Single Patient Multiple Explosions: A Case Report on Exploding Head Syndrome

Exploding head syndrome (EHS) is an uncommon sleeping disorder that is described by patients as a loud noise occurring while transitioning into and out of sleep. It is not accompanied by a headache but causes a sense of fright. We describe the case of a 58-year-old female patient, presenting with a total of 11 events of EHS occurring at bedtime. Events shared some features but also had unique characteristics. The workup was negative, making a diagnosis of EHS more likely. CPAP was recommended for a newly diagnosed obstructive sleep apnea, but despite non-compliance with the treatment plan, the patient had a complete resolution of her symptoms. Exploding head syndrome is an underreported parasomnia reported in the literature. Our case report demonstrates that a single patient could exhibit different features in displaying EHS, which was shown by changes in the noise description, pattern, and accompanying jerk movement. It also hints at patient education and reassurance as a possible treatment plan.