Exploding Head Syndrome: Symptoms, Causes And Treatment

In recent years, parasomnias, known to belong to a group of sleep disorders, have been diagnosed with greater frequency, being more common in childhood and adolescence, although various cases have been found in which they have persisted during the stage of adulthood, so it is advisable to continue researching in this field of sleep disorders.

Exploding head syndrome is a type of parasomnia that is characterized by a sudden awakening in which the person is experiencing an intense headache and also perceives a loud sound in their head. At the same time, it is also common to experience bright flashes in your vision.

In this article We will explain in greater detail exploding head syndrome and various relevant factors associated with this parasomnia. since it is worth wondering what its causes are and also if there is any type of treatment.

    What is exploding head syndrome?

    Exploding head syndrome is a parasomnia that is less recognized at a diagnostic level than others such as sleepwalking, night terrors or bruxism, among others, which is why it also has a smaller number of investigations and is also not classified within the most important diagnostic manuals on mental disorders such as the DSM-5 or the ICD-11. However, in recent years it has gained greater interest among researchers in the field of disorders related to sleep and rest.

    Exploding head syndrome is a rare parasomnia among the population that was diagnosed for the first time in 1988 in a patient who He frequently experienced loud, unpleasant sounds inside his own head. (for example, a roar or an explosion) as if it really came from there, being an auditory hallucination. On the other hand, one of the most frequent symptoms of this parasomnia is the experience of a type of electric shock in the head.

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    Also Bright flashes may be experienced visually or even tingling sensations throughout the body. All of this commonly generates nervousness and anxiety in the person, and they may experience tachycardia. These attacks are usually experienced when patients are trying to sleep or when they have just woken up, and there are usually continuous fluctuations over time, in the sense that sometimes the symptoms decrease and other times they increase again, and there may be periods of time in which these symptoms have completely subsided.

    Symptoms of exploding head syndrome

    When patients experience the symptoms associated with exploding head syndrome, they also often suffer from high levels of anxiety and a notable increase in heart rate due to fear of not knowing what is happening to them or what these symptoms could trigger as well as the helplessness felt during and after suffering them.

    Despite the discomfort it generates, exploding head syndrome It has generally not been considered a very serious disorder since it does not normally disable people who suffer from it in their daily life and the symptoms do not usually persist throughout the day, although cases have been found in which the symptoms have negatively affected the daily life of who suffer from them, so there could be different degrees of severity with respect to this parasomnia.

    This syndrome related to sleep disorders It is usually diagnosed more frequently in adults and usually has a higher prevalence in women than in men.

      Exploding head syndrome in adolescents

      Exploding head syndrome is a parasomnia that, unlike other parasomnias, tends to develop more frequently in people over 50 years of age; However, research found that can also affect teenagers.

      In this research, a survey was conducted with 211 adolescents about the symptoms experienced when suffering from exploding head syndrome. The results showed that 18% of the sample stated that they had experienced these symptoms at least once. In some cases, they had come to experience these symptoms more frequently and even caused them serious discomfort that negatively affected their routine activities.

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      In other cases, this parasomnia occurred with a comorbidity with another disorder, such as sleep paralysis, so that these people, in addition to suffering from the symptoms associated with exploding head syndrome, also experienced an inability for a certain time to perform. any type of voluntary movement during the transition period between sleep and wakefulness.

        Causes

        The causes or etiology of exploding head syndrome are currently unknown; However, some research in this regard has developed the hypothesis that this parasomnia may be closely correlated with extreme fatigue or prolonged stress.

        Nor is it known with certainty what the physiological mechanism of this parasomnia is, although there are various theories such as the one that considers the hypothesis that exploding head syndrome could occur due to a sudden movement of the Eustachian tube or the middle ear. There is also another hypothesis that considers that it is a parasomnia produced as a result of some attack at the brain level and, more specifically, in the area of ​​the temporal lobe, the part where the cells of the central nervous system associated with hearing are located.

        Because there is no reference theory that allows us to determine the causes and predisposing factors for the development of exploding head syndrome, it would be necessary to carry out more research in this regard, so there is still a long way to go.

          Is there a treatment for exploding head syndrome?

          In a clinical trial that was carried out in 2018 about the treatments that could be most effective in addressing exploding head syndrome, it was found that Psychological treatment could help reduce the frequency of episodes related to this syndrome if it was aimed at reducing symptoms of anxiety and fear due to the episodes. as well as a psychoeducational intervention providing all the relevant information regarding this parasomnia and in relation to a series of self-care guidelines that patients had to follow.

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          Prominent psychological techniques for the treatment of exploding head syndrome include relaxation techniques (e.g., Jacobson progressive muscle relaxation or autonomic training) for anxiety symptoms and tachycardia, as well as therapies that help manage stress, due to the correlation that it has been postulated that this could have with exploding head syndrome (e.g., systematic desensitization); You could also try mindfulness treatment or any meditation modality for stress and anxiety.

          For the patient’s self-care, it would be important to help them with a series of guidelines that improve their sleep hygiene. (e.g., maintain a fixed time to go to sleep, avoid consumption and/or excess of caffeine, try to avoid alcohol consumption, do not exercise late at night, do not have heavy dinners that make a restful rest difficult, etc.).

          Some benefits have also been found in terms of reducing the symptoms associated with exploding head syndrome through a pharmacological treatment through the administration of some antidepressants (amitriptyline, clomipramine), calcium blockers (flunarizine, nifedipine), antiepileptics (topiramate) or anticonvulsants (carbamazepine).

          A good intervention plan for exploding head syndrome could be the combination of psychological treatment with pharmacological treatment, although more studies are still needed to demonstrate its effectiveness, as is the case with research into the causes of this parasomnia.