Exploding Head Syndrome

Exploding head syndrome (EHS) is a rarely reported disorder of unknown etiology characterized by a momentary loud noise that patients usually experience during the early stages of sleep. Fear, terror, palpitations, or a forceful heartbeat usually follow with occasional descriptions of an associated flash of light or a sensation of stopping breathing. EHS can occur at any age, especially in people older than 50 years. Diagnosis is made by the clinical history and testing is not required. Although explanation and reassurance suffice for most, there are anecdotal reports of benefits for treatment with clomipramine, nifedipine, flunarizine, topiramate, and use of an oral appliance for a patient with obstructive sleep apnea.