Prevalence and impact of exploding head syndrome in a Japanese working population

Exploding head syndrome (EHS) is a parasomnia characterized by the perception of loud noises, or explosions inside the head during the sleep-to-wake transition. The prevalence of EHS remains unclear. This survey aimed to elucidate the prevalence of and factors associated with EHS in this cohort.

As part of the Night in Japan Home Sleep Monitoring Study (NinjaSleep study), a cross-sectional survey was conducted among government employees in Koka City, Shiga Prefecture, Japan, in 2022. Participants were queried regarding their experiences with EHS as defined in the International Classification of Sleep Disorders, 3rd Edition, including sudden loud noises or sensations of explosions, subsequent abrupt awakenings and feelings of fright. Various standardized instruments were employed to evaluate depression, anxiety, insomnia, quality of life, and fatigue.

Of the 2081 employees invited to participate, 1878 completed the survey. After excluding respondents with epilepsy and incomplete responses, 1843 participants were deemed eligible for analysis. Among them, 46 (2.49%) reported experiencing sudden noises or sensations of explosions, with 23 (1.25%) meeting the diagnostic criteria for EHS. The EHS was significantly related to the scores on the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Athens insomnia scale, and Chalder fatigue scale, even after adjusting for age, sex, body mass index, and categorized mean sleep duration.

This study elucidates the prevalence of EHS among the Japanese population and underscores its potential association with insomnia symptoms and various psychological factors.