Just after curling up into bed, turning off the lights, and settling in for a night of sleep, you hear a massive explosion. An explosion so loud it startles you from your impending sleep, sending a wave of shock all through your body. But you open your eyes, and other than your pounding heart, there's nothing there making a sound. No guns, fireworks or bombs anywhere to be seen. What could it have been?
This type of nighttime hallucination is a sleep disorder called exploding head syndrome. Don't get too far thinking about the iconic scene from the movie "Scanners" where a man's head bursts into a mess of blood and brains. This disorder is, thankfully, much milder than that. Rather than the gruesome picture the name paints, it's actually just a relatively harmless type of parasomnia (a disorder characterized by abnormal behavior of the nervous system during sleep). Those afflicted with exploding head syndrome will hear sudden (imaginary) sounds that seem to originate from inside the head. These loud and explosive noises have been reported as sounding like cymbals crashing, bombs exploding, gunshots and so on. There's no pain associated with the disorder, but as you might imagine, the person wakes up very scared and confused.
Episodes of this disorder can go on for many nights in a row, sometimes many times in a single night. Or they can come and go, then stop altogether for some unknown reason [sources: Mitchell, Tanchanco]. And that's not the only unknown about this condition. Strange as it may seem, it is pretty harmless, so not much research has been conducted on the causes and treatments for the syndrome.
What are the chances your head will explode?
Exploding head syndrome was first described in a few medical case studies by a doctor named Silas Weir Mitchell in 1876 [source: Thomson]. The name of the disorder was not coined until much later by J.M.S. Pierce in 1988, but Mitchell described the symptoms as "sensory discharges" and they were later described in a clinical journal in 1920 as a "snapping of the brain" [source: Sharpless]. Nice descriptions, but J.M.S. Pierce definitely wins the prize for creativity in naming.
There have been varying reports of how much of the population experiences exploding head syndrome. A 2015 study of 211 students showed that 18 percent had experienced the sensation [source: Thomson]. This number is likely inflated, however. Sleep experts believe that people who are more sleep deprived tend to have exploding head, and students typically don't get as much sleep as others. A more conservative estimate states that close to 11 percent of healthy people have had to deal with the syndrome, with women at a higher risk than men [source: Mitchell].
The average age of onset is in the 50s, although it has been reported to have occurred in someone as young as 10 years old [sources: Mitchell, Sleep Education]. Psychiatric patients tend to experience exploding head syndrome a bit more, with 13.8 percent of them reporting that they have experienced the symptoms of the disorder [source: Tanchanco].
In addition to the terror of loud noises, exploding head syndrome can cause a few other symptoms in patients. Many report palpitations or tachycardia — the feeling that their heart is beating too hard or fast or skipping a beat. Some have even described an aura of electrical sensation – like a shock – that travels from their lower torso to their head while they are experiencing an episode. Quite a shocking way – literally – to be woken from sleep.
So, what causes it?
No, That Wasn't an Alien — Your Head Was Just Exploding.
During a normal night of sleep, your body slowly shuts down and becomes somewhat paralyzed (a good thing, so we don't act out our dreams). In the transition from wake to sleep, the brain closes shop a little at a time and brainwaves slow down. With exploding head syndrome, however, there's a glitch that happens somewhere along this path and your brainwaves don't slow down. While the disorder has not been the focus of many clinical studies, scientists have formulated a few theories on what causes this glitch [source: Sharpless].
- Exploding head syndrome may be associated with minor temporal lobe seizures in the brain. Most have ruled this theory out, however, since EEG testing (which detects epileptic activity in the brain) has not shown epilepsy as a cause.
- Some have suggested that a sudden shift of middle ear components or other ear dysfunctions may be at the root of the problem.
- For some patients experiencing the symptoms, it may be as a side effect of rapid withdrawal from drugs like benzodiazepines (brand names include Valium and Xanax) or some antidepressants (like Zoloft).
- Dysfunction in how our bodies transport calcium in our cells may cause the disruption in the transition from wake to sleep.
- The disorder arises from some sort of brainstem neuronal dysfunction.
This final theory is the most popular amongst scientists. They suggest that there is a glitch in the brainstem reticular formation. That's the part of the brain that regulates sensory motor reflexes, eye movements, motor control, and is responsible for overseeing transitions between sleep/wakefulness. This hiccup results in the reduction of activity and a delay in shutting down certain areas. Scientists have seen a suppression of alpha brainwaves which are responsible for drowsiness, while simultaneously noting an increased burst of activity in areas of brain that process sound [sources: Sharpless,Thomson].
Interestingly, some scientists have hypothesized that exploding head syndrome, coupled with other sleep disorders, may be an explanation for the origins of alien abduction stories, government conspiracy theories and supernatural demons. Exploding head is often linked to another sleep disorder, sleep paralysis, where the sufferers feel like they are having a dream while they are awake. So hallucinations like being a victim of an alien abduction feels very real, when in fact, they are only dreams.
Treatment for Exploding Head Syndrome
Although the name invokes some pretty grisly images, exploding head syndrome is quite benign and generally does not require treatment. In fact, one of the best courses of treatment has been to have doctors assure patients that the condition is not a symptom of something more serious. Upon hearing these assurances, some patients have gone into remission [source: Sharpless].
Exploding head syndrome can easily be confused with other conditions, such as other sleep disorders, different types of headaches, side effects from medications or substance abuse, or mental health disorders. It is not uncommon for PTSD and nightmare disorder patients to hear loud noises that startle them awake from sleep. Exploding head, however, can be distinguished from these other conditions by a notable lack of context around the noise. Patients with PTSD, for example, may hear noises while having a flashback, for instance. Exploding head syndrome is just a noise, albeit a loud one.
Once confirmed that a patient is suffering from exploding head syndrome, a doctor may want to conduct an overnight sleep study (polysomnogram) to see if he or she has any other sleep disorders, since 10 percent of patients with another sleeping disorder will also have exploding head [source: Tanchanco]. The doctor will chart brain waves, heart beat and breathing during sleep, and also record the movement of arms and legs.
But if no other treatable sleep disorder is found, physicians will typically suggest improved sleep hygiene for the patient. This includes practices like keeping a regular sleep schedule; making sure the bedroom is quiet and dark; cutting out alcohol and coffee after 5 p.m.; restricting naps; not reading or watching television in bed and embarking on a morning exercise routine. On the medication side, tricyclic antidepressants (like clomipramine) and calcium channel blockers have been known to help some people [source: Mitchell]. And then there's the advice that can help all of us – not just exploding head patients: Reduce stress and learn how to relax!
Author's Note: How Exploding Head Syndrome Works
When I first heard of exploding head syndrome, I was pretty sure this would be a short article: Your head explodes and you die. Thankfully for all of us, that isn't something that actually happens. I'll take loud scary noises during sleep over blood and brain explosions any day!
More Great Links
- Brain, Marshall. "How Sleep Works." HowStuffWorks.com. April 1, 2000. (June 7, 2016) https://science.howstuffworks.com/life/inside-the-mind/human-brain/sleep.htm
- Mitchell, Emma. "Exploding Head Syndrome." American Sleep Association. 2016. (June 7, 2016) https://www.sleepassociation.org/patients-general-public/exploding-head-syndrome/
- Sharpless, B.A. "Exploding Head Syndrome." Sleep Medicine Reviews. Vol. 18, no. 6. Page 489-93. Dec. 2014.
- Sleep Education. "Exploding Head Syndrome." 2014. (June 7, 2016) http://www.sleepeducation.org/sleep-disorders-by-category/parasomnias/exploding-head-syndrome/
- Tanchanco, Rod. "How to Defuse Exploding-Head Syndrome." The Atlantic. Jan. 30, 2015. (June 7, 2016) http://www.theatlantic.com/health/archive/2015/01/how-to-defuse-exploding-head-syndrome/384553/
- Thomson, Helen. "I have exploding head syndrome." April 10, 2015. (June 7, 2016) http://www.bbc.com/future/story/20150409-i-have-exploding-head-syndrome