A Mind-Blowing Sleep-Wake Transition Disorder: Exploding Head Syndrome Can Happen to Anyone
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Have you ever been abruptly awakened from a near-sleep state by a loud sound that seemingly no one else perceived? This issue often arises when someone is on the verge of falling asleep or just starting to wake up. It’s quite rare during the stages of deep sleep. Individuals often report hearing loud noises such as screams, gunshots, crashes, clangs, or explosions. This isn’t simply a figment of the imagination. It’s a sleep disorder, though an uncommon one.
Scientists initially believed this problem to be unique among human beings, but off-late, a large percentage of adults are reporting experiences that point towards the precedence of exploding head syndrome. The experience of the loud noise or explosion gives the disorder its moniker. Experts call these loud explosion-like noises hypnagogic hallucinations or delusions that occur immediately before a person is about to fall asleep. These are in their auditory form, but at times they occur with visual hallucinations as well. It is not a part of paracusia that usually accompanies psychiatric disorders.
While auditory hallucinations may be a part of several psychiatric diseases, they do not serve as the only distinguishing factor for them. Therefore, people experiencing auditory hallucinations like explosions, gunshots or even loud voices do not necessarily have psychiatric disorders. Earlier, the scientists and doctors attributed auditory hallucinations to cognitive suppression, but newer research shows their co-existence with speech misinterpretations. Several underlying neural activity disorders might contribute to auditory hallucinations in all ages.
Over the last decade, psychiatrists and neuroscientists have tried to link several instances of auditory hallucinations during sleep with genetic components. The trials have remained unsuccessful till now. The non-psychotic causes of hypnagogia are still majorly unknown. The research on the causes and treatment of the same are ongoing. Some psychologists and sleep experts are of the opinion that sleep-related disorders are forms of dissociative disorders that people experience when they are about the fall asleep.
People with this complaint often have dissociative episodes during sleep-wake transitions. They are more likely to have a history of childhood trauma, PTSD, and borderline personality disorders. Experts often refer to exploding head syndrome as nocturnal disorders or dissociative pseudo parasomnia.
“Episodic sensory shock,” “resetting of neural pathways,” “snapping of the brain” and “sensory discharges,” many terms often refer to the same syndrome. The exploding head is a phenomenon a lot of people experience on a regular basis while falling asleep or while waking up from a deep sleep. Some of them have been experiencing this ever since they were children. As a result, they do not think of it as something extraordinary or a disorder.
Several studies over the last couple of years show that the exploding head syndrome is another parasomnia or sleep-wake transition disorder that manifests in the form of sudden loud sounds that jolt people out of their slumber. It is a sleep-wake transition disorder that usually takes place during hypnagogia or hypnopompia. These two phases occur during different stages of the sleep cycle, and they facilitate a plethora of auditory hallucinations.
Most people experience hypnagogic hallucinations on a regular basis, but the problem arises when part of it involves loud bangs or booms that disrupt their resting state and send them on a trip to sleep deprivation.
The beginning of the episodes comes without any indication. Initially, this particular disorder did not have as many reported cases as insomnia, RBD or restless leg syndrome. It could be due to the taboo associated with mental disorders and people’s proclivity to believing that hearing “inaudible” noises is a sign of mental illness.
Experts found one of the first instances of EHS is in the biography of Rene Descartes dating back to 1691. Current studies on the epidemiology of the disease show that over 13.5% of the American population may be suffering from this nocturnal disorder.
It is everyday sleep-wake transition disorder experts have observed among children. People who experience EHS also experience isolated incidents of sleep paralysis and vivid dream-like hallucinations during their transition between sleep and wakefulness.
Parasomnias are all the unnatural or abnormal things that can happen to people when they are falling asleep, waking up, or sound asleep. Apart from sleep apnea, other sleeping disorders including night terrors, sleep-eating, sleep-walking, and hypnic jerks are all forms of parasomnia. It can encompass all types of strange behaviors, emotions, and perceptions during different stages of sleep.
Most parasomnias are part of the transition between REM and NREM sleep. Some of the parasomnias disappear as they grow older. This class of sleeping disorder often causes people to hallucinate. It can even result to auditory hallucinations and visual hallucinations. Exploding head syndrome falls under the category of parasomnia. It involves hearing unpleasant loud noises that do not exist.
It is a perfect example of a parasomnia that disrupts rest. It sometimes causes people to believe that they are suffering from a stroke or a heart attack. Further, it can result in physical distress due to the suddenness, but they rarely occur due to physical suffering. Therefore, it is a classic case of parasomnia in children and adults. Sometimes, it coincides with phases of sleep paralysis in children.
It can be quite disorienting and terrifying for a child. It can lead to further problems with sleep schedules, and sleep hygiene if recurrence of sleep paralysis in kids does not receive enough attention. Not all parasomnias have a medical cure. However, children might require counseling and extra care to help them get over the fear of auditory and visual hallucinations during the nighttime.
EHS lacks diagnostic procedures due to the lack of observation or real-time testing. There are several symptoms and signs that people have reported over the last couple of years. There are several known and unknown genetic factors, environmental stressors and other causes of such sleep disorders. These are more common in children than adults due to the high plasticity of their brain structure.
We do hear sudden loud noises when we are asleep from time to time. As long as it is our neighbor mowing the lawn at an ungodly hour, we should be thankful. People with EHS often hear loud sounds that are not even real. They seem to be coming from within their heads since no one else in the house, or the neighborhood can listen to them. People describe the loud noises in the following ways.
The brain works in mysterious ways. Some people experience just the sound, while others always see a flash of light accompanying it. There is no real source of light, just like there is no real source of the sound. There is no current explanation for this symptom of EHS.
It is very uncommon for anyone to report the physical sensation of pain accompanying an episode of this parasomnia. However, they describe feeling anxious and afraid as a result of the sudden loud noise. The suddenness often causes considerable distress, which causes people to wake up feeling upset, disturbed or even scared.
People often report feeling short of breath as the sound startles them awake. Some of them bolt upright that increases the heart palpitations. Experiencing faster heartbeat for an extended period can cause breathing difficulties that might require medical attention.
Some cases of EHS come with accompanying sleep paralysis. It is a popular sleep-wake dissociative disorder that gives people a feeling of OBE-ing or losing control of their limbs. Perceptions of a hefty weight on the chest and sensation of a supernatural presence in the room are standard parts of the audio-visual hallucination.
People suffering from frequent attacks of EHS and other forms of hallucinations often feel paranoid. Some claim government conspiracies or even presence of alien beings in their neighborhood to explain their “unexplainable” auditory hallucinations. However, the episodes are the scariest for children, who are learning to sleep in their rooms alone. The confirmed diagnosis assures them that they are not alone in the world. There are thousands of ordinary productive people out there, who suffer from this nocturnal hypnagogia.
The exact causes of this syndrome are still unknown. There have been several theoretical explanations that put forth neural misfiring, neurological disorders, psychological issues, and even stress as the probable cause of this disorder.
Some scientists prefer classifying the occurrence of EHS with hypnic jerks. These are common myoclonus or muscle jerk movements that occur when someone is in the process of falling asleep. According to Thorpy and Plazzi, authors of The Parasomnias and Other Sleep-Related Movement Disorders, 2010, exploding head syndrome is an amplified form of a hypnic jerk.
One of the most prevalent theories among the experts is the abnormality of the reticular formation in the lower part of the brain (brainstem) that is responsible for the transition. Other approaches include the antidepressant discontinuation syndrome, decline in delta sleep, and PTSD. The current research cites the issues with how a brain “shuts down” during sleep as the leading cause of hypnic jerks and audio hallucinations.
Other sleeping disorders, both REM and non-REM, underlying medical conditions, mental health challenges and history of substance abuse often contribute to exploding health syndrome among the adult population. In children, the causes are less well known, and experts believe it to be another parasomnia that can potentially disrupt their sleep quality and result in sleep deprivation.
Hypnagogic jerk is typical for all ages by several names including sleep start, sleep twitch, night start and myoclonic jerk. It usually results from involuntary muscle twitches that can make a person “jump” while falling asleep. It usually cause rapid breathing, excessive sweating, feeling of a “shock,” or falling from a great height.
The incidences of the hypnic jerk usually increase in frequency with an increase in stress levels. People with irregular sleep schedules often suffer from sleep starts more often than those with regular sleeping habits. Improvement of sleep hygiene can improve sleep quality and reduce the frequency of sleep starts.
Sleep deprivation is a significant reason behind hypnagogic jerk. It usually occurs during a non-REM sleep cycle, and it is an abrupt movement of the muscles. They are very common during childhood. A child aged eight can experience over ten myoclonic jerks per hour. The occurrence decreases with age to almost 1 per hour by the time people are 65.
Interestingly, most cases of night starts occur without any particular signs or reasons. Research by the American Academy of Sleep Medicine cites caffeine consumption, stress, anxiety, and excessive strenuous activities post evening as leading causes, but these factors do not elicit sleep jerks in everyone.
Other leading hypothesis states that the reflex might be evolutionary. The brain misinterprets the relaxing of muscles while falling asleep as the signal the body sends when a primate is dropping out of the tree. The hypothesis also states that it allows people to readjust their sleeping postures to something more comfortable than their initial one.
The name might sound scary and dramatic, but it can be quite misleading. Yes. It is indeed frightening to hear sudden loud bangs and crashes immediately before falling into a deep sleep state, but it is more perplexing for the individual since they cannot find the source of it after they are wide awake. It often leads to a semi-groggy state of confusion.
From a physiological point of view, exploding head syndrome does not cause any physical harm. There is rarely any physical pain associated with these episodes unless there are additional complications that cause the sufferer to act out after the loud sounds. Other than the occasional hard knocks on the head on the bookshelf above or the stubbing of the toe on the bed frame, there are no reports of physical injury that the EHS causes.
However, people suffering from exploding head syndrome often lay awake after an episode. The trauma from the EHS experience can either last for the night or for coming few nights as well. People, who experience EHS on an almost regular basis often report accompanying insomnia and sleep deprivation that results due to the rapid breathing, anxiety, and shock.
Sleep deprivation can be a serious issue, depending on its extent. While some people report missing an hour of sleep each week due to recurring events of EHS, others lose between 60 to 90 minutes of sleep per day due to regular episodes. Lack of enough restorative rest can compromise cognition and decision-making abilities.
People operating heavy machinery, driving for long distances daily and making critical decisions on a regular basis either as a part of their job or life, often find it difficult to perform to their best abilities after extended periods of staying awake or losing rest. While EHS is a benign condition, its effects are not always that benign. It deserves medical attention and treatment due to its potential interruptive quality.
Since most doctors and sleep specialists view EHS as physically harmless, finding a treatment can be difficult. There are not many options to treat a parasomnia like EHS, but it does help to know that you are not the only one suffering from it. Just learning more about the condition often allows people manage it better than before and find a way to reduce the frequency of these episodes.
In case the condition becomes chronic, and you are crying for a good night’s sleep, here are some mind-blowing things you can try.
A study on a group of 11 physicians revealed that 9 of them had experienced incidents like loud noises and flashes of bright light while falling asleep. Two of them experience these incidents on a regular basis and have been doing so ever since they were children. Therefore, there is still hope that your doctor will understand the seriousness of your complaint and take the latest research on parasomnias into account before giving you actionable advice.
Sometimes, doctors will prescribe tests to ensure that there are no minor seizures or headache disorders. They will likely reassure you that these processes are harmless. It is prevalent practice for all general physicians. Additionally, they might ask you to keep a personal sleep-log that will hold your day’s activity and sleep quality.
It should be a step that follows the doctor’s visit. Ideally, you should never try taking medicines that promise to boost sleep quality or duration without expert advice. Additionally, medications are not a confirmed cure for EHS. Some investigations indicate that tricyclic antidepressants like clomipramine and calcium channel blockers might work in reducing the frequency of it.
People, who exert themselves more throughout the day are more likely to experience parasomnias while falling asleep. Sleep-wake transition disorders often coincide with nighttime anxiety, regular stress, and physical exhaustion.
Modern alternative treatments suggest the use of mindfulness techniques to boost positive energy and channel out the tension. Meditation before bedtime and working out in the mornings are beneficial for treating stress and anxiety in all ages. You can also try some simple relaxation workouts in bed to end the unpleasant saga of night starts.
Good sleeping habit is a broad term that encompasses everything from regulating a sleep schedule, maintaining a regular dinner time, practicing a healthy diet and maybe even meditating for 10 to 20 minutes before sleep.
A large number of people often complaint of insomnia, sleep deprivation, and excessive daytime sleepiness due to a severe lack of regular sleep time. Lifestyle choices and excessive use of electronic gadgets are making the problem worse for all ages.
Although the taboo on mental illnesses and psychological care is receding, several individuals still shy away from asking for expert help from psychologists and psychiatrists. Since there are no apparent causes for the explosive noises, people often assume that they are suffering from one psychological disorder or another.
Incidentally, whether there is an underlying psychiatric condition or not, people often benefit from opting for regular counseling sessions. Firstly, these sessions help people express their feelings, fears, and trepidations about the EHS episodes. Secondly, they can understand that they are neither odd nor untreatable. Finally, talking about life problems and the challenges sleep-wake disorders pose in their lives can help them unwind. It reduces the stress levels significantly and automatically reduces the EHS incidents.
People often spend many sleepless hours worrying about sleep. Checking your watch every 20 minutes and calculating the amount of sleep you will get before the alarm goes off hardly helps in calming you down. Research shows that when people worry more about their sleep onset or sleep duration, they end up staying up for long hours.
A fascinating study states that people often benefit from letting the thoughts and ideas flow before sleep. If there are a bunch of to-dos for you the next day, you might benefit from making a mental list of the tasks. Do not resist the process. The moment you stop worrying about sleep and start thinking about every other thing in that might flow through your mind. You will find the sleep-onset time coming closer than before.
Stay away from alcohol for a while and see if that helps. Many people believe that nightcaps help them fall asleep quickly. What they do not realize is that the effect of alcohol is temporary. As soon as the ephemeral stupor passes, they might find themselves wide awake. Hypnic jerks and EHS can occur while they are falling asleep or waking up due to the effects of the liquor. Remaining well hydrated and drinking juices with a lot of Vitamin C often help more than drinking alcohol before bedtime.
Sometimes, a few simple changes can help you embrace better sleeping quality. Sleep-wake transition disorders are characteristics of poor sleep hygiene. Taking a warm bath before bedtime, adding muscle relaxing bath salts, and massaging your calves and back with warm oil can help you enjoy your sleep. You can also try using lavender oil blends such as Roman chamomile blend with sweet orange blossom essential oil in your bath or your body lotion to induce relaxation of your body and mind.
Chamomile tea, jasmine tea, and lemon zest tea reportedly help people fall asleep faster without unpleasant episodes of nighttime starts or loud imaginary noises. Respected research papers on essential oils and their effects on sleep highlight the impacts of these aromatic compounds on decreasing the recurrence of sleep-wake disorders or parasomnias.
A list of essential precautions you must take to protect yourself, and your loved one include removing solid headboards, detaching sharp bed ornaments, moving the bed from in front of windows and by reducing the height of the bed. Sudden movements like sitting upright with a start or falling back on the mattress after the “spasm” ends, can cause the sufferer to hit his or her head on the hard headboard or bang his or her feet on the hard bed frame. To prevent them from taking a hard tumble, always prefer sleeping on a low bed that is away from open windows.
For children, you might want to keep the idea of a bunk bed or an open French window at bay for the time being. Sometimes, management of sleeping disorders like EHS is more important than finding a cure. Learning more about this particular parasomnia will help you take care of yourself and to keep your loved ones safe.
People who suffer from EHS do not realize that they fall in the broad spectrum of sleep-wake disorders. Sometimes, they drift into regular sleep and start dreaming. Occasionally, their common dream will turn into an episode of sleep paralysis that precedes a loud, horrific scream and maybe buzzing sounds. A few folks, who can control lucid dreaming and out-of-body experiences, believe these episodes of loud noises to be a part of their regular lucid dreaming. With practice, some of them can control the screams, explosions, bangs, and clangs, and channel them into more tolerable and less shuddering electrical whirring noises.
Sometimes, auditory hallucinations are as simple as rings of the doorbell, barking of dogs, and slamming of doors. If you live alone, and without pets, this can be terrifying indeed. However, forums for people who have experienced EHS before assuring others that there is always a way to control these instances.
While reading about the explosive head syndrome, you will notice most blogs, articles and research papers stating that it is a rare disorder that only affects a few. It could not be more untrue right now. With the fast-paced lifestyle, almost 15% of the population report auditory hallucinations. It includes children, adults and seniors alike.
To understand the cause, you may want to think of your brain as a computer processor. When your mind prepares for the sleep mode or hibernation mode, several neural connections are still firing. There are times when the computer freezes while starting or shutting down. There can be the rare misfiring of neurons inside the brain. It results in small but significant kinks that manifest in the form of auditory hallucinations and visual hallucinations.
A recent Journal of Sleep Research study showed that out of the 211 undergraduates who were a part of the survey, almost 18% had experienced EHS in the past at least once. 33% of the group stated that they had experienced sleep paralysis and visual hallucinations along with the loud noises. Psychologists further demonstrated that these episodes were not indicative of brain aneurysms, strokes, or epileptic seizures.
Further research has revealed that sleep experts indeed had no idea of how common this experience was since people usually did not approach their physicians with their bizarre and often scary accounts. Many people experiencing this sleep-wake disorder on a regular basis still believe they are alone and they do not want to attract undue attention to themselves.
In reality, EHS is a widespread phenomenon, especially among kids. It is utterly manageable since the introduction of a few good sleeping habits can alleviate the symptoms significantly. Many of the medications that claim to treat EHS, actually dull the noises instead of eliminating them entirely. There is always another way for beating the exploding head syndrome, recognize the category of sounds and not be afraid of them. This method can work better than medication for children and the elderly.
Co-founder of Counting Sheep and Sleepaholic