Hypnagogic Hallucinations: Causes, Symptoms, and More https://www.healthline.com/health/sleep-health/hypnagogic-hall...

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Hypnagogic Hallucinations
Medically reviewed by Alana Biggers, MD — Written by Erica Cirino — Updated on August 15,
2017

Symptoms Causes See a doctor Treatment Complications

Outlook
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What are hypnagogic hallucinations?
#
If you think you’re seeing — or smelling, hearing, tasting, or feeling — things when
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you’re asleep, you may not be dreaming. It’s possible you’re experiencing hypnagogic
%hallucinations. These can occur in the consciousness state between waking and
sleeping. Dreams, on the other hand, occur during sleep.

Hypnagogic hallucinations often cause confusion. This is because it can be hard to

distinguish hallucination from reality. They create strong, intricate visual images in the
mind that may be distorted in an unrealistic way. As a result, these hallucinations often
cause fear. In some cases, they can even cause you to jump out of bed or accidentally
injure yourself.

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What are the symptoms of hypnagogic

hallucinations?
A hallucination is defined as perceiving the presence of an object or an event through
any of the five senses (sight, smell, taste, touch, or hearing) without the actual object or
event existing or occurring.

The defining symptom of a hypnagogic hallucination is imagining very realistic objects

or events right before falling asleep (usually visually). You may wake up in extreme fear
that your hallucination was real.

Auditory hallucinations are also common when the body is falling asleep. These
hallucinations are more common when a person is under stress. Most common
auditory hallucinations are simple and don’t have a real meaning or purpose. This can
vinclude:

"
beeping
# high-pitched noises
z random noises
popping noises
%
unclear noises

Severe cases of anxiety may produce more complex hallucinations. They may involve
voices, which are sometimes associated with rapid thoughts. This can lead a person to
believe the voices are real.

Another common type of hallucination is the vision or sensation that bugs are crawling
over your body. This is most common in people who take or misuse certain drugs.
Experiencing this sensation during sleep may cause a person to scratch, pick, or even
cause harm to their body in an attempt to rid it from bugs.

Sleep paralysis and lucid dreams

Hypnagogic hallucinations are different from other sleep-related conditions —
including lucid dreams and sleep paralysis — that may cause perception of things that
are not real. Lucid dreams are very realistic dreams that occur when a person is

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asleep.

Sleep paralysis is a separate condition from hypnagogic hallucinations. However, it

may occur simultaneously. Sleep paralysis is a state of sleep where a person is
physically immobile but mentally conscious. This condition may cause even more fear,
as the physical immobility — often difficulty breathing and muscle tightness — can
make a person feel as though they’re frozen in place. As a result, a person may
remember a sleep paralysis and hallucination episode as a dream where they were
frozen in place or unable to move. In reality, it was these two conditions working
together.

What causes hypnagogic

hallucinations?
In one study in the United Kingdom, experts found that about one-third of the
population & experienced a hypnagogic hallucination at some point in their life.
v
American researchers have put the number at 25 percent.
"
These hallucinations are more common in teens and young adults, with the number of
#hallucinations decreasing with age. Females appear more likely to experience these
hallucinations than males.
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%The exact causes of hypnagogic hallucinations are not well understood. Some
possible risk factors include:

alcohol or drug use

insomnia
anxiety
stress
narcolepsy
mood disorders such as bipolar disorder or depression

Epileptic seizures may also cause hypnagogic hallucinations. When epilepsy is the
cause, hallucinations may appear as short visual fragments.

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Should you see a doctor?

Hypnagogic hallucinations are harmless in most cases. However, you should see a
sleep specialist if these hallucinations cause you anxiety or disrupt you frequently
during your sleep. If your hallucinations are accompanied by unusual sleepiness during
the day, you should seek a specialist’s help right away, as you might have narcolepsy.

If you seek help from a sleep specialist, they will begin your appointment by asking
you questions such as:
v
When did your hallucinations begin?
"
How often do your hallucinations occur?
#
How long do your hallucinations last?
z Do you have any other sleep problems, such as insomnia?

% Are you sleepy during the day?

Besides inquiring about your sleep, a sleep specialist will also ask you about your
medical and psychiatric history. Remember to tell them about any past or present drug
or medication use.

The sleep specialist may ask you to bring home a sleep diary for two weeks. This helps
the specialist gain insight into your sleeping patterns. This insight may help them
better diagnose your condition and figure out how to correct it.

The sleep specialist may also recommend a sleep study (polysomnogram) if your
hallucinations are intensely disturbing to your sleep. A sleep study involves attaching
wires and equipment to your head and body to chart your brain waves, heartbeat, and
breathing as you sleep. It also records how your arms and legs move. This kind of
study can uncover if your hypnagogic hallucinations are related to any other type of
sleep disorder.

The specialist may ask you to do a daytime nap study (multiple sleep latency test) if

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you are very sleepy during the day. This test measures how quickly you fall asleep
during the day, and what kind of sleep you have when you nap. This test can reveal
whether or not your hallucinations are related to narcolepsy.

How are hypnagogic hallucinations

treated?
Treating hypnagogic hallucinations requires treating any underlying conditions that
may be the cause. Often, hallucinations will decrease over time. They may also
decrease if you do the following:

Focus on getting enough sleep. Recommendations are:

8-10 hours for teens ages 14-17
7-9 hours for adults ages 18-65
7-8 hours for older adults over 65 years
v Keep a regular sleep schedule in which you go to sleep and wake up at the
" same times daily.
Avoid alcohol, illicit drugs, and certain medications.
#

zIf your hypnagogic hallucinations are caused by anxiety, your doctor may recommend
psychiatric treatment. Treatment for anxiety could involve talk therapy, meditation, or
%medication, as well as other at-home care to reduce stress. If you’re diagnosed with
narcolepsy, your sleep specialist will prescribe narcolepsy medications.

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Can hypnagogic hallucinations cause

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Hypnagogic Hallucinations: Causes, Symptoms, and More https://www.healthline.com/health/sleep-health/hypnagogic-hall...

complications?
In cases of severe hypnagogic hallucinations, people have been known to jump out of
bed and accidentally injure themselves. People may also cause themselves harm if
they have a hallucination that bugs are crawling on them. So it’s important to seek
treatment if your hallucinations are severe.

What’s the outlook for hypnagogic

hallucinations?
Often hypnagogic hallucinations resolve on their own over time. If there’s an
underlying cause to your hallucinations, seeking treatment for the condition can help
prevent future hallucinations from occurring. This will improve your quality of sleep.

Last medically reviewed on August 15, 2017

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