Have you ever experienced a visual or auditory event just as you’re falling asleep that seemed very real at the moment only to realize that you’re hallucinating? If so, according to the American Sleep Association, you are one of the 25% of people that experience a sleep related hallucination at some point in their lifetime.
A hallucination is a parasomnia involving unwanted events that can occur with sleep. Hallucinations can often leave a person confused whether or not the event was real. Usually they involve one or more of the senses like touch, taste, smell, sound, and most commonly, sight. People often dismiss or confuse hallucinations with dreams and illusions. Dreams occur while a person is asleep and the dreamer typically does not experience lingering fear or paranoia from the dream. Illusions occur while a person is awake and is a sensory misunderstanding of what is actually there, like confusing the shadow of a tree for a person lurking in the dark.
Surprisingly, sleep related hallucinations are very common. Typically hallucinations are experienced by teens and young adults, and more so in females than males. Approximately 84% of hallucinations reported are sleep related. Causes of hallucinations can include past or current drug use, on-going anxiety, mood disorders such as bipolar disorder and depression, stress, insomnia, and narcolepsy.
There are two types of sleep related hallucinations that can occur. Hypnagogic hallucinations occur as a person falls asleep. This type of hallucination is sometimes accompanied by sleep paralysis, where the person feels as though they are physically unable to move and even have difficulty breathing. A common hypnagogic hallucination is the feeling of falling, followed by a sudden jerk as though they are trying to stop themselves from falling. The second type of hallucination is hypnopompic hallucinations, which occur as a person is waking up. For example, some people will wake up suddenly from a vivid dream and continue to see or hear things from their dream. It can be very scary, intimidating, and give the feeling of paranoia.
Unfortunately, not much is known about the brain during a hallucination because they are unpredictable, infrequent, and momentary when they do occur. It is believed that a transformation within the electrical activity of the brain could lead to a hallucination involving smell or touch. Studies of hypnopompic hallucinations show they occur when the brain signals to the body fail to open up quickly enough after a person wakes up. This results in the person being in-between a dreaming state of mind and awake. To fill in the gaps the body draws information from the dreaming state of mind to compensate for the lack of sensory information in reality. For example, the scary noise from your dream suddenly feels like it wasn’t a dream at all, which is why sleep related hallucinations can lead to increased confusion, stress, and lack of sleep. Hypnagogic hallucinations are usually a side effect related to prescription medications, street drugs, or narcolepsy. Various medications and drugs cause changes to chemicals in the brain and how the brain functions, which can often lead to hallucinations. Head or spinal injuries have also been pinpointed as a cause for hallucinations. They can cause changes in brain chemicals and pinched nerves, altering the normal functioning of the brain
and can affect the state between wakefulness and sleep, which is when hypnagogic and hypnopompic hallucinations occur.
Hallucinations may or may not require treatment depending on their cause. If the hallucinations are affecting an individual’s ability to sleep, a doctor may recommend a sleep study. The sleep study can help to diagnose the cause of the person’s sleep deprivation. Sleep deprivation alone can sometimes lead to hallucinations. In this case just improving the number of hours slept and the consistency of the time you go to bed can eliminate or reduce the hallucinations. Others may need over-the-counter or prescription medications. Sleeping pills like Ambien, antidepressants, or antipsychotic medications like Thioridazine may be recommended depending on your specific symptoms. Natural remedies include Valerian Herb Natural Valium and Gingko Biloba. A non-medication option that can be explored is a sleep class
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that focuses on relaxation and meditation techniques, teaching you to calm your thoughts before going to bed. Developing a normal exercise routine can be an inexpensive option to promoting better sleep as well. If you are experiencing chronic hallucinations or sleep related problems, please contact your family doctor.