Exploding head syndrome's clinical features and an evaluation of polysomnographic findings

Exploding head syndrome (EHS) is defined by the sudden onset of a short-term loud sounds or explosion-like sensation in the head during sleep, or sleep-wake transitions.

To evaluate the clinical characteristics and polysomnographic (PSG) findings of patients diagnosed with EHS.

The files of patients with an EHS diagnosis were retrospectively examined. Patients' clinical characteristics; PGS data; and results from the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Beck Depression and Anxiety Inventory were evaluated. Also, PSG findings were compared with control group data.

In total, 26 patients with EHS and 22 healthy controls were included in our study. The 16 patients who underwent PSG testing and the control group were similar in terms of age and gender. The total sleep time (p = 0.001), sleep efficiency (p < 0.001), and rapid eye movement (REM) percentage (p = 0.019) were significantly lower in the patient group. The sleep latency (p = 0.001), wakefulness after sleep onset (p = 0.001), N1 percentage (p = 0.010), and PSQI score (p = 0.016) were significantly higher in the EHS group. Furthermore, 96% of the patients reported stress, and 84% of the patients had difficulties falling asleep.

In this study the features of EHS are characterized and insomnia patterns emerge from PSG data. Examination with PSG should be considered in the presence of sleep disorders that disrupt sleep continuity. Patients' awareness about EHS should be increased, and people should be educated on taking sleep hygiene measures to strengthen sleep structure.