Abstract
Background Exploding head syndrome (EHS) is characterized by hearing a sudden loud noise or
experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep.
The experience of EHS shares similarities with tinnitus, where an individual perceives
a sound without any external sound source. To the authors' knowledge, the possible
relationship between EHS and tinnitus has not been explored.
Purpose Preliminary assessment of prevalence of EHS and its related factors among patients
seeking help for tinnitus and/or hyperacusis.
Research Design Retrospective cross-sectional study.
Study Sample A total of 148 consecutive patients who sought help for tinnitus and/or hyperacusis
at an audiology clinic in the United Kingdom.
Data Collection and Analysis The data regarding demographics, medical history, audiological measures, and self-report
questionnaires were collected retrospectively from the patients' records. Audiological
measures comprised of pure-tone audiometry and uncomfortable loudness levels. The
self-report questionnaires which were administered as a part of standard care comprised
of the Tinnitus Handicap Inventory, numeric rating scale of tinnitus loudness, annoyance,
and effect on life, hyperacusis questionnaire, Insomnia Severity Index, Generalized
Anxiety Disorder scale 7, and Patient Health Questionnaire (PHQ-9). To establish presence
of EHS, participants were asked “Do you ever hear a sudden, loud noise, or feel a
sense of explosion in your head at night?”
Results EHS was reported by 8.1% of patients with tinnitus and/or hyperacusis (12 out of
148). The patients with and without EHS were compared, but no significant relationships
were found, between the presence of EHS and age, gender, tinnitus/hyperacusis distress,
symptoms of anxiety or depression, sleep difficulties, or audiological measures.
Conclusion The prevalence of EHS in a tinnitus and hyperacusis population is similar to that
in the general population. While there does not seem to be any association with sleep
or mental factors, this might be due to the limited variability in our clinical sample
(i.e., most patients exhibited high level of distress regardless of EHS). Replication
of the results in a larger sample with more variety of symptom severity is warranted.
Keywords
exploding head syndrome - tinnitus - hearing loss - hyperacusis
