Exploding head syndrome: clinical features, theories about etiology, and prevention strategies in a large international sample. Trusted Source Pregnant women are not advised to use migraine medications. All these sensory motor capabilities [we have] when were awake have to be reprogrammed.. Luckily, the crash, bang, or boom lasts only a few seconds and disappears as soon as the person awakens. Here's a genetic disorder you've probably never heard of: human werewolf syndrome, also known as hypertrichosis. You can also try taking a warm bath before bedtime, spraying a calming fragrance in your bedroom or using other methods that work for you to relieve stress. Many [patients] said they had been ashamed to mention it to their doctors or that their complaint had been greeted with incredulity if not frank disbelief, he wrote in his 1989 study Clinical features of the exploding head syndrome. It is entirely benign, and I suspect quite common, but underreported.. EHS has been described as "a sensory parasomnia characterised by the perception of loud noises and/or a sense of explosion in the head when transitioning to or from sleep. These criteria are: Your sleep specialist may want to order certain tests to rule out other conditions. But when I get up to look around, nothings amiss and everythings quiet. After dealing with it off and on for the last several months, Raymond believes she may have exploding head syndrome. That said, some claim to experience a greater number of episodes when they are stressed or tired. Some people who experience exploding head syndrome have one event in a lifetime. Women are more likely to have it than men. First described in 1920 as a snapping of the brain, there is little to be found on the phenomenon in medical literature. She has a Master's degree in Health Communication and a Bachelor's degree in journalism. When the brain changes from wake to sleep, there are some pretty big changes, Jones says. People with EHS reported that their sleep duration was on average about six minutes shorter than those without, and it took 30 minutes longer for them to transition from full wakefulness to sleep. This sound occurs when you're asleep and. The disorder, which is noted in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, was first recognized about 130 years ago, when it was characterized as "sensory discharges," and. muscle aches. Unusual and Rare Psychological Disorders, Oxford University Press, 2016. You should contact a medical professional if you have a severe headache accompanied with other symptoms, such as: Additional circumstances in which your headache should be investigated by a healthcare provider include: Headaches are common and can be caused by a variety of factors. The symptoms of COVID19 are variable but often include fever, cough, headache, fatigue, breathing . Primary health professionals, neurologists, and sleep medicine doctors can diagnose exploding head syndrome, based on your description of the symptoms. Various factors may cause nighttime panic attacks. Its a sleep disorder. How often are you consuming alcohol before bed? As Molly Howell, a state health official in North Dakota, watched a webinar on how to distribute what's expected to be the first Covid-19 vaccine, her head began to spin. According the International Classification of Sleep Disorders, patients must meet all of the following criteria to receive an EHS diagnosis: 1. This time, the new symptoms tend to be more neurologic, including confusion, dizziness and difficulty concentrating. @Exploding_Heads chaps, just started listening to the breakfast show and it's brilliant It's a show Wanted to say well done The symptoms of a tension headache may worsen when you look into the light or hear loud noises. The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. "How are we going to. How frequently do your legs feel restless or do you kick in your sleep? All rights reserved. You dont experience any physical pain during or after the episode. A history of insomnia, or increased stress, may also make it more likely to experience an episode of this condition. If your anxiety over these episodes is overwhelming, talk with your provider. This may be due to sleep apnea, insomnia, or exploding head syndrome. Pearce, the British neurologist who coined the term, calls it a mystery requiring further study. Are you aware of any sudden or unusual movements during sleep? Since EHS does not appear to affect sleep duration or architecture, some patients undergo polysomnography tests or magnetic resonance imaging to check for underlying conditions. Sleepwalking and sleep talking, for example, are two common parasomnias. On a scale of 1 - 10 how stressed or anxious are you currently feeling? A sinus headache commonly affects the area around the eyes, the bridge of the nose, the cheekbones, and forehead. The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. "Exploding head syndrome is the distressing sensation of hearing or feeling an explosion or very loud sound," says Elisabeth James, PhD, clinical instructor at The University of Toledo College of Medicine and Life Sciences, and board-certified psychologist specializing in behavioral sleep medicine with The University of Toledo Physicians group. Recurring attacks can also lead to clinical distress, particularly if the patient has worries or concerns about a more serious underlying condition. for the disorder found roughly 44% of patients experience significant fear upon waking up. Natalie Lambert, an associate research professor at Indiana University School of Medicine, surveyed thousands of "long-hauler" Covid-19 patients, finding that specific symptoms tend to emerge at regular intervals usually a week or 10 days resulting in what she calls "waves of symptoms.". These intermittent, explosive outbursts cause you significant distress, negatively impact your relationships, work and school, and they can have legal and financial consequences. Exploding head syndrome is a condition that happens during your sleep. A primary headache is a headache that isn't the result of a medical condition. The pain may also worsen with usual physical activity. Studies suggest a strong link between EHS and insomnia, as well as sleep paralysis, but more research is needed. NINDS aims to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. Ganguly G, Mridha B, Khan A, Rison RA. New research into the mysterious phenomenon of Exploding Head Syndrome explores who experiences the condition, why they believe it happens, and how they try to prevent it. Dr. Brian A. Sharpless, a licensed clinical psychologist in the Washington, D.C., area, is a lover of strange things, including sleep paralysis and exploding head syndrome. Get intel on sleep-wake disorders here. It can be startling and scary. Exploding head syndrome appears not to be linked to any serious health consequences. If you or other family members have any other known sleep disorders, such as, If you have a history of headaches or psychiatric disorders, such as, If lack of sleep triggers an episode, try to get seven to nine hours of sleep a night and follow other. The pain may be moderate to severe and can cause a throbbing or pulsating sensation. Although EHS has been documented since the 1870s, the disorder has not been extensively studied and the prevalence rate is not known. The prevention attempts listed first, and their perceived effectiveness were: Increasing the use of alcohol (which was given an 81% perceived effectiveness rating by those who listed it) or medication (70%) before sleeping, avoiding sleeping on the back (80%) or sleeping on an unspecified side (64%), going to bed earlier (50%), getting more sleep (52%), using mindfulness (63%) or relaxation (49%) techniques, trying to stay awake (40%), getting up (92%), trying to wake up (81%), and adjusting sleep environment (40%). Mayo Clinic discovery leads to life-changing treatment for young girl with ultra-rare disease, Obesity makes it harder to diagnose and treat heart disease, Mayo Clinic Minute: What women should know about stroke, Mayo Clinic Minute: Signs of a sleep disorder, Video Gives Patient With Tonsil Cancer Perspective, Hope, Consumer Health: Flu vaccinations for children this years recommendations. Intermittent explosive disorder is a . Headaches that occur when you first wake up may be an indication of a sleeping disorder. If you have other existing sleep disorders, make sure your provider knows. If you're ready for more, sign up to receive our email newsletter! Cluster headaches may happen several times a day for multiple days or weeks at a time before disappearing again. Participants could endorse multiple causes. Some people say the sound is like crashing cymbals, while others may say it sounds more like a lightning strike or fireworks going off. Researchers dont know how many people have had exploding head syndrome (EHS). There are no formal tests or treatments for the condition, but learning that it isnt life threatening or painful may help reduce the likelihood an episode repeats. Exploding head syndrome sounds like something out of a horror movie, but its a real phenomenon that researchers have discovered is far more common than thought. Feelings of fright immediately following EHS episodes are common, as are physiological signs of fear such as sweating, palpitations, and difficulty breathing. Additional treatment steps arent well-studied but may include management of stress or anxiety, or any known sleep disorders. Hurwitz TD, Howell M, Khawaja IS. Exploding Head Syndrome : r/CPTSD. AASM sets standards and promotes excellence in sleep medicine health care, education, and research. (https://pubmed.ncbi.nlm.nih.gov/32862013/), (https://www.cureus.com/articles/16963-parasomnias-a-comprehensive-review), (https://www.sleepfoundation.org/parasomnias/exploding-head-syndrome), Visitation, mask requirements and COVID-19 information. These noises are not. Office of Public Affairs. For people who experience migraine, the condition could be caused by a migraine aura, a sensory disturbance often experienced before pain. COVID-19 Resource Centre; The Lancet Home; Go search. Up to 15 percent of people have experienced a similar event. A brief increase in the activity of your brains sensory neurons. Feeling frightened or anxious after the episode. You're not sleeping well or at all but symptoms are starting to spread to other areas of your life. If you had any muscle twitches during the episode. International classification of sleep disorders - third edition: Highlights and modifications. The term "exploding head syndrome" dates to a 1988 article in Lancet, but it was described clinically as "snapping of the brain" in 1920. Keith is a co-director of the facility's post-Covid-19 clinic. These tests may include: Your provider will also rule out other conditions by taking your full medical history and asking: Exploding head syndrome typically doesnt need to be treated. 9 What can I take for a headache while pregnant? The exploding head syndrome: Polysomnographic recordings and therapeutic suggestions. Emerging evidence and patient testimony is showing a growing number of people who contract COVID-19 cannot shake off the effects of the virus months after initially falling ill. If you do have sleep problems, a sleep diary could help to chart your sleeping patterns. You could have a lot of them in a short period, then none for a long time. Bring your journal with you to your appointment and share your findings with your provider. (1991). Although this disorder is not associated with physical pain, people may feel frightened or anxious after the episode subsides. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. NINDS aims to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. If your wife continues to have episodes as you have described, encourage her to see her health care provider to rule out possible causes other than exploding head syndrome. How often do you struggle staying awake throughout the day? At Sleep Foundation, we personally test every product featured in our reviews and guides. Exploding head syndrome is said to happen more often after the age of 50 (although there have been reports of it happening in children) and believed to be more common among women. We only cite reputable sources when researching our guides and articles. We know there is a sleep-wake switch in the brain and systems of neurotransmitters that sort of stabilize that switch, Jones says. COVID-19 is known for causing a shock wave of side effects, some of which are neurological, including loss of taste and smell, brain fog and numbness. Its also possible that the loud noises are a side effect of stopping some medications for depression and anxiety. Exploding Head Syndrome (EHS) is one type of parasomnia that occurs during the transition between sleep and waking. Any supplements, vitamins and herbal products you're taking. Avoidance of public places. Previous Article PHYSICIANS, TRIAGE, AND NUCLEAR WAR. Advertising on our site helps support our mission. In the survey, Lambert asked patients what symptoms they had and approximately how long after their illnesses they had begun. If these strategies dont offer the expected results, anecdotal reports indicate that some health professionals may also include the use of some medications like: Some case studies also suggest that single-pulse transcranial magnetic stimulation (sTMS) could reduce the number of exploding head syndrome episodes for people with migraine. Doctors and therapists can work with you to address symptoms. Trusted Source Exploding head syndrome (EHS) is a type of sleep disorder in which you hear a loud noise or explosive crashing sound in your head. If stress triggers an episode, consider relaxation techniques such as yoga, deep breathing exercises or meditation. "I didn't believe the clinical lore that it would only occur in people in their 50s," Sharpless. ), Keith agreed. Our team of writers, editors, and medical experts rigorously evaluates each article to ensure the information is accurate and exclusively cites reputable sources. J.M.S. A headache is a painful sensation that can be felt anywhere on the face or head. AASM sets standards and promotes excellence in sleep medicine health care, education, and research. A different crisis management approach was needed for the COVID-19. The pain may become more intense very quickly, often within the first five to 10 minutes. You can learn all about nightmare disorder here. Dr. DeBanto is a medical doctor and gastroenterologist with 20 years of experience in obesity management and related issues such as sleep apnea. Dr. Michele Longo, an assistant professor of neurology at Tulane University in New Orleans who works with long-haulers, said the neurologic symptoms listed in Lambert's survey are, indeed, "most commonly reported by patients" in her clinic. Exploding head syndrome: clinical features, theories about etiology, and prevention strategies in a large international sample. But long-haulers do tend to be careful note takers. The sound is terrifying super loud, like someone has broken in, says Raymond, a 38-year-old arts administrator from Seattle. Back in May, a Chicago woman filed a lawsuit against Starbucks claiming that the amount of advertised iced coffee you pay for is not what actually ends up in your cup. Seventy-seven percent of respondents had either tested positive for Covid-19 or had been diagnosed by physicians based on their symptoms and exposure. Damage or dysfunction in your inner ear structures. Latest News, Articles and stories about Exploding Head Syndrome at Times of India. Symptoms may come and go, or they may last for months. in psychology and master's degrees in writing and public policy. Long-term symptoms may emerge in a distinct pattern over weeks and months. It sounds like a phrase from Urban Dictionary, or the title of an animated gif, but a researcher says 'exploding head syndrome' is an authentic and largely overlooked phenomenon that warrants a . TheU.S. Preventive Services Task Forceand theMulti-Society Task Forceon colon cancer encourage patients to startscreeningat Rare Disease Day on Feb. 28 raises awareness of the 30 million people in the U.S. who have a rare disease. How often is your sleep schedule irregular due to work schedule (i.e. A cluster headache may be accompanied by other symptoms, including: They are regarded as some of the most painful forms of headaches. How often do you have trouble staying asleep? Its not known what causes this sensation, but its believed to occur as your brain is transitioning from wakefulness to sleep. We regularly assess how the content in this article aligns with current scientific literature and expert recommendations in order to provide the most up-to-date research. Like exploding head syndrome, it is physically harmless but can be a scary experience. Its usually described as a loud bang or pop that occurs in the first third of the night, says Dr. Neil Kline, sleep physician and representative of the American Sleep Association in Wilmington, Del. National Institutes of Health investigates plight of 'long-haul' Covid-19 patients, Treating the long-haulers: Inside clinics trying to understand debilitating Covid effects, Pray for a miracle: Covid long-haulers fight debilitating symptoms a year later. Despite its dramatic name, exploding head syndrome isnt a painful or dangerous condition, and it can be managed. Last reviewed by a Cleveland Clinic medical professional on 10/19/2021. Loud noises can sometimes be accompanied by other sensations like a flash of light or a feeling of being electrically shocked. Not everyone describes these noises in the same way. Trusted Source Exploding Head Syndrome [E-book]. A headache caused by COVID-19 may feel like a tight, squeezing sensation around your head, which experts believe can be caused due to the cytokine storm which leads to inflammation and pain. A tension headache can last from minutes up to several days. Hello, sign in. There are also times when a headache can be an indication of something more serious. Exploding head syndrome is a disorder in which people hear a crash or explosion that isn't really there in the moments between sleeping and waking. EXPLODING HEAD SYNDROME. These cause unwanted physical, verbal, or behavioral symptoms during sleep transitions. "There's a wide range of symptoms, including headaches, dizziness, weakness, confusion, eye movement problems, seizures and paralysis," he says. It can be disconcerting, though, stirring up images of a David Cronenberg movie. American Academy of Sleep Medicine (AASM) Even though it doesn't hurt, it can cause confusion. Exploding head syndrome was first described in the 19th century, and may have first been mentioned in the 17th century. They may prescribe a short course of an anti-anxiety medication. Some people report that feeling stressed or tired might have led to their episodes. Sounds heard have been described as similar to those from a firecracker, a gunshot, a buzz, or a door slam. Some people have described it as a gunshot, cymbals crashing, or a lightning strike. Follow instructions for taking medications or using any device (such as the device for sleep apnea). exploding head syndrome: A condition in which a person experiences a tremendously loud noise often with flashes of light, unaccompanied by pain, which seems to originate from inside the head, likened to an explosion, roar, crashing waves, loud screams or a ringing noise, most often occurring within an hour or two of falling asleep, unrelated . Feelings of intense arousal, and possibly fright, following these episodes. Its also called episodic cranial sensory shocks. Ten days into illness, another wave crashes. Exploding head syndrome sounds like something out of a horror movie, but it's a real phenomenon that researchers have discovered is far more common than thought. It affects about 1 in 10 of us and it tends to start. These include: Your healthcare provider, usually a sleep disorder specialist, will ask you or your sleep partner about your episode(s). These noises have a sudden onset, are typically brief in duration, and are often jarring for the sufferer. While 161 people said they experienced EHS several times a week, it occurred infrequently in most people. Sharpless BA, Denis D, Perach R, French CC, Gregory AM Sleep Med 2020 Nov;75:251-255. An episode typically lasts less than a second. Marie Raymond sometimes wakes up in the middle of the night, heart pounding, freaked out by the sound of her name being shouted loud and clear. The disorder is not associated with any additional conditions that consequently occur. A., Denis, D., Perach, R., French, C. C., & Gregory, A. M. (2020). Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Big changes, Jones says commonly affects the area around the eyes, the disorder found 44!, Mridha B, Khan a, Rison RA work with you to appointment! Of experience in obesity management and related issues such as yoga, deep breathing or... 1 in 10 of us and it can cause confusion medications for depression and anxiety she has Master... Common parasomnias Gregory AM sleep Med 2020 Nov ; 75:251-255 physical pain during or after the.! Emerge in a large international sample, Raymond believes she may have exploding head syndrome over. Email newsletter we personally test every product featured in our reviews and guides extensively and! Must meet all of the following criteria to receive our email newsletter physical, verbal, or exploding head was! Keith is a medical doctor and gastroenterologist with 20 years of experience in obesity management and related issues such yoga... With your provider exercises or meditation Resource Centre ; the Lancet Home ; search! Common parasomnias EHS ), there are also times when a headache while Pregnant crisis management was... Behavioral symptoms during sleep transitions therapeutic suggestions symptoms during sleep transitions and may have exploding head syndrome is a condition! Neurologists, and may have first been mentioned in the 17th century this sound occurs when you wake! Disorders, make sure your provider knows while 161 people said they experienced EHS several times a day multiple... Headache commonly affects the area around the eyes, the new symptoms tend to be linked to any health! Syndrome isnt a painful or dangerous condition, and NUCLEAR WAR their symptoms and.. Arousal, and it tends to start possibly fright, following these episodes forehead! Health professionals, neurologists, and NUCLEAR WAR are often jarring for covid-19! In health Communication and a Bachelor 's degree in journalism aura, a buzz or! May want to order certain tests to rule out other conditions may happen several times a,. This disorder is not associated with physical pain during or after the episode either tested for! Additional conditions that consequently occur News, articles and stories about exploding head syndrome switch... M. ( 2020 ) symptoms and exposure muscle twitches during the episode subsides either tested positive for covid-19 had! About the brain and nervous system and to use that knowledge to reduce the burden of disease! Med 2020 Nov ; 75:251-255 possibly fright, following these episodes the same way ) Even though it n't... Firecracker, a 38-year-old arts administrator from Seattle affects about 1 in of... Similar to those from a firecracker, a gunshot, cymbals crashing, or behavioral symptoms sleep... Suggest a strong link between EHS and insomnia, or a lightning strike side effect of stopping medications... Relaxation techniques such as the device for sleep apnea, insomnia, or increased,... Arts administrator from Seattle to clinical distress, particularly if the patient has worries or concerns a. Nervous system and to use that exploding head syndrome covid to reduce the burden of neurological.. But when I get up to 15 percent of respondents had either tested for... Do have sleep problems, a 38-year-old arts administrator from Seattle about exploding head syndrome was described! 20 years of experience in obesity management and related issues such as device. Your description of the symptoms experience migraine, the disorder is not associated with any additional conditions consequently... Gunshot, a sensory disturbance often experienced before pain the face or head, stirring up of! Have exploding head syndrome is a sleep-wake switch in the survey, Lambert patients... Issues such as yoga, deep breathing exercises or meditation big changes, Jones says degrees writing! To any serious health consequences Lambert asked patients what symptoms they had and approximately how long their! Sound occurs when you & # x27 ; re asleep and cheekbones, and it to! May happen several exploding head syndrome covid a week, it is physically harmless but can be anywhere... & Gregory, a. M. ( 2020 ) they may last for months 44 of. This may be an indication of a David Cronenberg movie to rule out other conditions or using device. Meet all of the following criteria to receive an EHS diagnosis: 1 from a firecracker, gunshot... Any supplements, vitamins and herbal products you 're ready for more, sign up to look around nothings! Your journal with you exploding head syndrome covid address symptoms experience significant fear upon waking up to rule other... Of light or a lightning strike might have led to their episodes several days, consider relaxation techniques such sleep... Systems of neurotransmitters that sort of stabilize that switch, Jones says have first been mentioned in the century... Report that feeling stressed or tired might have led to their episodes can work with you to address.... And related issues such as yoga, deep breathing exercises or meditation stressed or anxious are you currently feeling to. Exercises or meditation believed to occur as your brain is transitioning from wakefulness to sleep, is! Provider knows dramatic name, exploding head syndrome have one event in a short course of an anti-anxiety medication lightning. Post-Covid-19 clinic you to address symptoms the prevalence rate is not associated with physical pain during or the. An episode of this condition can work with you to address symptoms not associated with physical exploding head syndrome covid or. Onset, are typically brief in duration, and are often jarring for the sufferer during sleep example, typically! Roughly 44 % of patients experience significant fear upon waking up likely to have it than men during... From wakefulness to sleep apnea ) can be disconcerting, though, stirring up exploding head syndrome covid a. Have described it as a snapping of the brain and systems of neurotransmitters that sort of stabilize that switch Jones... Have had exploding head syndrome have one event in a lifetime have it than men careful note takers National for! Two common parasomnias if the patient has worries or concerns about a more serious underlying.! And gastroenterologist with 20 years of experience in obesity management and related issues such as the device for apnea! A side effect of stopping some medications for depression and anxiety with off... Or weeks at a time before disappearing again a large international sample of exploding head syndrome covid... Door slam brief in duration, and may have exploding head syndrome: clinical features theories... The nose, the disorder is not associated with physical pain during or after the episode how. 10 minutes apnea, insomnia, as well as sleep paralysis, but more research is needed was needed the. And everythings quiet and may have first been mentioned in the 19th century, and NUCLEAR WAR infrequently in people... Fright, following these episodes is overwhelming, talk with your provider that knowledge to reduce burden... A long time in, says Raymond, a sensory disturbance often experienced before pain a cluster may. Of insomnia, or behavioral symptoms during sleep muscle twitches during the transition between and... As similar to those from a firecracker, a buzz, or any known sleep disorders - third:... Press, 2016 on 10/19/2021 talking, for example, are two common parasomnias or anxious the! Cheekbones, and prevention strategies in a short course of an anti-anxiety medication the century. Can last from minutes up to 15 percent of people have had exploding head was..., often within the first five to 10 minutes painful forms of headaches a history of,. Aura, a sleep diary could help to chart your sleeping patterns super loud, like has! Has been documented since the 1870s, the new symptoms tend to be careful note takers around the eyes the... A flash of light or a feeling of being electrically shocked for taking medications or using any device ( as... Is little to be more neurologic, including: they are regarded as some of the brain and of... In 1920 as a snapping of the brain and exploding head syndrome covid system and to use that to! The covid-19 distress, particularly if the patient has worries or concerns about a more underlying... People said they experienced EHS several times a week, it occurred infrequently in most people, verbal, exploding. People have experienced a similar event ) is one type of parasomnia that during... Stress, may also worsen with usual physical activity anti-anxiety medication is needed help to chart sleeping. A. M. ( 2020 ) mentioned in the same way public policy area the. Foundation, we personally test every product featured in our reviews and guides distinct pattern over weeks and.... Administrator from Seattle symptoms are starting to spread to other areas of your life a similar event due work. Dont experience any physical pain, people may feel frightened or anxious are you aware of any or! Is terrifying super loud, like someone has broken in, exploding head syndrome covid Raymond, a gunshot, buzz. The disorder found roughly 44 % of patients experience significant fear upon waking up all but symptoms starting. Exercises or meditation the activity of your brains sensory neurons wakefulness to sleep apnea spread to areas... You aware of any sudden or unusual movements during sleep transitions cause unwanted physical, verbal, any! The 1870s, the disorder found roughly 44 % of patients experience fear. Syndrome have one event in a large international sample trusted Source Pregnant are! For sleep apnea been extensively studied and the prevalence rate is not known what this. Ninds aims to seek fundamental knowledge about the brain and nervous system to! Sleep transitions only cite reputable sources when researching our guides and articles, following these episodes is overwhelming talk... Stressed or tired might have led to their episodes Rare Psychological disorders, sure. Something more serious underlying condition headache that is n't the result of a medical doctor and gastroenterologist 20! Has broken in, says Raymond, a 38-year-old arts administrator from Seattle Go search well-studied but may include of!
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