Does the sun make you sneeze? You have the ACHOO syndrome!

If you sneeze when you walk out into sudden, bright light, you can lay claim to your very own syndrome.

Autosomal dominant Compelling HelioOpthalmic Outburst is the technical name for the ACHOO syndrome, as it’s been abbreviated.

“It’s actually a gene that makes some people experience this kind of sneezing more often than others,” says Kaveh Rashidi. He is a doctor, author, and known to many from NRK broadcasting’s God bedring (Get well soon) podcast, where he first talked about the phenomenon.

Sneezing hasn’t been particularly welcome in public spaces in the past year. And since sneezing is an involuntary reflex that the body uses to get rid of foreign bodies and irritants, it sometimes comes at the worst times.

At least that’s how it feels for those who suffer from hay fever, or people with the achoo syndrome – and most of all, for folks with both conditions.

Several scientific articles on the somewhat curious syndrome have even been published.

Electrodes in the nostrils

In a study published in Nature in 2009, researchers conducted an experiment with seven people. All were healthy, and three of them had a history of sneezing due to bright light.

Participants were equipped with electrodes in their nostrils, and researchers flashed strobe or halogen lights in the participants' faces. The researchers wondered if the tingly feeling in the nose could be measured.

Not surprisingly, the achoo participants felt tingling and sneezed as soon as the light hit their eyes. The control group did not.

But despite a powerful and good sneeze, the electrodes didn’t pick up anything. The main centre of the phenomenon does not seem to sit in the nose. So what’s happening?

A lot of uncertainty

Another article Rashidi refers to was published in Medical Genetics Summaries in 2012 and summarizes some of the knowledge that exists about the achoo phenomenon.

And there’s a lot we don’t know.

“To the degree that we know anything about why some people have the syndrome, it has to do with the sensation or feeling of having to sneeze being amplified by other strong sensory impressions,” Rashidi says.

One such a sensory impression can be light.

“It’s a kind of cross-connection. You get a strong visual impression, and the whole brain turns on all its sensory modalities. Then suddenly the tiny tingling in your nose gets so strong that you sneeze.”

The body readying us for a new day?

The research article from 2012 makes clear that we don’t quite know how that connection in the brain works.

“One thought is that it may involve an overstimulation of somatosensory nerve pathways,” says Rashidi.

The somatosensory system is based on sensations at the surface of the body, such as touch or sight.

And from the perspective of evolution, their function can be a little difficult to comprehend.

“I imagine a Stone Age man who comes out into the bright light, and that the body then thinks, ‘Okay, things are happening here. It’s daytime and all our senses have to be on high alert,’” Rashidi says.

“Unlike when he’s inside his cave, where it’s unlikely that anything’s going to happen. He doesn’t want to be on alert there, and takes it easy. It’s conceivable that the achoo syndrome evolved from there – so the body would ramp up a notch when needed.

Pretty normal

You aren’t that unique if you have achoo syndrome. But you are in the minority, if we’re to believe the figures from some of the studies published on the phenomenon.

The Nature article from 2009 refers to another study in which the researchers examined the prevalence of the syndrome among medical students. They found that the most common occurrence was among men who were fair-skinned; in that group, 28 percent reported that they experienced the phenomenon.

Twenty-six percent of women with fair skin reported the same. The researchers found far fewer occurrences among men and women who were dark-skinned. In those groups, only two percent experienced sneezing in response to bright light.

Itching that isn’t noticeable

But Rashidi emphasizes that light alone rarely makes the difference.

“There has to already be a certain tingling in the nose,” he says.

But the journalist for this article does not completely agree with that. Almost every time the undersigned takes a breather from the home office and into daylight, a sneeze finds its way out – regardless whether there’s any tingling.

“At least not any that you can feel,” Rashidi says.

“But probably the tingling is there, without you being conscious of it. A bit like if you don’t look at your wrist, it can be difficult to know if you have a watch on or not. The sensory signals are there, but the body’s used to them and doesn’t bother to pay attention,” he says.

The same sort of thing happens inside the nose.

“Something may already be there, like hair or dust, but you don’t notice it until the light hits you.

Thought of sex – and achoo!

It’s not just light that can cause sneezing in some people. An article published in the Journal of the Royal Society of Medicine in 2008 discusses sneezing induced by orgasm – or just by thinking about something sexual.

One of the researchers behind the article came across a middle-aged male patient who said that he sneezed uncontrollably when he had sexual thoughts. The phenomenon had followed him through adulthood.

The researchers think the phenomenon occurs in the nervous system – in a similar way to the achoo syndrome. They also believe that the phenomenon is underreported and hereditary, but this is a little difficult to say for sure, for the simple reason that the topic is hardly ever raised between parents and children.

Maybe dangerous if you fly fighter jets

Although the word "syndrome" sounds a bit dramatic, it is really only a set of symptoms that are grouped into a category, or unit. And most people who live with the achoo syndrome hardly experience any dramatic effect on their everyday lives.

“You probably have to be a little creative to find out what kind of problems the symptoms can lead to,” Rashidi says.

He notes that so far he hasn’t had any patients raise the issue in his office.

But, to be fair – some people have speculated what dangers might actually be hiding behind the clever name of the syndrome.

In 1993, the Military Medicine journal published an article in which researchers pointed out that uncontrolled sneezing could be a potential danger to fighter pilots if they sneeze at the wrong time.

Translated by Ingrid Nuse.

Read the Norwegian version of this article on forskning.no.

References:

Bhutta, Mahmood F., Maxwell, Harold. (2008). Sneezing induced by sexual ideation or orgasm: an under-reported phenomenon. Journal of the Royal Society of Medicine.

Breitenbach, RA., Swisher, PK., Kim, MK., Patel, BS. (1993). The photic sneeze reflex as a risk factor to combat pilots. Military Medicine.

Dean, Laura. (2012). ACHOO Syndrome. Medical Genetics Summaries.

Hydén, D., Arlinger, S. (2009). On light-induced sneezing. Nature.