Have you ever had a particularly detailed dream where you wake up wondering if it was real? Or have you woken suddenly from a nightmare with a sensation of falling? Dreams can seem very real at times but, for some people, they become a reality.

Rapid eye movement (REM) sleep behavior disorder is a condition in which you physically act out your dreams. For most people, the body remains immobile during REM sleep but, for people with this disorder, they engage in both sounds and movements while they are dreaming.

This sleep disorder may not be life-threatening, but it can worsen over time and may affect your quality of life as well as your relationships. In this article, we’ll explore the topic of rapid eye movement sleep behavior disorder, providing an overview of what it is, what symptoms it causes, and how it is related to other sleep disorders. We’ll also provide information about diagnosis and treatment options.

What is Rapid Eye Movement Sleep Behavior Disorder?

When you go to bed at night, you drift off to sleep, and your brain goes through four distinct stages of sleep that cycle through until you wake in the morning. There are two different sleep states: non-rapid eye movement (NREM) and rapid eye movement (REM). The first three stages of sleep are NREM while the fourth is REM sleep.

Every night, your brain goes through the four stages of sleep several times. A complete cycle lasts between 90 and 110 minutes with each individual stage lasting for 5 to 15 minutes.

During the first stage of NREM sleep, you become drowsy, and your brain wave activity begins to slow down as your muscles relax. In the second stage of NREM sleep, your eyes move slowly while your brain waves continue to slow down.

You may experience sudden bursts of brain activity known as sleep spindles, but you won’t wake as easily as in the first stage. The third stage of NREM sleep is the most restorative stage of sleep, consisting of delta waves.

After passing through the first three stages of sleep, your brain enters REM sleep – this accounts for about 20% of your total sleeping time.

In this stage, your eyes move rapidly from side to side, and your brain waves become more active – this is the dreaming stage. Even though you are technically asleep, your brain is almost as active as it is while you are awake.

For a person with rapid eye movement sleep behavior disorder, the line between wakefulness and sleep is even more blurred.

Rapid eye movement sleep behavior disorder is a condition in which the sleeper acts out his or her dreams.

For most people, the body is paralyzed during REM sleep but, in people with this disorder, that paralysis is incomplete or completely absent. Someone with this disorder might talk, yell, punch, kick, flail, grab, sit up, or even jump out of bed.

Sleep-Mystery-–-You-Get-Dream-At-REM-But-Nightmares-At-Non-REM-Sleep-Cycle
Credit: lifewithmomandlewybodiessyndrome.blogspot.com

What Are the Symptoms of Rapid Eye Movement Sleep Behavior Disorder?

The primary symptom associated with rapid eye movement sleep behavior disorder is dream-enacting behavior that comes during sleep. In most people, the REM stage of sleep is one in which arm and leg movements are minimized if not fully restricted. The body becomes increasingly more relaxed as you move through the first three stages of sleep until you are almost completely paralyzed during the REM stage. This is also when sleep paralysis occurs – the transition between sleeping and waking.

People with rapid eye movement sleep behavior disorder exhibit incomplete or absent paralysis that normally comes with REM sleep. As such, they actually act out their dreams with various movements and vocalizations.

Here are some of the most common symptoms of rapid eye movement sleep behavior disorder:

  • Arm movements such as punching, flailing or grabbing
  • Leg movement such as kicking
  • Sitting up suddenly or jumping out of bed
  • Talking, laughing, shouting, cursing, or yelling

All of these movements occur while you are dreaming and are in response to the dream you are having. In many cases, episodes of rapid eye movement sleep behavior disorder occur during particularly vivid or violent dreams.

You might dream, for example, that you are being chased or that you are defending yourself from an attacked. In these cases, you might wake up to find that you’ve physically left your bed in an attempt to escape or that you’re flailing against your bed partner, imagining that they are the assailant from your dream.

People who suffer from rapid eye movement sleep behavior disorder typically find that the symptoms come on gradually and that the disorder worsens over time.

At first, you may wake suddenly, but you will be alert and not disoriented – many people with the disorder find that they clearly remember their dreams upon waking. They may not, however, realize that they were acting out dream behavior unless there is a bed partner or family member there to witness it.

Rapid eye movement sleep behavior disorder is sometimes described as a parasomnia because it is characterized by involuntary and unwanted behaviors that occur during sleep.

It can be particularly problematic when the dreamer enacts a violent dream against a bed partner or if they leave the bed and put themselves in danger. Each episode can last anywhere from a few minutes to an entire REM sleep cycle, occurring as many as four times per night. These episodes don’t tend to happen during naps, and they generally don’t lead to daytime sleepiness.

What Causes Rapid Eye Movement Sleep Behavior Disorder?

The underlying cause of rapid eye movement sleep behavior disorder is a blurring of the line between the different sleep states.

As is true for other sleep disorders like narcolepsy and parasomnia, the brain may not make the transition from wakefulness to sleep and back to wakefulness as smoothly as it should. In a way, the characteristics of one sleep state carry over into the others.

Rapid eye movement sleep behavior disorder is commonly linked to other sleep disorders such as narcolepsy, periodic limb movement disorder, and sleep apnea. Though rapid eye movement sleep behavior disorder itself may not lead to excessive daytime sleepiness, any of these other sleep disorders can. This, combined with the interruption of sleep for bed partners or family members, can lead to a significant disturbance that may affect the patient’s quality of life.

The exact cause of rapid eye movement sleep behavior disorder is unclear.

What researchers do know is that there is a connection between rapid eye movement sleep behavior disorder and various degenerative neurological conditions such as multiple systems atrophy, Parkinson’s disease, and diffuse Lewy body dementia. In about 45% of cases, the condition is associated with withdrawal from alcohol or sedative-hypnotic medications or certain antidepressants. The exact nature of these relationships is still the subject of study.

This sleep disorder occurs most commonly in men, particularly after the age of 50. It is fairly uncommon in women and children, and it is thought to affect less than 1% of the population.

Rapid eye movement sleep behavior disorder affects the elderly at a higher rate and is most often seen in people with neurological conditions such as Parkinson’s disease and multiple system atrophy. In many cases, symptoms of this disorder present years or decades before these neurological conditions.

In addition to the correlation between this disorder and neurological conditions, there is also a link between rapid eye movement sleep behavior disorder and other sleep disorders.

For example, people with this condition have a higher risk for developing sleep apnea, narcolepsy, and periodic limb movement disorder. Other risk factors include withdrawal from drugs or alcohol, sleep deprivation, brainstem tumors, stroke, and the use of certain medications.

How is Rapid Eye Movement Sleep Behavior Disorder Diagnosed?

Rapid Eye Movement Sleep Behavior Disorder Diagnosed

Though rapid eye movement sleep behavior disorder is not immediately life-threatening, there is some risk for sleep disturbance and potential injury if you leave your bed while still asleep.

If you sleep with a partner or live with family, your dream-enacting behavior might interfere with their sleep or even put them at risk for physical harm. Some people with this disorder also develop anxiety about the problem and isolate themselves from others. These things are enough for most people to seek treatment.

Something else you should consider if you’re thinking about ignoring the symptoms of rapid eye movement sleep behavior disorder is that people who have this condition have a higher risk for developing more serious cognitive, neurological, and emotional problems later in life.

The link between this disorder and neurological conditions like Parkinson’s has already been discussed, but some other connections have been identified for things like apathy, anxiety, attention deficits, and problems with executive functioning skills.

If you’re concerned about symptoms of rapid eye movement sleep behavior disorder, talk to your doctor.

Your primary care physician will likely be unqualified to make a clinical diagnosis of this uncommon condition, but they can refer you to a sleep specialist.

To make a diagnosis, you may need to undergo the following:

  • A thorough review of your medical history
  • A discussion of symptoms, including frequency and severity
  • Physical and neurological exam to rule out other sleep disorders
  • Discussion between your doctor and sleep partner
  • Nocturnal sleep study (polysomnogram) performed in a sleep lab

Any or all of these things may be required to rule out underlying medical causes for your behavior and to confirm a diagnosis of rapid eye movement sleep behavior disorder.

In order to make a diagnosis, your sleep specialist will likely use the criteria from the International Classification of Sleep Disorders, Third Edition (ICSD-3).

Here are those criteria:

  • Repeated times of arousal during sleep where the patient talks, makes noises or performs complex motor behaviors that often correlate with the content of the dream
  • Patient recalls the dreams associated with these sounds and movements
  • No confusion or disorientation if woken during an episode
  • Polysomnogram results showing increased muscle activity during REM sleep
  • Sleep disturbance not caused by another sleep disorder, mental health condition, or by medication or substance abuse

Because rapid eye movement sleep behavior disorder is closely linked to neurological diseases like Parkinson’s, a diagnosis of this condition may lead to further testing and treatment.

If you haven’t yet begun to exhibit symptoms of a neurologic disorder, treatment may be limited to safety measures to keep you safe and, possibly, medications to mitigate symptoms.

What Are the Treatment Options for Rapid Eye Movement Sleep Behavior Disorder?

Though rapid eye movement sleep behavior disorder is not a life-threatening condition, it does tend to worsen over time. If your symptoms progress, you could put yourself or your bed partner at risk. It is also important to remember that this condition is frequently linked to other sleep disorders as well as more serious neurological conditions. For all of these reasons, it is important to seek treatment for rapid eye movement sleep behavior disorder as early as possible.

When it comes to treatment of rapid eye movement sleep behavior disorder, there are two primary focuses: safety precautions and medications.

Bedroom safety precautions can help keep both the patient and the bed partner safe. These precautions might include things like moving objects away from the bedside and moving the bed away from the window. You could also place a large object like a dresser in front of the window or door. Another option is to place your mattress on the floor to reduce the risk of injury.

Medications for rapid eye movement sleep behavior disorder typically include clonazepam and melatonin, as well as certain antidepressants.

Clonazepam is a benzodiazepine that is effective in roughly 90% of cases for this disorder. It suppresses muscle activity and helps relax the body during sleep to prevent you from acting out your dreams. Melatonin is a hormone produced naturally in the body that helps reduce muscle tone to decrease movement during REM sleep.

Here are some other things you can do to manage rapid eye movement sleep behavior disorder:

  • Stick to a regular sleep schedule to avoid sleep deprivation
  • Seek treatment for any concurrent sleep disorders
  • Avoid excessive use of alcohol or certain medications
  • Undergo additional monitoring for neurologic symptoms

We all have strange dreams from time to time, but most people don’t act on them or even remember them in the morning.

For people with rapid eye movement sleep behavior disorder, however, the line between sleeping and waking becomes blurred which sometimes leads to dream-enacting behavior. If you or a bed partner exhibits symptoms of this disorder, seek medical care sooner rather than later.

Disclaimer: The information on this website is not intended to be used as a substitute for professional medical advice, clinical diagnosis, or treatment. Always seek the advice of your personal physician or another qualified health provider with any questions you may have regarding a medical condition.

About Kate Barrington Kate Barrington holds a Bachelor’s degree in English and is the published author of several self-help books and nutrition guides. Kate also holds a certificate in fitness nutrition and enjoys writing about health and wellness topics including sleep hygiene, natural remedies, and sleep disorders. In addition to her work as a ghostwriter and author, Kate is also a blogger for a number of holistic health companies and writes product reviews about mattresses and other sleep solutions.

As the sun starts to set and your day comes to a close, you begin to feel tired. After a few hours, you’re ready to go to bed, and you sleep through the night until morning.

At least, this is the typical sleep-wake pattern for most people. For people with circadian rhythm sleep disorders, however, the daily cycle of wakefulness and tiredness may be very different.

In this article, we’ll explore the topic of circadian rhythm sleep disorders, providing an overview of what they are how they are related to other sleep disorders. We’ll also provide information about diagnosis and treatment options for each of these disorders.

What is a Circadian Rhythm Sleep Disorder?

Circadian rhythm sleep disorders affect your biological clock, causing a disruption in your sleep-wake rhythm. The circadian rhythm is also known as your internal body clock – the part of your brain that regulates your 24-hour biological cycle including sleeping and wakefulness.

There are two categories of circadian rhythm sleep disorders: intrinsic and extrinsic. Before getting into the details, let’s take a deeper look at the circadian rhythm itself.

Your internal biological clock regulates your periods of tiredness and wakefulness over the course of a 24-hour period and is calibrated by the rising and setting of the sun.

The function of your circadian rhythm is controlled by the hypothalamus region of the brain, or more specifically by a group of cells called the suprachiasmatic nucleus (SCN) which is linked to the optic nerves that sense changes in daylight.

The SCN is thus also responsible for regulating the other bodily functions that are connected to a 24-hour cycle such as heart rate, body temperature, blood pressure, and the release of the hormone melatonin. In the afternoon and evening, melatonin levels start to rise, making you sleepy then taper off in the morning which is what causes you to wake.

For most people, the biological clock is set to make you ready for sleep around 11pm and to wake around 7pm. Everyone’s circadian rhythm is a little different, however, and it can be impacted by your work schedule as well as other factors. When these patterns become disrupted, it results in a circadian rhythm sleep disorder.

Intrinsic circadian rhythm sleep disorders are disorders in which your body clock is significantly different from the rest of society.

You might go to bed and wake up much later than usual or much earlier than usual – you might also experience fragmented sleep or a sleep pattern that changes frequently.

Extrinsic circadian rhythm sleep disorders are those in which your circadian rhythm is in sync with the typical 24-hour day, but your clock has been disrupted by work, school, or travel.

Here are the 6 most common circadian rhythm sleep disorders:

  • Delayed Sleep Phase Syndrome (DSPS)
  • Advanced Sleep Phase Syndrome (ASPS)
  • Non-24-Hour Sleep-Wake Syndrome
  • Irregular Sleep-Wake Rhythm
  • Shift-Work Sleep Disorder
  • Jet Lag

Delayed sleep phase syndrome is characterized by a delay in melatonin production. People with DSPS don’t feel tired until about 2 hours later than most people, though they still require the same 7 to 9 hours of sleep.

Because melatonin production is normal but delayed, they may sleep later in addition to staying up later. When this cycle doesn’t line up with work or school, it can cause problems.

Advanced sleep phase syndrome is almost the opposite – you feel sleepy earlier in the day than usual and may rise earlier in the morning as well.

Non-24-hour sleep-wake syndrome is also known as free running disorder and occurs when the circadian rhythm is out of sync, having a slightly longer than 24-hour cycle.

This causes the patient to get sleepy later and later every few days, causing the internal clock to shift.

Irregular sleep-wake rhythm is another problem with the circadian rhythm being out of sync, but it usually causes the person to sleep in several short periods of sleep or “naps” over a 24-hour cycle instead of one long period of sleep.

Shift-work sleep disorder happens when a person’s circadian rhythm conflicts with their school or work schedule, causing them to experience daytime sleepiness and/or insomnia. People who work early morning shifts or night shifts can generally adjust as long as the schedule is regular, but people with rotating shifts have a harder time.

Jet lag happens when you travel quickly into a new time zone (generally by plane), so your body has to adjust to a new sleep-wake cycle that might be off from your normal circadian rhythm.

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circadian rhythm chart. Image credit: luciddreamexplorers.com/dreamscience/

What Are the Symptoms and Causes of Circadian Rhythm Sleep Disorders?

Generally speaking, circadian rhythm sleep disorders are characterized by a disruption in the typical sleep-wake cycle or circadian rhythm. There are six different types of disorder, each with its own unique set of symptoms. Here is an overview of the symptoms associated with each of these disorders:

  1. Delayed Sleep Phase Syndrome (DSPS)

This is a circadian rhythm disorder in which the patient’s sleep-wake pattern is delayed by two or more hours then what is desired or socially acceptable. People with this disorder tend to prefer later bedtimes and wake-up times, though once they fall asleep, they usually get a normal amount.

Symptoms of delayed sleep phase syndrome may include the following:

  • Delay in sleep pattern in relation to the desired sleep-wake time
  • Difficulty falling asleep at the desired time at night
  • Being unable to wake up at the desired time in the morning
  • Having a normal duration or quality of sleep when left to their own schedule
  • Having a stable but delayed sleep pattern for at least 7 days

In many cases, the cause of delayed sleep phase syndrome is another sleep disorder, a medical condition, a mental health disorder, or related to the use of medication or substances. This disorder is most common in teenagers and usually develops during the early teenage years and lasts into the mid-twenties. In fact, this disorder is so common in teenagers that there is some progress being made in changing school start times.

  1. Advanced Sleep Phase Syndrome (ASPS)

This is a circadian rhythm disorder in which the patient’s sleep-wake pattern is advanced by 2 or more hours. In other words, they start to feel sleepy earlier than is typical and thus go to bed earlier, waking earlier in the morning as well.

Symptoms of advanced sleep phase syndrome may include the following:

  • Advanced sleep pattern in relation to the desired sleep-wake time
  • Feeling tired earlier than is typical in the evening
  • Waking earlier than is typical in the morning
  • Excessive daytime sleepiness or insufficient sleep
  • Feeling sleepy in late afternoon and alert between 2 and 5am

This circadian rhythm disorder is not very common but is usually seen in middle-aged adults and seniors. There is thought to be a genetic link, as it appears to run in families, and it may be linked to another sleep disorder, a medical condition, a mental health disorder, or related to the use of medication or substances. It affects men and women at an equal rate.

  1. Non-24-Hour Sleep-Wake Syndrome

People with non-24-hour sleep-wake syndrome may sleep for a normal period of time every day, but their sleep-wake cycle shifts a little later each day. Because the sleep-wake cycle is changing from day to day, this condition is easily confused with other circadian rhythm disorders. It is particularly common in blind people because light is the biggest influence on resetting the brain’s biological clock.

Symptoms of non-24-hour sleep-wake syndrome may include the following:

  • Having a sleep cycle that gets later each night
  • Waking up later and later each day
  • Having a sleep cycle that seems to change often
  • A sleep cycle that gets consistently later without outside interruption

More than half of blind people have this disorder, though those who still have a working pathway to the part of the brain that controls the internal clock do not. Though this condition is rare in people who are not blind, contributing factors may include limited exposure to daylight, concurrent psychiatric or personality disorders, and neurological conditions.

  1. Irregular Sleep-Wake Rhythm

People with this circadian rhythm disorder has a sleep pattern that doesn’t follow the typical sleep-wake rhythm of sleeping for one extended period at night and staying awake for an extended period of time during the day. Instead, these people tend to sleep in several shorter periods of time (naps) dispersed over a 24-hour period. Though they may only sleep for 2 to 4 hours at a time, the total amount of sleep they get in any 24-hour period is normal and adequate.

Symptoms of irregular sleep-wake syndrome may include the following:

  • Sleeping on and off in a series of naps over 24 hours
  • Having no regular sleep schedule from day to day
  • Difficulty sleeping for an extended period of time
  • Trouble waking from a long nap
  • Having a total sleep time that is normal for age

Irregular sleep-wake rhythm disorder is very rare, so its prevalence is unknown. It seems to be most common in people who have neurological conditions such as dementia or mental retardation and in people who live in institutions where exposure to natural daylight and structured daily activity is low.

  1. Shift-Work Sleep Disorder

This is a circadian rhythm disorder in which a person’s sleep-wake cycle conflicts with their work schedule. People with this disorder often experience insomnia or excessive daytime sleepiness because their circadian rhythm is out of sync. Shift-work is considered hours worked outside the traditional 9-to-5 schedule and often consists of early morning or night hours as well as a rotating schedule.

Symptoms of shift-work sleep disorder may include the following:

  • Excessive sleepiness during the day
  • Difficulty falling or staying asleep at night
  • Lack of energy while awake
  • Trouble concentrating or focusing at work
  • Frequent headaches or migraines
  • Low mood and increased irritability

Having shift-work disorder can increase your risk for injury on the job or while driving. It leads to the increased use of sick time as well as an increased risk of substance abuse in people who use drugs or alcohol to obtain sleep. Long-term health risks include heart disease, obesity, cancer, and infections.

  1. Jet Lag

This disorder occurs when you travel across multiple time zones (at least two), and you have trouble adjusting your sleep-wake cycle to the new schedule. When you travel quickly by air, your body will most likely still be aligned with your typical circadian rhythm, and it could take several days to adjust to the new one. As such, jet lag is a temporary condition.

Symptoms of jet lag may include the following:

  • Feeling tired or disoriented
  • Having trouble falling asleep at the appropriate time
  • Being unable to function during the daytime
  • Mild to moderate sickness
  • Stomach problems or digestive issues
  • Menstrual symptoms in women

Jet lag can be worsened by sleep loss caused by travel as well as spending extended time in an uncomfortable position, such as an airplane, especially for sleeping. Stress, excessive caffeine or alcohol use, and poor air quality can also contribute.

How are Circadian Rhythm Sleep Disorders Diagnosed?

If you have trouble sticking to a regular sleep schedule or you find that you have trouble falling or staying asleep, you may want to talk to your doctor. You should also consult your physician if you experience excessive daytime sleepiness or other symptoms. If you’re concerned that you might have a circadian rhythm sleep disorder, your doctor will be able to help you identify which disorder it is and recommend a course of treatment.

Here are some of the things you may undergo in diagnosing a circadian rhythm sleep disorder:

  • Thorough history of your symptoms and medical background
  • A physical exam to rule out underlying medical problems
  • A sleep diary to track symptoms and sleep habits for at least 7 days
  • Wearing an actigraph to record your sleep-wake times
  • Undergoing an overnight sleep study in a sleep lab (polysomnography)
  • A Multiple Sleep Latency Test (MSLT) to see how long you take to fall asleep
  • Additional tests such as blood tests, urinalysis, and MRI

In addition to diagnosing you with the proper circadian rhythm sleep disorder, your doctor may also want to identify any triggers that could be contributing your symptoms. Things such as chronic stress, sleep deprivation, and changing work schedules can all be a factor in the development of sleep disorders. It could also be related to your drug use, alcohol consumption, or use of medications.

What Are the Treatment Options for Circadian Rhythm Sleep Disorders?

When it comes to the treatment of circadian rhythm sleep disorders, your options are determined by the type of disorder and the degree to which its symptoms impact your daily life. In some cases, treatment may not be necessary at all. For example, if you have delayed sleep phase syndrome, but you don’t actually need to be awake early in the morning, you may simply be able to adjust your sleep schedule to accommodate for the condition.

In other cases where your symptoms impact your life, you may want to consider treatment options such as the following:

  • Behavior Therapy
  • Light Therapy
  • Medication
  • Chronotherapy

Behavior therapy can take many different forms. For the treatment of circadian rhythm sleep disorders, it often involves making changes to your lifestyle and sleep habits to accommodate your disorder. For example, you might work with a therapist to establish and maintain a regular sleep-wake schedule while including things such as exercise, regular meals, and social interaction. You may also need to avoid daytime naps, caffeine in the evening, and bright light at night.

Bright light therapy is a treatment that can be used to reset your circadian rhythm. All that is required is a high-intensity light (about 10,000 lux) and an exposure time of 1 to 2 hours. Timing is important, so only use this therapy under the guidance of a sleep specialist.

When behavior therapy and light therapy don’t work, you might consider medications or chronotherapy.

Chronotherapy is simply the progressive delay or advancement of sleep time by about 1 to 2 hours per day.

The timing is determined by the type and severity of your disorder as well as your daily obligations. Medications like melatonin can help you fall asleep outside of your circadian rhythm, and wakefulness-promoting agents can help you feel alert when you wake up earlier than usual.

Sleep is an essential part of life but, for some people, it doesn’t come so easily.

If you suffer from a circadian rhythm sleep disorder, you may struggle to work your sleep schedule around your work or school obligations. If you’re having trouble, talk to your doctor about the treatment options discussed above to see whether one of them might be right for you.

Disclaimer: The information on this website is not intended to be used as a substitute for professional medical advice, clinical diagnosis, or treatment. Always seek the advice of your personal physician or another qualified health provider with any questions you may have regarding a medical condition.

About Kate Barrington Kate Barrington holds a Bachelor’s degree in English and is the published author of several self-help books and nutrition guides. Kate also holds a certificate in fitness nutrition and enjoys writing about health and wellness topics including sleep hygiene, natural remedies, and sleep disorders. In addition to her work as a ghostwriter and author, Kate is also a blogger for a number of holistic health companies and writes product reviews about mattresses and other sleep solutions.

Sleep Hallucinations

If you have ever woken from sleep and felt as if someone were in the room with you, you may have had a sleep hallucination.

Often correlated with sleep paralysis, hallucinations can happen when you are falling asleep or waking from sleep – when there is a disturbance as your brain moves through the different stages of sleep.

Sleep hallucinations are not necessarily an indication of mental illness, and they are actually fairly common, affecting nearly 40% of adults.

These hallucinations are frequently correlated with other sleep disorders, and they can be triggered by a variety of different things.

In this article, we’ll explore the topic of sleep hallucinations in depth, providing an overview of what they are, what causes them, and how they are related to other sleep disorders.

We’ll also provide information about diagnosis and treatment options.

What is Sleep Hallucination?

The word hallucination is derived from a Latin term meaning “to wander mentally.” Hallucinations may involve seeing, hearing, feeling, or even tasting or smelling things that are not real.

Another definition is a sensory experience that is not caused by the stimulation of the relevant sensory organs.

Hallucinations are most commonly associated with schizophrenia, a form of mental illness characterized by delusions, incoherence, and extreme agitation in addition to hallucinations.

They can also occur with bipolar disorder, both type 1 and type 2. When hallucinations occur in the transition between sleep and waking, however, they are called sleep hallucinations.

Depending on the stage of sleep in which the hallucinations occur, they may be either hypnagogic or hypnopompic.

Before getting into the details about sleep hallucination, let’s take a closer look at the five different types of hallucinations:

  • Auditory – The most common type of hallucination, you might hear voices or sounds.
  • Visual – The second most common type of hallucination, you might see shapes, colors, people, or objects that aren’t really there.
  • Tactile – You might feel a sensation that isn’t real such as being touched or having bugs crawling across your skin.
  • Taste – You may experience a taste in your mouth that is not real – this type is rare.
  • Olfactory – You might smell something that has no physical source.

Hypnagogic hallucinations are those which occur while you are falling asleep. In most cases, these sleep hallucinations are tactile or visual, commonly involving the perception of sounds or sights that aren’t real. This type of hallucination is twice as common as hypnopompic hallucination and they are a common symptom of narcolepsy.

Hypnopompic hallucinations occur during the transition between sleep and wakefulness, and they may include sights, sounds, and sensations. The lifetime prevalence of this type of hallucination is between 6% and 13% while researchers believe that most adults will experience at least one hypnagogic hallucination in their lifetime.

What Are the Symptoms of Sleep Hallucinations?

It’s easy to confuse sleep hallucinations with dreaming because they occur during the transition between waking and sleep. You might even find yourself wondering whether you are awake or asleep. In some cases, sleep hallucinations can be similar to nightmares except for the fact that when you wake up from a nightmare, you are generally aware that it happened while you were asleep.

Some of the most common symptoms of sleep hallucinations include the following:

  • Vivid hallucinations while falling asleep or before falling asleep
  • Hallucinations that occur while you are waking up
  • A feeling as if you are still moving while your body remains still
  • Perceptions of sights or sounds that aren’t real
  • A sensation of falling or flying
  • Images of people, animals, or moving objects in the room

In addition to these hallucinations, people who experience them may experience fragmented sleep which can then lead to excessive daytime sleepiness. A common symptom of several sleep disorders, excessive daytime sleepiness can impact your ability to fulfill daily obligations at work or school, and it could increase your risk for having an accident.

Sleep hallucinations are very similar to sleep paralysis for some people. Sleep paralysis is an episode during which you are unable to move or speak but can still breathe normally.

These episodes usually occur in the transition periods between waking and sleep. For some, they are very brief and only mildly concerning, but some people experience hallucinations during these episodes which can be very scary.

If you experience hypnagogic hallucinations during the day, it could be a sign of narcolepsy. Other symptoms of narcolepsy include excessive daytime sleepiness, uncontrollable attacks of sleep, and sleep paralysis.

If you have these symptoms, consider talking to your doctor about your concerns.

What Causes Sleep Hallucinations?

For many years, sleep hallucinations and sleep paralysis were associated with mental illness. After all, seeing or hearing things that aren’t there are symptoms of psychiatric disorders like schizophrenia and bipolar disorder.

Researchers now know, however, that these hallucinations can occur in people who do not suffer from mental illness, though having anxiety, depression, or bipolar disorder doubles your risk for experiencing sleep hallucinations.

The underlying cause for sleep hallucinations is a hitch in the transition between the different stages of sleep. There are four stages of sleep – three non-REM stages and REM sleep.

The first stage is the lightest stage of non-REM sleep which can be easily disrupted.

As your body relaxes and your brain activity slows, you move into the second stage where brain waves slow down more with specific bursts of rapid activity called sleep spindles. Deep NREM sleep is the third stage and the most restorative of the four, consisting of slow delta waves.

The fourth stage of sleep is characterized by rapid eye movement which is why it is called REM sleep.

This is the dreaming state, so you are most likely to experience sleep hallucinations and sleep paralysis in the transition into and out of this state.

Again, hypnagogic hallucinations occur while you are falling asleep and hypnopompic hallucinations happen as you are waking up.

In most cases, sleep hallucinations are mild, but they can be complex – in these cases, they may suggest the presence of some kind of visual or neurologic disorder.

Aside from psychiatric disorders like bipolar disorder and schizophrenia, having a concurrent sleep disorder or certain other medical conditions can trigger sleep hallucinations.

The use of certain medications or the overuse or abuse of drugs and alcohol might be a trigger as well.

Even if you’re not currently using drugs or alcohol on a regular basis, it could still be a trigger for sleep hallucinations. Sleep hallucinations can also be related to insomnia and sleep deprivation.

Sleep deprivation is both a trigger and a symptom of sleep hallucinations. When you don’t get adequate sleep to meet your needs, you may experience excessive daytime sleepiness.

In severe cases, you may find yourself falling asleep involuntarily during the day, and you could experience sleep hallucinations during the transition into that sleep. The more sleep-deprived you are, the higher your risk for hallucinations.

In most cases related to sleep deprivation, hallucinations are visual, and they can be either simple or complex.

Sleep deprivation can also contribute to other symptoms such as disorientation and paranoia – these symptoms mimic those of certain mental illnesses like schizophrenia. Fortunately, these symptoms are typically resolved when your sleep deprivation is resolved. In fact, some evidence suggests that a single night of adequate sleep may be enough to reverse the negative effects of sleep deprivation, including hallucinations.

If you experience sleep hallucinations on a regular basis, you should talk to your doctor about your concerns. A single episode of hallucination may not be cause for concern, but if you also experience symptoms such as disorientation or paranoia, it could be the result of an underlying condition.

How is Sleep Hallucination Diagnosed?

Sleep Hallucination Diagnosed

Generally speaking, sleep hallucinations are fairly common – they have been reported in as many as 33% of all people. Sleep hallucinations are more common in teens and young adults and in women than in men. Some of the factors which may increase your risk for sleep hallucinations include drug use, alcohol use (past or current), anxiety, mood disorders, and insomnia.

Sleep hallucinations are often linked to other sleep disorders, so one of the primary goals of diagnosis is identifying or ruling out underlying conditions. To start, your doctor will take a thorough health history and perform a physical exam to determine whether there are any underlying factors at play. The more information you can provide about your symptoms, the better – your doctor may even ask you to keep a sleep diary for a week or more to track your symptoms and sleeping habits.

Here are some of the things you should keep track of to tell your doctor:

  • How much sleep you tend to get on an average night
  • Your sleep schedule – when you go to bed and when you wake up
  • How you feel in the morning, whether your sleep was restful
  • Whether you woke up during the night and, if so, whether you feel back asleep
  • How often you experience sleep hallucinations
  • When you experienced your first sleep hallucination
  • At what point during the night the sleep hallucinations tend to occur
  • How long the hallucinations last and which sensations are involved
  • Any other sleep-related symptoms or problems

In some cases, your doctor may refer you to a sleep specialist who may then ask you to complete an overnight sleep study including a polysomnogram.

A polysomnogram is a sleep study that measures your brain activity, heart rate, breathing, body temperature, and other metrics while you sleep.

The goal is to identify fragmented sleep patterns that could indicate a sleep disorder or another underlying condition. You may also need additional testing such as an MRI or a Multiple Sleep Latency Test (MSLT).

This test simply measures how long it takes you to fall asleep.

What Are the Treatment Options for Sleep Hallucinations?

Sleep hallucinations are not dangerous to your health, though the experience can certainly be concerning. Depending how often you experience sleep hallucinations, no treatment may be necessary.

If you can easily identify the trigger for your sleep hallucinations, taking steps to avoid that trigger might be all you need to do.

For example, if you experienced a sleep hallucination after sleeping poorly for a few days, you might assume that sleep deprivation was the trigger and catching up on sleep the best resolution.

If you experience sleep hallucinations somewhat regularly, it is possible that the frequency will decrease over time. Doing the following things may help speed that process along:

  • Sticking to a regular sleep schedule for bedtime and waking
  • Getting an adequate amount of sleep every night (about 7 to 9 hours)
  • Avoiding drug use and certain medications
  • Moderating your alcohol intake and avoiding alcohol before bed
  • Taking steps to reduce your stress such as meditation or relaxation exercises
  • Engage in talk therapy to work through stress and other potential triggers

Sleep hallucinations occur during the transition between sleeping and wakefulness.

Anything that interferes with your brain’s ability to move smoothly through that transition can trigger a sleep hallucination. The best thing you can do is get as much sleep as possible and to make sure that the sleep you do get is restful.

Disclaimer: The information on this website is not intended to be used as a substitute for professional medical advice, clinical diagnosis, or treatment. Always seek the advice of your personal physician or another qualified health provider with any questions you may have regarding a medical condition.

About Kate Barrington Kate Barrington holds a Bachelor’s degree in English and is the published author of several self-help books and nutrition guides. Kate also holds a certificate in fitness nutrition and enjoys writing about health and wellness topics including sleep hygiene, natural remedies, and sleep disorders. In addition to her work as a ghostwriter and author, Kate is also a blogger for a number of holistic health companies and writes product reviews about mattresses and other sleep solutions.