Exploding Head Syndrome Isn't As Deadly As It Sounds, But It's Still A Mystery To Scientists

Scientists regularly solve mysteries about the body. For instance, they've recently discovered that magnetism is behind why your molecules are right or left-handed and that the ability to walk upright is why 90% of people are right-handed. However, exploding head syndrome (EHS) isn't one that scientists have been able to figure out yet.

When you first hear about EHS, you probably picture a head literally exploding. It's not deadly like that, but it's a rare form of parasomnia — a category of sleep disorders that are associated with unusual behaviors. The unusual characteristic of EHS involves affected individuals feeling the sensation of an explosion or other loud noise that's not real and only imagined, typically as they fall asleep or wake at night. While most people don't report experiencing pain during such incidents, some have described feeling a sharp pain in their heads that doesn't linger.

Nevertheless, EHS attacks are not just startling, they disrupt sleep, cause anxiety, and make some people think that they're having a stroke. They can also be totally random, occurring weeks or months apart or in clusters several nights in a row.

While EHS remains among the mysteries that scientists still can't explain, they've put forth several hypotheses regarding the cause. Research published in Cephalagia found that, although the episodes happen spontaneously, affected patients experienced more oscillatory activity (rhythmic fluctuations) in the brain's alpha waves than non-affected patients during sleep-wake periods and wakefulness. Because of that, the scientists proposed that the underlying mechanism behind EHS is aberrant attentional processing (or hyper focus) that may amplify and regulate external stimuli of the senses.

Researchers have also hypothesized a few dysfunctions as the underlying cause, such as a neuronal impairment in the brain stem during sleep-wake cycles and a dysfunction in the ears. In a study published in Sleep Medicine, the scientists noticed that two patients experienced EHS attacks following intermittent photic stimulation (flickering lights). That brought them to propose that the condition could be caused by abnormal activity in the occipital network — the part of the brain that processes visual signals.

Another possibility could be a compromised transmission of gamma-aminobutyric acid (a neurotransmitter that blocks certain signals) to the dorsal raphe nucleus, a cluster of neurons in the brainstem that helps to alleviate pain, among other functions. On top of that, researchers have linked EHS to a handful of secondary conditions, such as sudden benzodiazepine withdrawal, migraine with brainstem aura, and sick sinus syndrome (a heart rhythm disorder).

If scientists have yet to determine what causes EHS, how can the condition be diagnosed and treated? Doctors generally review personal and family medical history alongside a diary or journal that tracks the occurrence of the episodes to identify a pattern for clues of a potential cause. In cases of severe sleep disturbance, doctors conduct sleep studies to monitor brain waves, breathing, heartbeat, and limb movement during sleep to identify or rule out whether they're related to the condition.

When it comes to managing and treating EHS, education and assuredness that the episodes are benign are vital. A plan may be designed to reduce anxiety and stress, address other sleep disorders, and practice healthy sleep habits. For example, scientists have known for years that regular sleep patterns are important to quality of life, while sleeping too much may actually decrease your lifespan.

If these don't work, certain types of therapies and prescriptions used to treat other forms of parasomnia may aid or completely eliminate the frequency of symptoms. A study published in the European Journal of Neurology also found that single-pulse transcranial magnetic stimulation — a painless therapy that delivers low-frequency electromagnetic fields to the brain to calm hyperactive nerves — significantly reduced the episode frequency. For many people, though, EHS incidents gradually happen less often over time.