Exploding Head Syndrome: A Systematic Scoping Review.

Exploding head syndrome (EHS) has historically been viewed as a disorder predominantly affecting older people and being more common in females. Through a comprehensive review of data since 2005, this scoping review provides updated evidence from 4082 participants reporting EHS across a variety of study designs on: how EHS presents; key information on comorbidity and correlates of EHS; how EHS is experienced in terms of symptoms and beliefs; causal theories arising from the research reviewed; and evidence-based information on how research has reported on the management of EHS. Since 2005, EHS has attracted increasing research interest; however, there are significant gaps in the research that are hindering a better understanding of EHS that might be helpful for clinicians.

Single Patient Multiple Explosions: A Case Report on Exploding Head Syndrome.

Exploding head syndrome (EHS) is an uncommon sleeping disorder that is described by patients as a loud noise occurring while transitioning into and out of sleep. It is not accompanied by a headache but causes a sense of fright. We describe the case of a 58-year-old female patient, presenting with a total of 11 events of EHS occurring at bedtime. Events shared some features but also had unique characteristics. The workup was negative, making a diagnosis of EHS more likely. CPAP was recommended for a newly diagnosed obstructive sleep apnea, but despite non-compliance with the treatment plan, the patient had a complete resolution of her symptoms. Exploding head syndrome is an underreported parasomnia reported in the literature. Our case report demonstrates that a single patient could exhibit different features in displaying EHS, which was shown by changes in the noise description, pattern, and accompanying jerk movement. It also hints at patient education and reassurance as a possible treatment plan.

The associations between paranormal beliefs and sleep variables.

Previous studies have found significant associations between paranormal beliefs and sleep variables. However, these have been conducted on a small scale and are limited in the number of sleep variables investigated. This study aims to fill a gap in the literature by investigating paranormal beliefs in relation to a wide range of sleep variables in a large sample. Participants (N = 8853) completed a survey initiated by the BBC Focus Magazine. They reported on their demographics, sleep disturbances and paranormal beliefs. Poorer subjective sleep quality (lower sleep efficiency, longer sleep latency, shorter sleep duration and increased insomnia symptoms) was associated with greater endorsement of belief in: (1) the soul living on after death; (2) the existence of ghosts; (3) demons; (4) an ability for some people to communicate with the dead; (5) near-death experiences are evidence for life after death; and (6) aliens have visited earth. In addition, episodes of exploding head syndrome and isolated sleep paralysis were associated with the belief that aliens have visited earth. Isolated sleep paralysis was also associated with the belief that near-death experiences are evidence for life after death. Findings obtained here indicate that there are associations between beliefs in the paranormal and various sleep variables. This information could potentially better equip us to support sleep via psychoeducation. Mechanisms underlying these associations are likely complex, and need to be further explored to fully understand why people sometimes report "things that go bump in the night".

[Exploding head syndrome]. / Sindrom vzryvayushcheisya golovy.

Exploding head syndrome (EHS) is a paroxysmal sensory parasomnia characterized by the sensation of a loud noise or «explosion in the head¼ during the wake-sleep/sleep-wake cycle. The most popular explanation for this condition is the decrease of reticular formation activity during the transition between wakefulness and sleep. The authors present a review of literature on the diagnosis and treatment of EHS and clinical observations of patients with classical signs.

Explosive sound without external stimuli following electroencephalography kappa rhythm fluctuation: A case report.

BACKGROUND: The pathology underlying exploding head syndrome, a parasomnia causing a loud sound/sense of explosion, is not well understood. Kappa rhythm is a type of electroencephalogram alpha band activity with maximum potential between contralateral temporal electrodes We report a case of preceding kappa activity before exploding head syndrome attacks. CASE REPORT: A 57-year-old woman complained of explosive sounds for 2 months; a loud sound would transpire every day before sleep onset. She was diagnosed with exploding head syndrome. During polysomnography and the multiple sleep latency test, the exploding head syndrome attacks occurred six times. A kappa wave with activity disappearing a few seconds before most exploding head syndrome attacks was observed. The alpha band power in T3-T4 derivation gradually waxed followed by termination around the attacks. CONCLUSION: This case demonstrated that the dynamics of kappa activity precede exploding head syndrome attacks. Finding ways to modulate electroencephalogram oscillation could elucidate their causality and lead to therapeutic intervention.

Exploding head syndrome (a.k.a. episodic cranial sensory shock) responds to single-pulse transcranial magnetic stimulation.

We present the case of a patient with a sleep disturbance attributed to the exploding head syndrome, recently redefined as episodic cranial sensory shock. The patient, who suffered with concomitant migraine, was treated for headache prevention with daily single-pulse transcranial magnetic stimulation (sTMS). Following treatment, he reported a significant reduction in the episodes of exploding head syndrome, albeit not of his migraine. Neurologists could consider sTMS in the management of patients troubled by episodic cranial sensory shock, as it is a safe and noninvasive treatment that might provide benefit for this benign but occasionally bothersome parasomnia.

Two cases of exploding head syndrome documented by polysomnography that improved after treatment.

NONE: Exploding head syndrome is a rare sleep disorder, characterized by an explosive feeling in the head, that occurs during the sleep-wake transition. Usually the attacks are painless, but the fear caused by the attack can result in awakening and insomnia when it is generated frequently. It has been suspected that exploding head syndrome is related to emotional stress, because most patients report stressful life situations in periods when attacks are intense and frequent. The benign character and good prognosis of exploding head syndrome are the most likely reasons why it has not become a subject of more extensive neurologic research. Moreover, most of the articles reported symptomatic episodes but a lack of objective physiologic examinations, such as polysomnography, and effective treatment. Here, we report two cases of exploding head syndrome with the attacks documented by polysomnography and our trial treatment.

Exploding head syndrome, chronotype, parasomnias and mental health in young adults.

Although inadequate sleep among young people is well documented in the literature, anomalous sleep experiences, such as the parasomnia termed exploding head syndrome (EHS), have received little empirical attention. The current study examined the association of sleep quality, symptoms of psychological distress and other unusual sleep experiences with EHS in a sample of young adults (n = 135, age M = 21.77, SD = 2.08). We also aimed to account for the possible effect of participant chronotype on sleep experiences. The lifetime prevalence of EHS among participants was 20.0%. Three-quarters (75.6%) of participants reported poor quality sleep according to the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis showed that participants with a lifetime prevalence of EHS experienced more symptoms of anxiety and poorer sleep quality; age, gender and symptoms of depression were not significantly related to EHS. Parasomnias (OR [95% CI] = 1.62 [1.02-2.57], p = .040) and action-related sleep disorders (OR [95% CI] = 1.87 [1.09-3.20], p = .023) were associated with lifetime experience of EHS in a logistic regression analysis. Chronotype did not significantly impact mood, sleep quality or presence of EHS. Results suggest that EHS is more common in young people than previously considered and ought to be examined in conjunction with the presence of other unusual sleep disorders. This study provides valuable insight into young peoples' sleep experiences and key factors associated with EHS.

Exploding head syndrome: new observations.

BACKGROUND AND PURPOSE: The etiology of 'exploding head syndrome' (EHS) is currently highly controversial and its management is unknown. The object was to explore these. METHODS: This observational study describes my personal experience of EHS and discusses its implications. RESULTS: I experienced, while suffering from EHS, recurrent episodes of transient cardiac arrests due to sick sinus syndrome. Implantation of a cardiac pacemaker resulted in immediate, dramatic, permanent cessation of both cardiac arrest episodes and EHS. This has not been reported previously. CONCLUSIONS: This striking temporal relationship indicates a possible association between EHS and sick sinus syndrome.

Exploding head syndrome: clinical features, theories about etiology, and prevention strategies in a large international sample.

OBJECTIVE: Exploding head syndrome (EHS) is a benign sensory parasomnia characterized by the perception of loud noises or a sense of explosion in the head. Few studies have assessed clinical features and little is known about demographic differences or prevention strategies. PATIENTS/METHODS: A cross-sectional study of 3286 individuals with and 2954 without lifetime EHS episodes was conducted via online questionnaires. RESULTS: Those with EHS had shorter sleep durations, longer sleep onset latencies, poorer sleep quality, and less sleep efficiency, but effect sizes for these differences were small. Females were slightly more likely than males to endorse EHS. 44.4% of individuals with EHS experienced significant fear during episodes, but fewer reported clinically significant distress (25.0%) or interference (10.1%) as a result of EHS. Most sufferers believed it to be a brain-based phenomenon, but a small minority endorsed anomalous causes. Five prevention strategies with >50% reported effectiveness were identified. CONCLUSIONS: EHS was assessed in the largest sample to date. Though associated with clinical impacts, no empirically supported interventions yet exist. The five prevention strategies may prove useful for treatment development.

Co-activation of rhythms during alpha band oscillations as an interictal biomarker of exploding head syndrome.

BACKGROUND: Exploding head syndrome is a rarely reported benign sensory parasomnia that may nonetheless have significant impact on patients' quality of life and their perceived well-being. To date, the mechanisms underlying attacks, characterised by a painless perception of abrupt, loud noises at transitional sleep-wake or wake-sleep states, are by and large unclear. METHODS AND RESULTS: In order to address the current gap in the knowledge of potential underlying pathophysiology, a retrospective case-control study of polysomnographic recordings of patients presenting to a tertiary sleep disorders clinic with exploding head syndrome was conducted. Interictal (non-attack associated) electroencephalographic biomarkers were investigated by performing macrostructural and event-related dynamic spectral analyses of the whole-night EEG. In patients with exploding head syndrome, additional oscillatory activity was recorded during wakefulness and at sleep/wake periods. This activity differed in its frequency, topography and source from the alpha rhythm that it accompanied. CONCLUSION: Based on these preliminary findings, we hypothesise that at times of sleep-wake transition in patients with exploding head syndrome, aberrant attentional processing may lead to amplification and modulation of external sensory stimuli.

Exploding Head Syndrome Accompanied by Repeating Panic Attacks: A Case Report.

To the best of our knowledge, we report here for the first time a case of exploding head syndrome (EHS) that caused repeating panic attacks. A 62-year-old woman experienced a sudden sensation of a loud noise just before going to sleep. The frequency of these episodes rapidly increased to multiple times per night, and she soon began to fear sleep, which led to the occurrence of nighttime panic attacks. She was diagnosed with EHS at our sleep clinic, and clonazepam was prescribed accompanied by reassurance about the benign nature of this syndrome. The intensity of the loud noise gradually reduced, and her fear of sleep and panic attacks disappeared at around the same time. In this report, we argue the importance of gaining further knowledge about EHS, including that about complicating psychiatric symptoms and that about its treatment.

Exploding Head Syndrome: a Review.

PURPOSE OF REVIEW: To explain our current understanding of exploding head syndrome (EHS), an unusual and underreported sensory parasomnia. RECENT FINDINGS: Based on findings from recent studies of EHS, the prevalence is higher than previously suggested by the literature, which historically has consisted mostly of case reports. The typical presentation also has been better illustrated by recent case series, and diagnostic criteria have been defined. Its pathophysiology is still unclear. EHS is underrecognized and its symptoms are alarming, but a review of our current state of knowledge will allow physicians to make a diagnosis of this benign condition with greater confidence.

Did René Descartes Have Exploding Head Syndrome?

ABSTRACT: René Descartes (1596-1650), "the Father of Modern Philosophy" and advocate of mind-body dualism, had three successive dreams on November 10, 1619 that changed the trajectory of his life and the trajectory of human thought. Descartes' influential dreams have been of interest to a number of commentators including the famous neurologist and psychoanalyst Sigmund Freud. Descartes' second dream in particular, in which he heard a loud noise in his head before seeing a bright flash of light upon awakening, has been discussed extensively. Commentators have employed psychoanalytic and medical explanations to account for Descartes' unusual nocturnal experience. In this tradition, I propose that Descartes' second dream was not a dream at all; rather, it was an episode of exploding head syndrome; a benign and relatively common parasomnia. I further suggest that Adrien Baillet's account of Descartes' experience constitutes the earliest description of exploding head syndrome, predating the account described by Silas Weir Mitchell in 1876 by nearly 200 years.

Characteristic symptoms of exploding head syndrome:one case report and literature review / 中华神经科杂志

Exploding head syndrome(EHS)is a rare sensory parasomnia and rarely reported in China, leading to serious misdiagnosis, mistreatment, and unnecessary testing. A detailed collection of clinical symptoms and longterm polysomnography-electroencephalography monitoring is very important for diagnosis and differential diagnosis of EHS. We diagnosed a patient with EHS according to the International classification of sleep disorders, third edition diagnostic criteria. The electro-clinical feature of the patient and relevant references were analyzed in order to improve the understanding of EHS, meanwhile to prevent unnecessary testing and avoid misdiagnosis and mistreatment.

Exploding Head Syndrome in the Epilepsy Monitoring Unit: Case Report and Literature Review.

Diagnosis of paroxysmal events in epilepsy patients is often made through video-telemetry electroencephalography in the epilepsy monitoring unit. This case report describes the first-ever diagnosis of exploding head syndrome in a patient with longstanding epilepsy and novel nocturnal events. In this report, we describe the presentation of exploding head syndrome and its prevalence and risk factors. In addition, the prevalence of newly diagnosed sleep disorders through video-telemetry electroencephalography in the epilepsy monitoring unit is briefly reviewed. This report also illustrates the novel use of clobazam for the treatment of exploding head syndrome.

Exploding head syndrome is common in college students.

Exploding head syndrome is characterized by the perception of loud noises during sleep-wake or wake-sleep transitions. Although episodes by themselves are relatively harmless, it is a frightening phenomenon that may result in clinical consequences. At present there are little systematic data on exploding head syndrome, and prevalence rates are unknown. It has been hypothesized to be rare and to occur primarily in older (i.e. 50+ years) individuals, females, and those suffering from isolated sleep paralysis. In order to test these hypotheses, 211 undergraduate students were assessed for both exploding head syndrome and isolated sleep paralysis using semi-structured diagnostic interviews: 18.00% of the sample experienced lifetime exploding head syndrome, this reduced to 16.60% for recurrent cases. Though not more common in females, it was found in 36.89% of those diagnosed with isolated sleep paralysis. Exploding head syndrome episodes were accompanied by clinically significant levels of fear, and a minority (2.80%) experienced it to such a degree that it was associated with clinically significant distress and/or impairment. Contrary to some earlier theorizing, exploding head syndrome was found to be a relatively common experience in younger individuals. Given the potential clinical impacts, it is recommended that it be assessed more regularly in research and clinical settings.

Exploding head syndrome: six new cases and review of the literature.

BACKGROUND: Exploding head syndrome (EHS) is characterized by attacks of a sudden noise or explosive feeling experienced in the head occurring during the transition from wake to sleep or from sleep to wake. METHODS: We present six new cases extending the clinical experience with the syndrome. We also reviewed all available cases from the scientific literature and evaluated the typical features of EHS. RESULTS: The female to male ratio is 1.5 to 1. The median age at onset is 54. In average, one attack per day to one attack per week occurs. Some patients suffer from several attacks per night. In about half of all patients, a chronic time course can be observed but episodic or sporadic occurrence is also common. The most frequent accompanying symptoms beside the noise are fear and flashes of light. Polysomnographic studies do not reveal any specific sleep pattern associated with EHS. Tricyclic antidepressants are helpful in some patients. However, most patients do not need treatment because of the benign nature of the syndrome. CONCLUSION: EHS is a well-defined disease entity with a benign nature.