Exploding Head Syndrome Associated With Severe Obstructive Sleep Apnea

Exploding head syndrome (EHS) is characterized by a sudden loud noise or sense of explosion in the head at the wake-sleep transition or upon waking during the night. In many cases, its symptoms tend to disappear spontaneously without requiring treatment. Some studies have suggested an association between EHS and obstructive sleep apnea. Here I present an elderly man having an intermittent sense of lightning with a little sound in his head during sleep. Polysomnographic evaluation revealed hypopnea preceding his habitual symptom. EHS symptoms decreased by positional therapy with weight reduction. They nearly disappeared after auto-adjusting positive airway pressure therapy.