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This noise usually occurs within an hour or two of falling [[asleep]], but is not necessarily the result of a [[dream]] and can happen while awake as well.<ref name= "Pearce89Clinical">{{citation |title=Clinical features of the exploding head syndrome |journal=Journal of Neurology Neurosurgery and Psychiatry |author=Pearce JM |year=1989 |volume=52 |issue=7 |pages=907–910 |pmid=2769286}}</ref> While the sound is perceived as extremely loud, it is usually not accompanied by pain. Attacks appear to change in number over time, with several attacks occurring in a space of days or weeks followed by months of remission. Sufferers often feel a sense of [[fear]] and [[anxiety]] after an attack, accompanied by elevated [[heart]] rate. Attacks are also often accompanied by perceived [[Closed-eye hallucination#Levels of CEV perception|flashes of light]] (when perceived on their own, known as a "visual sleep start") or difficulty in breathing. The condition is also known as "auditory sleep starts". It is not thought to be dangerous,<ref name="Pearce89Clinical"/> although it is usually distressing to experience. Sufferers may experience an inability to vocalize any sound, or mild forms of [[sleep paralysis]] during an attack.
==Causes==
The cause of the exploding head syndrome (EHS) is not known, though some physicians have reported a correlation with [[stress (medicine)|stress]] or extreme [[fatigue (physical)|fatigue]]. The condition may develop at any time during life and women suffer from it slightly more often than men. It is more common over the age of fifty, although it has been reported as young as age 10. Attacks can be one-time events, or can recur with attacks increasing or decreasing over time, sometimes with no incidents over long periods of time.<ref name=asa>{{cite web | title=Exploding Head Syndrome | month=September | year=2007 | publisher=American Sleep Association |url=http://www.sleepassociation.org/index.php?p=explodingheadsyndrome |accessdate=2011-03-18 }}</ref>
The mechanism is also not known, though possibilities have been suggested; one is that it may be the result of a sudden movement of a [[middle ear]] component or of the [[eustachian tube]], another is that it may be the result of a form of minor [[seizure]] in the [[temporal lobe]] where the [[nerve]] cells for hearing are located.<ref name=asa/> [[Electroencephalogram]]s recorded during actual attacks show unusual activity only in some sufferers, and have ruled out [[epilepsy|epileptic seizures]] as a cause.<ref name= "PMID 1896728">{{citation |journal=Sleep |year=1991 |month=June |volume=14 |issue=3 |pages=263–266 |title=The exploding head syndrome: polysomnographic recordings and therapeutic suggestions |author=Sachs C, Svanborg E |pmid=1896728}}</ref> But an attack must happen during an episode. If results are normal during the test, only then can [[epilepsy]] be completely ruled out. [[SSRI]] withdrawals have also been known to cause similar phenomena (i.e. [[brain zaps]]). ==Related phenomena==These loud noises are a common feature of [[out-of-body experience]]s. In surveys, as many as 85% of respondents indicate perception of them during the onset of such experiences.<ref>{{cite web |url=http://www.astralinfo.org/obesurvey.htm |accessdate=2011-03-18 |title=Results of OBE Survey |last=Buhlman |first=William |work=The Out of Body Experience }}</ref><ref>{{cite journal |title=The out-of-body experience: a phenomenological typology based on questionnaire responses | author=Twemlow SW, Gabbard GO, Jones FC |journal=American Journal of Psychiatry |year=1982 | first=April |volume=139 |issue=4 |pages=450–455 |pmid=7039367 }}</ref>
==Symptoms==
The exploding head syndrome was first described in 1920 by the Welsh physician and psychiatrist [[Robert Armstrong-Jones]]. He characterized this condition as an exploding sensation in the head. Patients were awakened from their sleep by this event and the sensation persisted for several seconds.<ref name=lancet196_5066_720>{{cite journal |author=Armstrong-Jones R |title=Snapping of the brain |journal=The Lancet |volume=196 |issue=5066 |page=720 | date=October 2, 1920 |doi=10.1016/S0140-6736(01)19948-4 }}</ref> A detailed description of the syndrome was given by British neurologist John M. S. Pearce in 1989, who noted that it was most common in patients that were more than 50 years old.<ref name=torpy_plazzi2010>{{cite book |author=Thorpy MJ, Plazzi G |page=231 |title=The Parasomnias and Other Sleep-Related Movement Disorders |publisher=Cambridge University Press |year=2010 |url=http://books.google.com/books?id=bCh5vsI4AjcC&pg=PA231 |accessdate=2011-03-18 |isbn=0521111579 }}</ref>
Exploding head syndrome is a condition that causes the sufferer to occasionally experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, a ringing noise, the terrific bang on a tin tray, or the sound of an electrical arcing (buzzing). In some cases an instant flash of what is perceived as video "static" is reported.
==Treatment==
Symptoms may be resolved spontaneously over time. It may be helpful to reassure the patient that this symptom is harmless. [[Clomipramine]] has been used in three patients, who experienced immediate relief from this condition.<ref name="PMID 1896728"/>
==See also==
* [[Hypnic jerk]]
[[esCategory:Síndrome de la cabeza explosivaMedical terms]][[frCategory:Syndrome de la tête qui explose]][[fi:Räjähtävän pään oireyhtymä]][[sv:Exploding head syndromeConditions]]
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