Sleep and "Exploding Head" Syndrome

By Jane Farrell

“Exploding head syndrome” sounds like the latest slang term, but it’s a real, though underdiagnosed, sleep disorder.

People who have the syndrome usually hear loud noises – doors slamming, fireworks or gunshots – as they are going to sleep and waking up.

 “It’s a provocative and understudied phenomenon,” said Brian Sharpless, a Washington State University assistant professor and director of the university psychology clinic who recently reviewed the scientific literature on the disorder for the journal Sleep Medicine Reviews. “I’ve worked with some individuals who have it seven times a night. Some people start to become anxious when they go into their bedroom or when they try to go to sleep. Daytime sleepiness can be another problem.”

Patients can have mild pain; some people hear an explosion in one ear, others in both ears and some within their head. Additionally, patients may see what Some patients report mild pain. Some hear an explosion in one ear, others in both ears and yet others within their heads. Some also see what looks like lightning or bright flashes.

Researchers do not know how widespread the problem is, but Sharpless is fielding enough reports of people with the disorder that he thinks it is more widespread than presumed.

The term “exploding head syndrome” dates to a 1988 article in the British journal Lancet, but it was described clinically as “snapping of the brain” in 1920.

Experts still aren’t sure exactly what happens to cause the disorder, but they have some theories.  “In layman’s terms, our best guess is that it occurs when the body doesn’t shut down for sleep in the correct sequence,” said Sharpless. “Instead of shutting down, certain groups of neurons actually get activated and have us perceive the bursts of noise. Behavioral and psychological factors come into play as well, and if you have normally disrupted sleep, the episodes will be more likely to occur.”

Sharpless said the syndrome seems to be more common in women than men.

As of now, there are no treatments, though Sharpless said one possible remedy is assuring the patient that the syndrome isn’t a dangerous condition.