Exploding Head Syndrome (EHS)
Exploding head syndrome alternately termed episodically
cranial sensory shock is a benign condition in which a
person hears loud "imagined" noises(such as a bomb
exploding, a gunshot or a cymbal crash) or experiences an
explosive feeling when falling asleep or waking up.
These noises have a sudden onset, are typically brief in duration, and are often herring for the person. Neither the cause nor the mechanism is known. Though harmless in and of themselves, episodes have been known to create distress or impairment in the lives of individuals.
A small percentage of people experience a loud popping sound just before drifting into deep sleep, or when coming out of one. The sound resembles a gunshot, the sound of an explosion, or any loud disturbing sound that originates in the head or the ears. The sound generally lasts for only a few seconds.
Classification:
Exploding head syndrome is classified as a parasomnia and a sleep-related dissociative disorder by the 2005 international classification of sleep disorders and is an unusual type of auditory hallucination in that it occurs in people who are not fully awake.
Symptoms:
Individuals with exploding head syndrome hear or experience loud imagined noises as they are falling asleep or waking up have a strong, often frightened emotional reaction to the sound, and do not report significant pain, around 10% of people also experience visual disturbances like perceiving visual static, lightning, or flashes of light. Some people may also experience heat, strange feelings in their torso, or a feeling of electrical tinglings that ascends to the head before the auditory hallucinations occur. With the heightened arousal, people experience distress, confusion, myoclonic jerks, tachycardia, sweating, and the sensation that feels as of they have stopped breathing and have to make a deliberate effort to breathe again. The pattern of the auditory hallucinations is variable. Some people report having a total of two or four attacks followed by a prolonged or total remission, having attacks over the course of a few weeks or months before the attacks spontaneously disappear, or the attacks may even recur irregular every few days, weeks or months for much of a lifetime.
Sometimes individuals believe that EHS episodes are not natural events, but are the effects of directed energy weapons which create an auditory effect. Thus, EHS has been worked into conspiracy theories, but there is no scientific evidence that EHS has non-natural origins.
Although the condition is benign, patients suffering from EHS experience the fear of the recurrence of loud sounds, and breathing difficulty. Patients suffering migraine are prone to increased episodes of a migraine due to the stress and fear of the recurrence of loud sounds, the unique characteristic of EHS that distinguishes it from other sleep disorders is that it does not trigger headaches, pain, or rupture of internal organs.
Epidemiology:
There have not been sufficiently conducted to make conclusive statements about prevalence nor who tends to suffer EHS. One study found that 13.5% of a sample of undergrads reported at least one episodes over the course of their lives, with higher rates in those also suffering from sleep paralysis.
History:
Case reports of EHS have been published since at least 1876, which Silas Weir Mitchell described as "sensory discharges" in a patient. The phrase "snapping the brain" was coined in 1920 by the British Physician and psychiatrist Robert Armstrong- Jones. A detailed description of the syndrome and the name "exploding head syndrome" was given by British neurologist Jhos M.S Pearce in 1989. More recently, Peter Goadsby and Brain Sharpless have proposed renaming EHS"Episodic cranial sensory shock" as it describes the symptoms more accurately(including the non-auditory elements) and better attributes to Mitchell.
Diagnosis of Exploding Head Syndrome:
The diagnosis if EHS varies from migraines, different types of nocturnal headache conditions(eg, cluster, hypnic, thunderclap), startled sleep, and nightmares. Obstruction sleep apnea is another diagnosis of EHS. The disturbing sounds occur in individuals during the stage of non- rapid eye movement sleep(non-REM), when individuals are in transition from wakefulness to deep sleep or vice versa. A research study also observed that such attacks occurred soon after snoring.
Individuals who suffer from EHS episodes should maintain a diary of their sleep patterns. This enables the doctor to understand the frequency of occurrence of the episodes. The doctor may also reduce the effect of other syndrome based on the pattern of the frequency of occurrence. Doctors tend to perform an overnight sleep study or Polysomnogram of an individual who is affected by frequent episodes of EHS and is unable to sleep. The polysomnogram records heartbeat, breathing rate, movement of limbs (arms, legs), and brain signals to confirm the condition as EHS or the result of another disorder.
Some palliative procedures to reduce the frequency of EHS:
Healthy, balanced diet:
Individuals are encouraged to eat a well- balanced diet. Vegetables and fruits provide a rich source of minerals and vitamins that aid in relieving stress. This leads to a restful night.
Reassurance:
A patient suffering from EHS should be reassured that the condition is not serious and physically debilitating. This is the best and often most reliable procedure to reduce a patient's anxiety related to EHS.
Relaxation:
Individuals are encouraged to relax in order to reduce the frequency of occurrence of EHS. Relaxing also reduces stress and anxiety that set in due to EHS.
Minimum of 6 hours of sleep:
It is a good idea to obtain a minimum of 6 hours fo sleep during the night. Individuals, who sleep for less than 6 hours, suffer from sleep-related disorders or myoclonus.
Minimize Stress:
Individuals are faced with different forms of stress every day. Hence, it is preferable to keep aside time for leisure activities such as relaxing with family and friends, spending some recreation time(eg, taking a walk, reading, listening to music, yoga, etc) before going to sleep. The body is thus relieved of stress and is relaxed before falling asleep.
Relax:
This is a benign condition while no one likes being startled out of sleep, exploding head syndrome is not a symptom of a more serious condition.
Reduce stress:
Stress and worry affect sleep and may contribute to exploding head syndrome. While no one can get rid of all stress in life, encourages people to work toward a more balanced life. Separate work and daily stress from sleep by setting aside time to read, take a walk or visit with friends.
These noises have a sudden onset, are typically brief in duration, and are often herring for the person. Neither the cause nor the mechanism is known. Though harmless in and of themselves, episodes have been known to create distress or impairment in the lives of individuals.
A small percentage of people experience a loud popping sound just before drifting into deep sleep, or when coming out of one. The sound resembles a gunshot, the sound of an explosion, or any loud disturbing sound that originates in the head or the ears. The sound generally lasts for only a few seconds.
Classification:
Exploding head syndrome is classified as a parasomnia and a sleep-related dissociative disorder by the 2005 international classification of sleep disorders and is an unusual type of auditory hallucination in that it occurs in people who are not fully awake.
Symptoms:
Individuals with exploding head syndrome hear or experience loud imagined noises as they are falling asleep or waking up have a strong, often frightened emotional reaction to the sound, and do not report significant pain, around 10% of people also experience visual disturbances like perceiving visual static, lightning, or flashes of light. Some people may also experience heat, strange feelings in their torso, or a feeling of electrical tinglings that ascends to the head before the auditory hallucinations occur. With the heightened arousal, people experience distress, confusion, myoclonic jerks, tachycardia, sweating, and the sensation that feels as of they have stopped breathing and have to make a deliberate effort to breathe again. The pattern of the auditory hallucinations is variable. Some people report having a total of two or four attacks followed by a prolonged or total remission, having attacks over the course of a few weeks or months before the attacks spontaneously disappear, or the attacks may even recur irregular every few days, weeks or months for much of a lifetime.
Sometimes individuals believe that EHS episodes are not natural events, but are the effects of directed energy weapons which create an auditory effect. Thus, EHS has been worked into conspiracy theories, but there is no scientific evidence that EHS has non-natural origins.
Although the condition is benign, patients suffering from EHS experience the fear of the recurrence of loud sounds, and breathing difficulty. Patients suffering migraine are prone to increased episodes of a migraine due to the stress and fear of the recurrence of loud sounds, the unique characteristic of EHS that distinguishes it from other sleep disorders is that it does not trigger headaches, pain, or rupture of internal organs.
Epidemiology:
There have not been sufficiently conducted to make conclusive statements about prevalence nor who tends to suffer EHS. One study found that 13.5% of a sample of undergrads reported at least one episodes over the course of their lives, with higher rates in those also suffering from sleep paralysis.
History:
Case reports of EHS have been published since at least 1876, which Silas Weir Mitchell described as "sensory discharges" in a patient. The phrase "snapping the brain" was coined in 1920 by the British Physician and psychiatrist Robert Armstrong- Jones. A detailed description of the syndrome and the name "exploding head syndrome" was given by British neurologist Jhos M.S Pearce in 1989. More recently, Peter Goadsby and Brain Sharpless have proposed renaming EHS"Episodic cranial sensory shock" as it describes the symptoms more accurately(including the non-auditory elements) and better attributes to Mitchell.
Diagnosis of Exploding Head Syndrome:
The diagnosis if EHS varies from migraines, different types of nocturnal headache conditions(eg, cluster, hypnic, thunderclap), startled sleep, and nightmares. Obstruction sleep apnea is another diagnosis of EHS. The disturbing sounds occur in individuals during the stage of non- rapid eye movement sleep(non-REM), when individuals are in transition from wakefulness to deep sleep or vice versa. A research study also observed that such attacks occurred soon after snoring.
Individuals who suffer from EHS episodes should maintain a diary of their sleep patterns. This enables the doctor to understand the frequency of occurrence of the episodes. The doctor may also reduce the effect of other syndrome based on the pattern of the frequency of occurrence. Doctors tend to perform an overnight sleep study or Polysomnogram of an individual who is affected by frequent episodes of EHS and is unable to sleep. The polysomnogram records heartbeat, breathing rate, movement of limbs (arms, legs), and brain signals to confirm the condition as EHS or the result of another disorder.
Some palliative procedures to reduce the frequency of EHS:
Healthy, balanced diet:
Individuals are encouraged to eat a well- balanced diet. Vegetables and fruits provide a rich source of minerals and vitamins that aid in relieving stress. This leads to a restful night.
Reassurance:
A patient suffering from EHS should be reassured that the condition is not serious and physically debilitating. This is the best and often most reliable procedure to reduce a patient's anxiety related to EHS.
Relaxation:
Individuals are encouraged to relax in order to reduce the frequency of occurrence of EHS. Relaxing also reduces stress and anxiety that set in due to EHS.
Minimum of 6 hours of sleep:
It is a good idea to obtain a minimum of 6 hours fo sleep during the night. Individuals, who sleep for less than 6 hours, suffer from sleep-related disorders or myoclonus.
Minimize Stress:
Individuals are faced with different forms of stress every day. Hence, it is preferable to keep aside time for leisure activities such as relaxing with family and friends, spending some recreation time(eg, taking a walk, reading, listening to music, yoga, etc) before going to sleep. The body is thus relieved of stress and is relaxed before falling asleep.
Relax:
This is a benign condition while no one likes being startled out of sleep, exploding head syndrome is not a symptom of a more serious condition.
Reduce stress:
Stress and worry affect sleep and may contribute to exploding head syndrome. While no one can get rid of all stress in life, encourages people to work toward a more balanced life. Separate work and daily stress from sleep by setting aside time to read, take a walk or visit with friends.
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