What you should know about sleep-related hallucinations (2023)

The sleep cycle involves a series of transition states that are repeated throughout the hours of sleep. It is not uncommon for people to experience some type of hallucination when falling asleep or waking up, although there are conditions such asnarcolepsythat makes it more likely.

hypnopompic womanHallucinations usually occur upon awakening. They are mostly visual and your dream state may appear to continue into your waking state, like a lucid dream.hypnagogic hallucinationsthey are similar, but occur more often when falling asleep.

This article explains how people can experience these sleep-related hallucinations and some of the behaviors seen in them. It explains the medical conditions that can make these episodes more likely.

What you should know about sleep-related hallucinations (1)

sound cycles

There are four distinct phases that occur during sleep and cycle until you wake up. Sleep phases can be divided into two categories:

  • Non-rapid eye movement (NREM) sleep, stage 1-3 restful sleep
  • rapid eye movement(REM) sleep, the active phase of sleep where dreams occur

The typical pattern of these phases goes from phase 1, when you start to sleep, to phase 2, and then to phase 3. Then you go back to phase 2, repeat the cycle, and finally reach REM sleep.

However, the sleep cycle is often disrupted.sleep disordersor in some cases due to other medical conditions. It is also in some way unique to each person, a trait experts calldream architecture.

A hypnagogic hallucination is likely to occur in the early stages of sleep when brain activity changes, while hypnagogic hallucinations often appear to be a continuation of a dream sequence within the first few seconds or minutes of the transition from sleep to wakefulness.

The 4 stages of sleep.


When people report hallucinations, they often describe visual experiences. They see something that isn't there or misinterpret something in the environment, also known as an illusion.

Other hallucinations involve auditory experiences, which means that a person hears things. In some cases, the hallucination may resemble a sensation of falling or some other movement.

Hallucinations can occur with other symptoms, such asparalysis i am.Awakening from this immobile state can induce terror. Some people may jump on the bed or have behaviors likesleepwalkingand talk in sleep Research shows that nearly 70% of adults talk in their sleep at some point in their lives.

A study of 2,533 Norwegians found that just over half had some form of hallucination upon falling asleep or waking up. Of those who did:

  • 173 people or 6.8% reported having auditory hallucinations.
  • 312 people or 12.3% reported seeing or feeling something that does not exist.
  • 816 people or 32.2% had experiences related to movement as if they were falling or floating.

Approximately two-thirds of people with hearing-related hallucinations during sleep also have them during the day. These were important findings as the Norwegian study of hypnagogic and hypnopompic hallucinations sought to clarify why hallucinations occur in other conditions such asschizophrenia.

(Video) Why We Hallucinate While Falling Asleep


Hallucinations may simply represent the persistence of dream images in the waking state. While this may be a typical phenomenon of sleep-wake transitions, it also occurs in the context of certain medical conditions and can be seen as part of a pattern of symptoms that occur with them.

sleep deprivation

When people don't get enough sleep to meet their body's physical and mental needs, they experiencesleep deprivation. this leads tofatiguebut also more serious problems, including:

  • Increased sensitivity to pain.chronic painConditions
  • Hormonal changes, includingthyroid disorders
  • Hallucinations associated with extreme sleep deprivation

One of the most comprehensive studies on how sleep deprivation affects mental health, including symptoms such as hallucinations, involved 261,547 adults from 56 countries. Sleep-deprived people were twice as likely to report hallucinations or delusions that someone was trying to hurt them.

The types of hallucinations that occur while falling asleep or waking up may be more common in sleep-deprived people because the transition between sleep and wakefulness is longer.

How lack of sleep affects the human body


The presence of hypnagogic hallucinations when falling asleep is considered one of the cardinal signs of narcolepsy, which affects up to 1 in 2,000 people. His hallucinations are usually visual, vivid, and may be mixed with other types of hallucinations, including hypnopompic.

People with narcolepsy may also experience symptoms of:

  • Fragmented sleep that causes disturbances in the sleep cycle.
  • excessive daytime sleepiness
  • paralysis i am
  • cataplexy, which are sudden attacks of muscle weakness

There is no cure for narcolepsy, but it can be controlled with medication and lifestyle changes. These may include more physical activity and improvinghygiene i amwith an established sleep schedule and improvements in your sleep environment.

Narcolepsy often has symptoms and features similar to those of psychiatric disorders. In some cases, this leads to an incorrect diagnosis of the disease. Be sure to talk to your doctor about your specific symptoms to ensure an accurate diagnosis and treatment.

Dealing with narcolepsy

Other sleep disorders

Several sleep disorders may contribute to or be associated with conditions that can lead to hypnagogic and hypnopompic hallucinations. They include:

  • Obstructive sleep apnea, which causes shortness of breath during sleep
  • restless leg syndrome, causing discomfort in the legs and movement during sleep
  • circadian disorders, which causes your "biological clock" to not coincide with your sleep schedules

These sleep disorders can lead to sleep deprivation or excessive daytime sleepiness, which in turn can increase the risk of hallucinations.

Obstructive sleep apnea is the leading cause of excessive daytime sleepiness, and narcolepsy is the second leading cause.In some cases, the similarities between the two have led to misdiagnosis in the early stages or when symptoms are atypical.

(Video) What Sleep Paralysis and Hypnagogic Hallucinations Can Feel Like

Can sleep deprivation or insomnia cause hallucinations?

Parkinson disease

Complex types of dream hallucinations are rare and may indicate the possible presence of a neurological disorder such asParkinson diseaseoDementia with Lewy bodies.

Mild hallucinations are the most common type associated with Parkinson's disease and tend to be visual in nature.They are considered a sign of increased risk of more serious psychiatric disorders in people with Parkinson's.

Similar states and hallucinations

Illnesses similar to Parkinson's disease can also cause hallucinations. Such a condition is known asCharles Bonnet Syndrome. Named after an 18th century scientist, it is the cause of hallucinations (in one or both eyes) after sudden loss of vision. These vivid episodes are similar to those seen withEpilepsy.

Dealing with Parkinson's disease


Hallucinations, both visual and auditory, may be possible due to the use of medications. This is especially true for drug interactions that occur when more than one drug is used.

Medical researchers have confirmed cases where drug interactions have caused hallucinations in people treated:

  • Chronic pain when anesthesiaultram(tramadol) has been added to your treatment
  • stem cell transplantsto treat certain types of cancer, including when tramadol was added
  • Infections by adding certainantibioticsled to hallucinations

Be aware that various drugs used alone can also cause types of visual hallucinations. This is more commonly seen with some medications used for:

  • to controlhypertension, high blood pressure
  • Deal withAngina pectoris(chest pain) likeNitroglycerine
  • Treatment of erectile dysfunction, such asViagra(sildenafilo)
  • Manage various psychiatric and mood disorders.

Your health care provider andpharmacistit can help you avoid unwanted drug interactions. Tell all your providers about any medicines or supplements you are taking.

Reduce the risk of unwanted drug interactions

use of alcohol or drugs

Hallucinations resulting from substance use may seem rare, but the prevalence of alcohol and drug use in the United States remains high.

(Video) Sleep-related Hallucinations

The US Department of Health and Human Services drug abuse statistics for 2019 show the following:

  • About 51% of people aged 12 and over had consumed alcohol in the past month
  • One in five (21.1%) had used tobacco in the previous month
  • Nearly 36 million people (13%) used an illicit drug in the past month

Hallucinations can occur when taking substances not classified as hallucinogens, such as LSD or MDMA (ecstasy). Cocaine is an example.

It is also important to remember that some people may experience hallucinations when they stop taking a medication, such asalcohol withdrawal syndrome.

Alcoholism is a disease?

When to seek help

Hallucinations, especially hypnagogic and hypnopompic, are generally harmless. However, you should talk to your doctor about your symptoms to rule out medical or psychological causes. This is especially true if you feel that stress or anxiety is contributing to the problem.

Asleep specialistit may help if your hallucinations are related to disturbances in your sleep patterns.

One way to understand your sleep patterns is to keep a journal of your symptoms, noting the following:

  • when your hallucinations start
  • how often do they occur
  • How long do the hallucinations last?
  • Any other sleep problems, such as insomnia.
  • Any daytime sleepiness and how often it occurs

Knowing these answers will help you keep track of your symptoms, but it will also give you the opportunity to provide more complete information when you talk with your medical team.


It is quite common to experience brief hallucinations called hypnagogic hallucinations when falling asleep. These episodes can also occur upon awakening and are known as hypnopompic hallucinations.

These fleeting visual or auditory hallucinations, which may appear as lucid dreams when you first notice them, are not necessarily a sign of a medical problem.

However, they may be a sign of a more serious condition. In some cases, hallucinations can be related to mental illness, but they can also be caused by a medical problem, such as narcolepsy or Parkinson's disease, or by prescription drugs or other medications.

A word from Verywell

Keep in mind that sleep-related hallucinations can occur due to lack of sleep. One step you can take to improve your sleep is to make lifestyle changes that include eating a healthy diet, getting plenty of exercise, limiting alcohol intake, and having a more structured sleep routine.

frequent questions

  • Are hypnopompic hallucinations different from lucid dreams?

    (Video) Hypnagogic and Hypnopompic Hallucinations - A Normal Phenomenon While Falling in or out of sleep

    There are similarities, but they are not completely identical. Lucid dreaming occurs when a person realizes that he is dreaming and is usually associated with narcolepsy and sleep paralysis.Hypnopompic hallucinations also occur during the transition between sleep and wakefulness. However, the two are so different that some researchers are working to see how hypnopompic episodes can be induced or generated to result in lucid dream states. This could improve understanding of these conditions and lead to possible treatments for sleep disorders.

    Know more:What is false awakening and lucid dreaming?

  • What is REM sleep?

    REM sleep (Rapid Eye Movement) is the deep phase of the sleep cycle in which dreams occur. Much of this occurs during the last third of the night's sleep. REM sleep is important for many health reasons, but it is often interrupted when there is a sleep disorder. A sleep study can help identify these patterns and interruptions.

    Know more:What is an overnight sleep study (polysomnography)?

  • How long are sleep cycles?

    It depends on your unique sleep pattern. Usually, the first phase of sleep lasts from five to ten minutes. Phase 2 lasts about 20 minutes. Stage 3 sleep is a longer, deeper phase of sleep, returning to stages 2 and 3 before reaching REM sleep (paradoxical sleep) for a total of 90 minutes. These sleep cycles are repeated four or five times during the night.

    (Video) What Happens To Your Body And Brain If You Don't Get Sleep | The Human Body


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