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The exploding head syndrome: polysomnographic recordings and therapeutic suggestions
1Department of Neurology, Karolinska Hospital, Stockholm, Sweden.
Sleep
|June 1, 1991
Summary
Exploding head syndrome involves startling auditory or visual hallucinations during sleep. Research suggests these episodes are not epileptic but may stem from waking stress, with symptoms improving over time or with medication.
Area of Science:
- Neurology
- Sleep Medicine
- Psychiatry
Background:
- Exploding head syndrome (EHS) is characterized by sudden, loud noises perceived during sleep transitions.
- This condition causes significant distress and anxiety in affected individuals.
Observation:
- Nine patients with EHS underwent polysomnographic recordings.
- Attacks were reported during sleep or drowsiness, but recordings indicated they occurred during wakefulness.
- Electroencephalogram (EEG) and electromyogram (EMG) showed increased alertness during some reported episodes.
Findings:
- No neurological disorders were identified in any patient.
- The study found no evidence of an epileptic origin for EHS.
- Symptoms showed spontaneous improvement over time and responded to reassurance and clomipramine treatment.
Implications:
- EHS may not be a true hypnagogic phenomenon but rather a manifestation of waking emotional stress.
- Further research into the psychological underpinnings of EHS is warranted.
- Treatment strategies should consider both reassurance and pharmacological interventions.