Hypnagogic Hallucinations - Healthline

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Medically reviewed by Megan Soliman, MD — Written by Erica Cirino — Updated on October 13, 2021

Symptoms
Causes
See a doctor
Treatment
Takeaway

Hypnagogic hallucinations occur in the state between waking and sleeping. They are different from dreams, which occur during sleep. You may be having these if you’re seeing extremely realistic objects or events right before falling asleep

If you think you’re seeing — or smelling, hearing, tasting, or feeling — things when you’re asleep, you may not be dreaming. It’s possible that you’re experiencing hypnagogic hallucinations. It’s more likely if you’re waking up in extreme fear that your hallucination was real.

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

What are the symptoms of hypnagogic hallucinations?

Hallucinating 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.

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. Examples include:

beeping
high-pitched noises
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 the perception of things that aren’t real.

Lucid dreams are very realistic dreams that occur when a person is 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.

Can hypnagogic hallucinations cause 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 causes hypnagogic hallucinations?

An older study among people ages 15 and older found that almost 25 percent experienced sleep-related hallucinations.

These hallucinations are more common in teens and young adults, with the number of hallucinations decreasing with age. Women appear more likely to experience these hallucinations than men.

The exact causes of hypnagogic hallucinations aren’t 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.

When should you see a doctor?

Hypnagogic hallucinations are harmless in most cases. However, you should considering seeing 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:

When did your hallucinations begin?
How often do your hallucinations occur?
How long do your hallucinations last?
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 whether 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 you’re 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 your hallucinations are related to narcolepsy.

If you need help finding a sleep medicine specialist, then check out our FindCare tool here.

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 focus on getting enough sleep. The National Sleep Foundation recommends the following:

8–10 hours for teens ages 13–18
7–9 hours for adults ages 18–64
7–8 hours for adults 65 and older

Doing the following may also help to decrease hypnagogic hallucinations:

To avoid lying awake and thinking stressful thoughts, don’t go to bed until you feel extremely tired.
Keep a regular sleep schedule in which you go to sleep and wake up at the same times each day.
Practice good sleep hygiene, such as sleeping in a cool environment.
Avoid alcohol, drugs, and medications that may be causing hypnagogic hallucinations. If the medication is prescribed, talk with your doctor before changing or stopping your dosage.

If 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.

The takeaway

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.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

How much sleep do you really need? (2020).https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/
Ohayon MM. (2000). Prevalence of hallucinations and their pathological associations in the general population.https://www.sciencedirect.com/science/article/abs/pii/S0165178100002274?via%3Dihub
Ryan T. (2021). Hypnagogic hallucinations.https://www.sleepfoundation.org/how-sleep-works/hypnagogic-hallucinations
Sleep hallucinations. (2020).https://sleepeducation.org/sleep-disorders/sleep-hallucinations/
Waters F, et al. (2016). What is the link between hallucinations, dreams, and hypnagogic–hypnopompic experiences?https://academic.oup.com/schizophreniabulletin/article/42/5/1098/2414048

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Medically reviewed by Megan Soliman, MD — Written by Erica Cirino — Updated on October 13, 2021

Hypnagogic Hallucinations - Healthline

What are the symptoms of hypnagogic hallucinations?

Sleep paralysis and lucid dreams

Can hypnagogic hallucinations cause complications?

What causes hypnagogic hallucinations?

When should you see a doctor?

How are hypnagogic hallucinations treated?

The takeaway

How we reviewed this article:

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