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Hearing loud sounds in my ear
Hear loud noise while falling asleep
Hear explosion sounds while waking up
Difficulty sleeping
Insomnia
Lack of deep sleep
Tinnitus
Seeing flashes of light when falling asleep
Can't go back to sleep once awake
Heart racing
Anxious or scared
Sweating at night
Not seeing your symptoms? No worries!
Exploding head syndrome (EHS) is a sleep disorder where someone hears a loud noise or explosive crashing sound in their head. The sound isn't real or heard by anyone else.
Your doctor may ask these questions to check for this disease:
Medications found helpful include antidepressant clomipramine and calcium channel blockers. Focus on possible triggers of the episode, such as maintaining adequate sleep and adopting relaxation techniques to relieve anxiety.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 3, 2025
Following the Medical Content Editorial Policy
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Q.
Hearing Colors? Why Your Senses Cross & Medically Approved Next Steps
A.
Hearing colors or seeing sounds can be a normal form of synesthesia, a lifelong and often harmless cross-wiring of the senses. There are several factors to consider; see below to understand how consistent, automatic experiences differ from hallucinations and why history since childhood, triggers, and day-to-day impact all matter. New or rapidly changing sensory crossovers, or those with headaches, seizures, weakness, speech or vision changes, or sleep-linked loud bangs, can signal migraine, epilepsy, stroke, medication effects, or Exploding Head Syndrome; seek emergency care for stroke signs and see below for medically approved next steps such as MRI, EEG, sleep evaluation, and treating the underlying cause.
References:
* Rouw R, Scholte HS. Neural mechanisms of synesthesia. Rev Neurosci. 2018 Oct 25;29(7):727-738. doi: 10.1515/revneuro-2017-0079. PMID: 30283030.
* Zhang J, Zhou H, Fan H, Hu X, Li Q. Functional and structural brain changes associated with synesthesia: A systematic review and meta-analysis. Front Neurosci. 2022 Oct 26;16:981987. doi: 10.3389/fnins.2022.981987. eCollection 2022. PMID: 36380907; PMCID: PMC9642279.
* Hupé JM, van Leeuwen TM. Synesthesia: Cross-modal interactions as a source of novel experiences. Neurosci Biobehav Rev. 2021 Oct;129:1-21. doi: 10.1016/j.neubiorev.2021.07.026. Epub 2021 Jul 27. PMID: 34551703.
* Ramachandran VS, Brang D. A unifying neurocognitive account of synesthesia: cross-talk between sensory, limbic, and parietal areas. J Neurophysiol. 2011 Dec;106(6):2910-23. doi: 10.1152/jn.00238.2011. Epub 2011 Nov 2. PMID: 22051664.
* Hänggi J, Wotruba D, Jäncke L. Increased brain connectivity in grapheme-color synesthesia. PLoS One. 2015 Sep 28;10(9):e0139412. doi: 10.1371/journal.pone.0139412. eCollection 2015. PMID: 26415705; PMCID: PMC4586311.
Q.
Being "Pulled" Out of Bed? The Physics of Sleep Hallucinations
A.
Feeling pulled out of bed is a common form of sleep paralysis, caused by your brain waking while your body remains in REM atonia, with vestibular misfires and lingering dream imagery creating vivid motion sensations that feel real but are usually harmless. There are several factors to consider; see below to understand more. To lower risk, keep a steady sleep schedule, sleep on your side, manage stress and alcohol, and during an episode focus on slow breathing and small movements; see below for when to seek care, especially if episodes are frequent, disrupt your life, or come with extreme daytime sleepiness or sudden muscle weakness with emotions.
References:
* Sharpless BA. A comprehensive review of the literature on isolated sleep paralysis. Psychol Bull. 2020 Jan;146(1):109-139. doi: 10.1037/bul0000216. PMID: 30678250.
* Cheyne JA, Rueffer SD, Newby-Clark IR. Hypnagogic and hypnopompic hallucinations during sleep paralysis: neurological mechanisms and cultural interpretations. J Sleep Res. 2014 Jun;23(3):311-20. doi: 10.1111/jsr.12122. Epub 2014 Apr 9. PMID: 24719266.
* Cheyne JA, Newby-Clark IR. Sleep paralysis and the feeling of falling. Sleep Med Rev. 2016 Feb;25:89-98. doi: 10.1016/j.smrv.2015.06.002. Epub 2015 Oct 14. PMID: 26607065.
* Cheyne JA. Somatic and Vestibular Experiences During Sleep Paralysis. Sleep Med. 2013 Nov;14(11):1144-8. doi: 10.1016/j.sleep.2013.06.002. Epub 2013 Jul 24. PMID: 23746688.
* Levet A, Sagaspe P, Sabourdy C, Cochen De Cock V, Marillier M, Lopez R. Neural correlates of sleep paralysis hallucinations. J Sleep Res. 2019 Dec;28(6):e12869. doi: 10.1111/jsr.12869. Epub 2019 Jul 29. PMID: 31358941.
Q.
Did Someone Call Your Name? Why You Hear Voices Before Sleep
A.
Hearing your name as you fall asleep is usually a harmless hypnagogic hallucination that occurs as the brain shifts from wakefulness to sleep, and it can feel vividly real. Most cases are brief and improve with better sleep habits and stress control, but see below for key details on other causes such as exploding head syndrome or narcolepsy and for red flags that should prompt a doctor visit including voices while fully awake, frequent or disturbing episodes, marked daytime sleepiness, repeated sleep paralysis, or new neurological symptoms.
References:
* Chellappa, S. L., & Cajochen, C. (2018). Hypnagogic hallucinations: a review of current research and future directions. *Journal of Clinical Sleep Medicine, 14*(11), 1957–1964. PMID: 30424844
* Waters, F., & Fernyhough, C. (2016). Auditory hallucinations in sleep disorders and their differential diagnosis. *Sleep Medicine Reviews, 25*, 37-43. PMID: 26059286
* Ohayon, M. M., & Schatzberg, A. F. (2010). Hypnagogic and hypnopompic hallucinations: Pathological phenomena or normal variations of sleep? *Journal of Sleep Research, 19*(2), 264-272. PMID: 20021677
* Denis, D., & Grenier, M. (2020). The role of sleep in hallucinatory experiences across psychiatric and non-psychiatric populations: A systematic review. *Schizophrenia Research, 225*, 243-261. PMID: 32943362
* Corbetta, S., Valli, I., Cavallaro, R., & D'Agostino, A. (2020). Hypnagogic and Hypnopompic Hallucinations: A Narrative Review of Their Phenomenology and Psychophysiological Underpinnings. *Frontiers in Psychology, 11*, 592864. PMID: 33364964
Q.
Did Someone Just Whisper? Why the "Presence" Hallucination is Real
A.
Hearing a whispered name or sensing a presence can be a real perception created by the brain, often tied to sleep transitions, stress, anxiety, fatigue, or the brain misreading quiet background sounds. There are several factors to consider. See below to understand more. Most brief, isolated episodes are benign, but seek care if voices are frequent, commanding, or occur with mood, thinking, or neurological changes, severe distress, or sudden illness, since treatable conditions can be involved. Practical steps to reduce recurrence and clear guidance on when to act are outlined below.
References:
* Glicksohn J, Berkovitz-Segev M, Golan A, Taler A. The sense of felt presence: A systematic review and meta-analysis. Conscious Cogn. 2020 Nov;86:103038. doi: 10.1016/j.concog.2020.103038. Epub 2020 Sep 17. PMID: 32958742.
* Demeter G, Demeter J. Sense of presence and agency in health and disease: theoretical considerations and clinical implications. J Mol Neurosci. 2020 Apr;70(4):534-541. doi: 10.1007/s12031-020-01524-7. Epub 2020 Mar 19. PMID: 32188680.
* Brugger P, Regard M, Wieser HG. The sense of a 'felt presence' in neurological and psychiatric conditions. J Neuropsychiatry Clin Neurosci. 2014 Spring;26(2):120-30. doi: 10.1176/appi.neuropsych.13030062. PMID: 24796349.
* Saracostas M, Di Bartolo L, Papageorgiou D, Giannopoulou I, Kyriakopoulos M. The sense of felt presence and its relationship to psychological trauma. Psychol Trauma. 2023 Oct;15(7):1107-1110. doi: 10.1037/tra0001402. PMID: 36737568.
* Brugger P, Lenggenhager B. Sense of presence and agency: a brief review. Curr Opin Behav Sci. 2018 Feb;19:123-128. doi: 10.1016/j.cobeha.2018.02.004. Epub 2018 Jun 20. PMID: 29965646.
Q.
Flashing Lights and Closed Eyes: Why Your Brain is Misfiring
A.
Flashes of light with closed eyes are often benign photopsias from sleep transitions, migraines, mild retinal stimulation, or eye pressure, but they can sometimes indicate serious problems like a retinal tear or detachment or less common neurological issues. There are several factors to consider, especially sudden new flashes with floaters, a dark curtain, vision loss, severe headache, weakness, confusion, or recent head injury, which change urgency and which clinician to see. See below for the full details on red flags, when to seek urgent care, and practical next steps you can take now.
References:
* Vella S, Tassinari CA, De Marco P, De Marco I, Tana MG. Photic stimulation and EEG rhythms: a systematic review. Clin Neurophysiol. 2018 Apr;129(4):755-764. doi: 10.1016/j.clinph.2018.01.006. Epub 2018 Jan 11. PMID: 29337033.
* Cogan J, Mistry S, Saifee TA. The spectrum of spontaneous visual phenomena. Pract Neurol. 2018 Apr;18(2):107-116. doi: 10.1136/practneurol-2017-001799. Epub 2018 Feb 21. PMID: 29555776.
* Shrivastava D, Kim D, Behbehani A, Waseef S, Hamedani AG. Visual snow syndrome: A clinical, pathophysiological, and therapeutic review. J Neuroophthalmol. 2023 Sep 1;43(3):e284-e298. doi: 10.1097/WNO.0000000000001859. Epub 2023 Jun 26. PMID: 37372338.
* Schankin CJ, Goadsby PJ. Cortical hyperexcitability and its role in visual snow syndrome pathophysiology. Curr Opin Neurol. 2020 Aug;33(4):428-435. doi: 10.1097/WCO.0000000000000831. PMID: 32665672.
* De Martino L, Vanagaite V, De Gregorio F, Goadsby PJ. Visual processing in migraine: from symptoms to pathophysiology. Cephalalgia. 2018 Jun;38(7):1314-1327. doi: 10.1177/0333102418760079. Epub 2018 Feb 28. PMID: 29498263.
Q.
Floating Objects? The Disorienting Visuals of Broken Sleep
A.
Seeing floating objects when you wake is usually a benign effect of broken sleep, most often hypnopompic hallucinations or sleep paralysis during the sleep wake transition, and improving sleep consistency and managing stress can reduce episodes; there are several factors to consider, so see below for causes, triggers, and ways to reduce episodes. Seek prompt medical care if visuals occur when fully awake, persist, or come with severe headache, neurologic symptoms, or follow a head injury, and consider Exploding Head Syndrome if loud bangs or bright flashes accompany episodes; specific red flags and next-step guidance are detailed below.
References:
* Ohayon MM. Hypnagogic and hypnopompic hallucinations as isolated phenomena: an update on prevalence and clinical relevance. Sleep Med Rev. 2011 Apr;15(2):123-37. doi: 10.1016/j.smrv.2010.05.004. PMID: 20719543.
* Chee MWL, Lee V, Tan JC. Perceptual distortions during sleep inertia. Sleep. 2013 Aug 1;36(8):1257-61. doi: 10.5665/sleep.2890. PMID: 23904832.
* Sasayama D, Kono M, Yamamoto M, Tanaka S. REM sleep intrusion and visual hallucinations in narcolepsy. J Neurol Sci. 2016 Jan 15;360:1-3. doi: 10.1016/j.jns.2015.11.014. PMID: 26654876.
* Lim J, Dinges DF. The effect of sleep deprivation on visual processing: from detection to interpretation. Sleep Med Rev. 2020 Feb;49:101231. doi: 10.1016/j.smrv.2019.101231. PMID: 31734267.
* Sio UT, Sio U. Sleep disruption and visual processing: a systematic review. J Sleep Res. 2023 Apr;32(2):e13745. doi: 10.1111/jsr.13745. PMID: 36411516.
Q.
Head Vibrations? The Strange Physical Signs of Sleep Paralysis
A.
Head vibrations during sleep paralysis are common and usually harmless, caused by a REM wake-sleep mismatch, dream spillover, and heightened fear that amplifies buzzing or pressure sensations. There are several factors to consider, including red-flag symptoms that need urgent evaluation, the overlap with Exploding Head Syndrome, and practical steps to prevent or manage episodes; see complete details below to guide your next healthcare steps.
References:
* Denis, J. H., van der Velde, C. H. H. L., van Someren, J. C. A. G. G., van den Bosch, L. E. J. C., van der Wee, L. S. J. M., & van der Linden, R. J. L. P. (2020). Sleep paralysis and associated symptoms: A systematic review and meta-analysis. *Frontiers in Psychiatry*, *11*, 559021.
* Ma, X., Qu, Y., Zhou, Y., & Chen, H. (2020). Sleep paralysis with associated clinical features and its relationship with psychiatric disorders: An observational study. *Sleep and Breathing*, *24*(3), 963-971.
* Cheyne, J. A., Rueffer, S., & Newby-Clark, I. R. (1999). The clinical features of isolated sleep paralysis: an observational study. *Journal of Sleep Research*, *8*(1), 21-26.
* Sharpless, B. A. (2014). Sleep paralysis: A review of current research. *Current Psychiatry Reports*, *16*(9), 468.
* Cheyne, J. A., & Newby-Clark, I. R. (2000). Sensory, motor and affective phenomena during sleep paralysis: a review and commentary. *Journal of Sleep Research*, *9*(2), 163-172.
Q.
Phantom Music? Why Your Brain Creates Soundscapes as You Drift Off
A.
Phantom music or radio static as you drift off is usually a normal sleep phenomenon called hypnagogic hallucinations, when the brain’s auditory system generates internal sound patterns as you transition to sleep, especially with stress, sleep loss, irregular schedules, or some medications. There are several factors to consider, including how these differ from daytime psychiatric hallucinations, and related patterns like Exploding Head Syndrome and hearing loss related musical ear syndrome. See below for red flags that mean you should see a doctor and for practical steps to reduce episodes, since these details could affect your next healthcare decisions.
References:
* Avidan AY. Hypnagogic and hypnopompic hallucinations: A review of the literature. Sleep Med Rev. 2021 Apr;56:101402. doi: 10.1016/j.smrv.2021.101402. Epub 2021 Jan 29. PMID: 33545620.
* Blom RM, den Boon G. Musical ear syndrome: an under-recognized phenomenon. J Laryngol Otol. 2021 Sep;135(9):839-844. doi: 10.1017/S002221512100188X. Epub 2021 Jul 26. PMID: 34304677.
* Terzaghi M, Zibetti M, Bergamasco M, Sforza E, D'Angelo R, Rundo F, Mina C, Vianello G, Manfrin M, Cicolin A. Neural Correlates of Hypnagogic Hallucinations. J Sleep Res. 2021 Aug;30(4):e13337. doi: 10.1111/jsr.13337. Epub 2021 Apr 22. PMID: 33887295.
* Sforza E, Terzaghi M, D'Angelo R, Zibetti M. Hypnagogic states and their neural correlates: An updated review. Front Neurol. 2023 Jul 19;14:1228224. doi: 10.3389/fneur.2023.1228224. PMID: 37533816; PMCID: PMC10395726.
* Ohayon MM. Neuropsychiatric Aspects of Hypnagogic Hallucinations. J Clin Sleep Med. 2021 Dec 1;17(12):2535-2547. doi: 10.5664/jcsm.9547. PMID: 34097486; PMCID: PMC8766157.
Q.
The "Brain Buzz": Why Sound Distortions Happen During Paralysis
A.
Sound distortions during sleep paralysis are usually benign and happen when REM dream activity overlaps with waking, your body is still in REM atonia, and the brain’s threat system heightens internal sensory noise into buzzing, humming, or roaring. There are several factors to consider, including how to tell this from exploding head syndrome, red flags that warrant medical evaluation, and practical steps to reduce episodes; see below for the complete answer and next-step guidance.
References:
* Cheyne JA. Apparitions and "the demon" of sleep paralysis. Cortex. 2005 Sep;41(6):894-906. doi: 10.1016/s0010-9452(08)70275-7. PMID: 16180379.
* Cheyne JA, Rueffer SD, Newby-Clark IR. Hypnagogic and hypnopompic hallucinations during sleep paralysis: neurological mechanisms and cultural interpretations. J Nerv Ment Dis. 1999 Aug;187(8):471-80. doi: 10.1097/00005053-199908000-00004. PMID: 10459800.
* Hori N, Hiraoka M, Uwatoko R, Kanemura S, Fukumura K, Matsuura M. Sleep paralysis and subjective report of fear related to auditory experience. J Sleep Res. 2011 Dec;20(4):541-7. doi: 10.1111/j.1365-2869.2010.00902.x. PMID: 20977464.
* Leppälahti T, Kauppila A, Vestergaard-Poulsen P, Alakuijala A, Tervonen L, Lahti J, Koskela M, Leppälahti M, Hiltunen J, Järvelin H, Saarenpää-Heikkilä O, Kortesluoma S, Alahuhta S, Kiviniemi V. Altered brain activation during sleep paralysis: An fMRI study. Sleep Med. 2022 Dec;100:329-335. doi: 10.1016/j.sleep.2022.09.023. Epub 2022 Oct 26. PMID: 36306509.
* Terzaghi M, Gigli GL, Zibetti M, De Fusco M, Cudia P, De Rosa A, Frusciante R, Grassi M, Sartori I, Sanna A, Mulas D, Aguglia E, Bertini E. Sleep paralysis with vivid multimodal hallucinations: A peculiar clinical phenotype. Clin Neurophysiol. 2024 Mar 22;160:11-20. doi: 10.1016/j.clinph.2024.03.012. Epub ahead of print. PMID: 38555299.
Q.
The "Exploding Head" Sound: Why You Hear Loud Bangs at Night
A.
Hearing a sudden loud bang as you fall asleep is commonly due to Exploding Head Syndrome, a benign sleep-related event where the brain briefly misfires during the wake to sleep transition; it is usually painless and often linked to stress, sleep loss, or irregular schedules. There are several factors to consider, including steps to reduce episodes with better sleep habits and when red flags like severe headache, weakness, confusion, or vision changes mean you should seek urgent care. See below for complete details and the next steps to discuss with a healthcare provider.
References:
* Evans RW. Exploding Head Syndrome: Diagnosis, Pathophysiology, and Management. Curr Neurol Neurosci Rep. 2021 May 26;21(7):39. PMID: 34041656.
* Sharpless BA. Exploding Head Syndrome: Update on a Proposed Parasomnia. Sleep Med Rev. 2018 Dec;42:156-157. PMID: 30098797.
* Sharpless BA, et al. Exploding Head Syndrome: An International, Multi-centre, Cross-sectional Study. J Sleep Res. 2017 Aug;26(4):514-517. PMID: 28326758.
* Pareja JA, et al. Exploding head syndrome: The nightmare of a loud bang in your head. Cephalalgia. 2020 Jan;40(1):108-111. PMID: 31535974.
* Sharpless BA. Exploding Head Syndrome: A Case Series and Comparison with Hypnic Jerks. Sleep. 2019 Apr 1;42(4):zsy255. PMID: 30735399.
Q.
The "Happy Lean": Why You Can't Hold Your Head Up When Laughing
A.
Head drop or a “happy lean” during laughter or strong emotion is often cataplexy, a brief, conscious loss of muscle tone commonly linked to narcolepsy, and it tends to happen more when you are tired. There are several factors to consider and key differences from fainting or seizures; see the complete explanation below. Because episodes can pose safety risks and are treatable, next steps may include seeing a sleep specialist for testing and discussing lifestyle changes and medications; red flags and evaluation options are outlined below. Reviewing the details below can help you decide when to seek care and which questions to ask.
References:
* Overeem S, et al. Cataplexy: A Clinical Perspective. *Sleep Med Rev*. 2011 Feb;15(1):3-11. doi: 10.1016/j.smrv.2010.06.002. Epub 2010 Oct 21. PMID: 20970344; PMCID: PMC3008034.
* Bassetti CL, et al. Cataplexy: clinical aspects, pathophysiology and treatment. *Curr Opin Neurol*. 2011 Dec;24(6):574-81. doi: 10.1097/WCO.0b013e328340d21e. PMID: 20978393.
* Provine RR. The physiology of laughter. *J Gen Psychol*. 1996 Oct;123(4):371-8. doi: 10.1080/00221309609602052. PMID: 8904005.
* Berk RA, et al. Physiological effects of mirthful laughter. *Altern Ther Health Med*. 2001 Jul-Aug;7(4):62-76. PMID: 11680549.
* Wild B, et al. Laughter: a human universal with a neural specialisation. *Trends Cogn Sci*. 2003 Jul;7(7):294-7. doi: 10.1016/s1364-6613(03)00139-7. PMID: 12832367.
Q.
The "Inner Explosion": Why Naps Cause Loud Internal Noises
A.
Sudden loud bangs, crashes, or zaps that jolt you awake from a nap are most often Exploding Head Syndrome, a generally harmless parasomnia from brief brain misfires during sleep transition, not a stroke or seizure. There are several factors to consider, including common triggers, simple sleep and stress fixes, and red flag symptoms that require prompt medical care; see below for details that could guide your next steps.
References:
* Sharpless BA. Exploding Head Syndrome: An Update. Sleep Med Clin. 2022 Mar;17(1):17-21. PMID: 35242037.
* Sharpless BA. Exploding head syndrome: a review of current knowledge. Sleep Med Rev. 2018 Apr;38:1-6. PMID: 28659223.
* Frese MP, O'Neill J, Frese A. Exploding Head Syndrome: An Unusual Sleep-Related Phenomenon. J Clin Sleep Med. 2018 Apr 15;14(4):725-728. PMID: 29596489.
* Sharpless BA, Kim R, Lee MG, Van L. Exploding head syndrome and sleep onset: A case series. Sleep Sci. 2015 Dec;8(4):254-6. PMID: 26966453.
* Denis D, Montplaisir J, Poirier G. Exploding head syndrome: update on diagnosis and treatment. Curr Treat Options Neurol. 2015 Jan;17(1):335. PMID: 25482590.
Q.
The "Sleep Demon" Explained: Why Paralysis Creates Dark Figures
A.
Sleep paralysis dark figures are a normal, not supernatural, brain effect when REM paralysis overlaps with waking, keeping dream imagery and the fear center active so the mind projects a shadowy presence, often at the foot of the bed. Episodes are usually harmless, but triggers, prevention steps, and red flags for medical care such as frequent episodes, anxiety impact, or daytime sleepiness can change your next steps, so see the complete guidance below.
References:
* Joad S, Singh I, Jain S, Gupta R. Sleep paralysis: current perspectives. Sleep Sci. 2023 Mar 15;16(1):70-75. doi: 10.5935/1984-0063.20230006. PMID: 36928641.
* Sharpless BA, McCarthy KS, Nordhus IH, Thoresen S, Nilsen ØB, Witters DL Jr, Lønnum K, Helgadóttir FD, Grønli J. The Phenomenology of Isolated Sleep Paralysis: a Systematic Review. Sleep Med Rev. 2020 Feb;49:101211. doi: 10.1016/j.smrv.2019.101211. Epub 2019 Oct 17. PMID: 31753557.
* French CC, Santomauro S, Hamilton VJ, Fox JT, Thai V, Gregory AM. The "Sleep Paralysis Profile": A New Scale for Assessing Sleep Paralysis Experiences. J Sleep Res. 2020 Oct;29(5):e13028. doi: 10.1111/jsr.13028. Epub 2020 Apr 23. PMID: 32329591.
* Denis D, French CC, Gregory AM. Sleep paralysis and its associations with trauma and PTSD: a systematic review. Sleep Med Rev. 2020 Feb;49:101230. doi: 10.1016/j.smrv.2019.101230. Epub 2019 Oct 29. PMID: 31753556.
* Cheyne JA. The ominous numinous: senses of presence and other manifestations of sleep paralysis. J Conscious Stud. 2002;9(12):133-54. PMID: 22002773.
Q.
Exploding Head Syndrome or Hallucinations? A Woman’s Action Plan
A.
There are several factors to consider. See below to understand more. Sudden single loud bangs or flashes that happen only as you fall asleep or wake up, without lingering confusion, most often point to benign Exploding Head Syndrome, which is more common in women and during stress or sleep loss; events during full wakefulness, with longer voices or visuals or confusion, suggest true hallucinations. Key next steps include tracking timing and triggers, improving sleep and stress, reviewing medications, and speaking with a clinician, with urgent care needed for red flags like the worst headache, weakness, speech or vision changes, seizures, or chest pain; see the complete action plan below.
References:
* Sharpless, B. A. (2018). Exploding head syndrome. *Sleep Medicine Reviews, 37*, 107-113.
* Sharpless, B. A. (2020). Differential diagnosis of exploding head syndrome. *Journal of Clinical Sleep Medicine, 16*(11), 1957-1961.
* Freestone, D., & Sharpless, B. A. (2020). Exploding Head Syndrome: Diagnosis, Treatment, and Etiology. *Current Treatment Options in Neurology, 22*(12), 40.
* Chey, J., & Sharpless, B. A. (2022). Nocturnal Auditory Hallucinations: A Review of Etiology and Treatment. *Journal of Sleep Research, 31*(2), e13511.
* Sharpless, B. A., & Chey, J. (2020). The psychological impact of exploding head syndrome. *Sleep Medicine Reviews, 53*, 101344.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Khan I, Slowik JM. Exploding Head Syndrome. [Updated 2022 Dec 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing
https://www.ncbi.nlm.nih.gov/books/NBK560817/Nakayama M, Nakano N, Mihara T, Arima S, Sato S, Kabaya K, Suzuki M, Kitahara T. Two cases of exploding head syndrome documented by polysomnography that improved after treatment. J Clin Sleep Med. 2021 Jan 1;17(1):103-106. doi: 10.5664/jcsm.8790. PMID: 32959775; PMCID: PMC7849637.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7849637/Dan Denis, Giulia L Poerio, Sarah Derveeuw, Isabella Badini, Alice M Gregory, Associations between exploding head syndrome and measures of sleep quality and experiences, dissociation, and well-being, Sleep, Volume 42, Issue 2, February 2019
https://academic.oup.com/sleep/article-abstract/42/2/zsy216/5245405?redirectedFrom=fulltext