Amitriptyline: another tricyclic antidepressant used to treat major depressive disorder.Clomipramine: a tricyclic antidepressant typically used to treat obsessive-compulsive disorder (OCD).If these strategies don’t offer the expected results, anecdotal reports indicate that some health professionals may also include the use of some medications like: If an underlying condition such as sleep paralysis or chronic migraine is suspected as the cause, addressing that condition directly could also bring some relief. Older research from 1991 suggested that reassuring someone that the condition isn’t life threatening can reduce their likelihood of experiencing more episodes. The International Classification of Sleep Disorders, 3rd edition (ICSD-3) includes the condition under “other parasomnias.”īecause exploding head syndrome is such a rare condition and episodes are hard to predict, there are no formal treatment guidelines. However, this reference handbook for mental health professionals does recognize non-specified parasomnias under sleep-wake disorders. Loud noises can sometimes be accompanied by other sensations like a flash of light or a feeling of being electrically shocked.Īn episode of exploding head syndrome usually lasts a few seconds, but it can be a frightening and draining experience that could lead to symptoms of anxiety, including panic attacks.Įxploding head syndrome isn’t a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The noise can resemble an explosion, gunshot, lightning strike, or any similar exploding sound. In exploding head syndrome, the undesirable event is an extremely loud noise you perceive in your head that happens while falling asleep or waking up. Sleepwalking and sleep talking, for example, are two common parasomnias. Specifically, the condition is a type of parasomnia - that’s any condition that involves undesirable or involuntary physical events during the sleep cycle. Exploding head syndrome, also known as episodic cranial sensory shock, isn’t considered a mental health illness. Hypnagogic and hypnopompic hallucinations, nightmares, and lucid dreaming may also co-occur.Is exploding head syndrome a mental health illness? Although there is no consistent precipitant, some patients have identified an association between increased frequency of events and insomnia or periods of increased stress. In one study, almost 37% of subjects with a history of sleep paralysis also reported experiencing EHS symptoms at least once. ĮHS appears to be more common in patients diagnosed with isolated sleep paralysis. Older adults are more likely to report symptoms without being prompted, likely due to anxiety surrounding age-related intracranial pathology. However, more recent research has shown that EHS may be more common than previously thought across all age groups, with up to 16% of college students reporting EHS events in one study. It was initially thought to be a rare disorder occurring predominantly in middle-aged women. There is no definitive gender predominance, although EHS reportedly occurs more often in females than males in several studies. Since the majority of journal articles about EHS are case reports, accurate prevalence rates are not available. It is an underdiagnosed and under-reported syndrome because patients may feel embarrassed about their symptoms, and healthcare providers may not be familiar with the diagnosis. These concerns are the reasons many seek medical evaluations. Patients may initially fear a more ominous cause is responsible for the sounds, such as a stroke, brain tumor, or brain hemorrhage. The phenomenon is often frightening to those who are unaware of its benign nature. More recently, the term episodic cranial shock has been proposed to describe this phenomenon. He reported a case study of two patients, who experienced the nocturnal sensation of loud sounds he described as “sensory shocks.” Despite earlier descriptions and case reports of EHS, it was not classified as a sleep disorder until 2005, when it gained inclusion in the 2nd edition of International Classification of Sleep Disorders (ICSD-2). ĮHS was first described in medical literature in 1876 by American neurologist Silas Weir Mitchell. The events occur with variable frequency, and there may be prolonged remission between episodes. The sounds have most commonly been described as explosions, gunshots, or thunder but can be almost any loud noise. Events are often accompanied by flashes of light and patient distress, but there is no significant associated pain. These events occur during the wake-sleep/sleep-wake transition period and generally last less than a second. Exploding head syndrome (EHS) is a benign parasomnia characterized by the perception of a loud sound while asleep, which leads to abrupt awakening.
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