Health Talk: Exploding head syndrome

Try and imagine this peculiar scenario — you are laying in your bed, about to fall asleep after a long day, when suddenly you are jolted awake by a bright flash of light and the intense sound of a cannon shooting right in your own room. Puzzled and shocked, with your heart racing, you look around anxiously for the source of the noise only to realize that there was no cannon, and that it had originated from within your own head.

This is typical of the strange disorder known as exploding head syndrome, a condition that causes a person to hear an incomprehensibly loud noise that is merely a vivid auditory hallucination.
However, unlike the name suggests, heads do not actually explode, and it does not usually cause the sufferer any physical harm. In some cases, however, a sharp stabbing pain can accompany the sound. The sound varies between people with this condition, having been described as a loud explosion, waves crashing, people screaming, or a loud ringing, among others.

People with exploding head syndrome usually report hearing the noises one or two hours after going to sleep. However, these sounds can also happen when waking up from a deep sleep, and during the day when the sufferer is wide awake. This shows that exploding head syndrome is not a sleep disorder. Many people who hear the noises have associated them with certain scenarios, as these hallucinations sound so real: The noises sound like a train is going through the room, a car is crashing outside, or someone is firing a gun next to their head.

Although these hallucinations are thought to be harmless, a person who has heard the noise will develop anxiety and an accelerated heartbeat. Sudden, unexplained, and extremely loud noises would cause any person to be shaken; however, personal accounts reveal that sometimes the related anxiety is not due to the sound itself, but rather is a physical reaction that may happen some time after the noise. Hearing the sound may actually feel as if a pressure were being relieved from inside the head. Along with the bright flash of light that is known to accompany the noises, muscle twitches and breathing difficulty are also associated with the noise.

Although exploding head syndrome may not cause adverse physical effects, it may lead to the sufferer being unable to sleep due to a fear of hearing the noise or experiencing the other symptoms. This may lead to other sleep disorders, such as insomnia. On the other hand, in some cases, the sufferer may actually become accustomed to the noise, and will no longer experience the anxiety and fear that usually develops after hearing the loud noises.

Currently, there is no known reason for the causes of these sounds. Some researchers have linked the syndrome to stress and sleep deprivation, as these are common among sufferers. Another explanation is a small seizure in the temporal lobe, which is a part of the brain that contains the cells responsible for hearing. A physical reason has also been proposed, explaining that a component of the middle ear or of the Eustachian tube may suddenly move. The Eustachian tube is responsible for the “popping” in the ear during pressure changes, like when one swallows during the descent of an airplane.

Currently, tests are being done on people who suffer from exploding head syndrome. These may lead to insights on the phenomenon, as well as how the brain interprets noises. No pattern of occurrence can be discerned for exploding head syndrome, as its frequency may decrease or increase over time. Some report hearing a series of noises over the course of a few days before stopping completely, but then the noises will return a few months later. Some people experience exploding head syndrome only once in their lifetimes; for others, it is a recurring event that they gradually learn to control. However, a few general trends have been observed; for example, women experience exploding head syndrome more than men, and people over the age of 50 are more likely to have exploding head syndrome, although it has been reported in patients as young as 10.

Reducing the frequency of exploding head syndrome symptoms can be done indirectly, through stress management. In addition, time management has been shown to help, as it enables sufferers to sleep more, lessening their sleep deprivation. It has been reported that doing stress-relieving activities before sleeping can reduce the occurrence of hearing noises. These include yoga, meditation, hot baths, and walking. In some cases, clomipramine, a drug clinically shown to treat depression, has been shown to help the patients.