. It will also be helpful if you fill out a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This data gives the doctor clues about what is causing your problem and how to correct it.

Tests are not normally needed for someone who has exploding head syndrome. Your doctor may have you do a sleep study if your problem is severely disturbing your sleep. This study is called polysomnography. It charts your brain waves, heartbeat, and breathing as you sleep. It also records how your arms and legs move. This study will help reveal if the events are related to any other sleep disorder.

How to treat exploding head syndrome?

If you notice exploding head syndrome symptoms while you are sleep deprived, getting more sleep every night can help alleviate the frequency of the events. Most people need 7 or more hours of sleep per night, although individual needs vary.

If stress triggers exploding head symptoms, you should consider using relaxation techniques to reduce stress. Stress relief could include short walks, reading before bed, yoga, or whatever works for you. Alcohol is a poor form of stress relief and causes sleep disruptions.

There is some evidence that the medicine clomipramine may help in treating exploding head syndrome symptoms. You can talk with your medical provider or sleep doctor about using this medication to treat exploding head syndrome.