Exploding Head Syndrome With Obstructive Sleep Apnea: Persisting Symptoms During Naps After Treatment

Exploding Head Syndrome (EHS) involves perception of sudden, loud noise or an explosive sensation in the head during transitions from wakefulness to sleep or upon awakening. Although generally benign, EHS can cause significant distress, leading to awakenings and insomnia. A few studies have suggested a potential association between EHS and obstructive sleep apnea (OSA). In this case report, a 48-year-old man with mild OSA experienced intermittent episodes resembling lightning sensations accompanied by loud noises in his head during sleep. These episodes primarily occurred at night and occasionally happened during naps, lasting only a few seconds but causing considerable distress and difficulty returning to sleep. Treatment with continuous positive airway pressure therapy and clonazepam effectively resolved his nighttime symptoms, although EHS episodes persisted during naps.