Exploding Head Syndrome – A Puzzling Parasomnia: A Literature Review
DOI:
https://doi.org/10.12923/2353-8627/2025-0008Keywords:
exploding head syndrome, parasomnias, sleep disordersAbstract
Introduction: Exploding head syndrome (EHS) is a rarely diagnosed sleep disorder classified as a parasomnia. It is characterised by sudden auditory hallucinations resembling explosions, gunshots, or loud cracking sounds that occur during falling asleep or waking up. Although EHS seldom causes physical pain, it is often associated with severe anxiety and sleep disruption. Despite its relatively high prevalence, awareness of this disorder among physicians and patients is low.
The aim and methods: The purpose of this article is to present the current state of knowledge about the EHS, its classification, symptomatology, diagnosis, and treatment methods. A literature review was conducted in the PubMed and Google Scholar databases, covering publications from 1980–2025, searching for the following terms: exploding head syndrome, parasomnias, sleep disorders.
Results: The incidence of EHS has not been clearly defined, while research results indicate that it may affect 10–52.7% of the population. Although the first descriptions of this disorder date back to the 17th century, the ICD Classification included this syndrome for the first time together with the criteria for its diagnosis in the last 11th edition. This syndrome may co-occur with other sleep disorders, neurological disorders, and mental disorders. The etiology remains unclear, but the most popular theories suggest that it may be related to abnormal brainstem activity, GABAergic, and serotonergic neurotransmission disturbances or sensory processing dysfunctions. Treatment is based mainly on psychoeducation, improved sleep hygiene, and in some cases, pharmacotherapy.
Conclusions: EHS is an underdiagnosed disorder that requires further research. Increased awareness and better diagnostics can improve the quality of life of patients. Additional research is needed to investigate its mechanisms and effective treatment methods.
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