Why Am I Having Hypnagogic Hallucinations?

Vivid nightime visions during your sleep may be what’s known as hypnagogic hallucinations, which are among the most common narcolepsy symptoms. Here, we explain their causes—and how you can treat them.

hypnagogic hallucinations

Vivid nightime visions during your sleep may be what’s known as hypnagogic hallucinations.

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Do you ever have wild visions or dreams that are extremely vivid and seem like real life just as you’re falling asleep? You may be experiencing hypnagogic hallucinations, a condition often associated with narcolepsy. In fact, hypnagogic hallucinations are among the four most common narcolepsy symptoms, along with sleep paralysis, daytime sleepiness, and cataplexy—a sudden loss of muscle tone and control while awake.

But hypnagogic hallucinations aren’t always signs of narcolepsy. Sometimes, antidepressant medications can trigger vivid bedtime dreams. For some people, hypnagogic hallucinations are the result of stress, anxiety, or insomnia.

Hypnagogic Hallucinations: “So Strange and So Real”

Hypnagogic refers to the transition between being wakefulness and sleep. It’s that drowsy feeling you have just as you’re falling asleep. You may be somewhat aware of your surroundings during this period. You may even have mild dream-like thoughts. But hypnagogic hallucinations are much different. They tend to seem very “lifelike” and have a strong sensory component. You’ll see, hear and feel things as though you were fully awake.

When you awake from a typical dream, you usually know that you were dreaming. And even if you had a disturbing dream or nightmare, you can chalk it up to a bad dream and get on with your day.


Maurizio Fava, MD, editor-in-chief of Mind, Mood & Memory, answers a common question about sleep paralysis.

Q: Is there any type of sleep paralysis treatment that helps people who experience these events, and if so, what does it consist of?

A: Sleep paralysis (SP) is a condition in which individuals awaken in the midst of vivid dreams that occur during the rapid eye movement (REM) stage of sleep and find themselves physically immobilized and unable to breathe normally. The frightening experience usually occurs when falling asleep or waking up, and ends after a minute or two. It is not dangerous, but it may sometimes involve hallucinations and can be very disturbing. If you experience these events regularly, feel anxious about going to sleep, or find that you are very sleepy during the daytime, consider seeing a health care provider for assessment. SP treatment varies from patient to patient, depending on factors such as the frequency of the SP events, your sleep patterns, and your medical and psychological history. Treatment usually involves adjusting your sleep routine to ensure proper sleep hygiene (such as making sure your sleep environment is cool, dark, and comfortable; keeping a regular sleep/wake schedule; and avoiding big meals, caffeine, exercise, alcohol, stimulating activities, or “screen time” on computers, smart phones, etc. close to bedtime). Learning to use meditation to promote relaxation, especially during SP attacks, can also be effective. In some cases an antidepressant such as clomipramine may be prescribed for its ability to alter REM sleep.

But if you have hypnagogic hallucinations, you may have a harder time separating them from reality. Because they’re often so strange and seem so real, they can leave you feeling afraid and confused because the contents of the hallucinations made no sense.

About one out of four people experience hypnagogic hallucinations at some point. This is in contrast to hallucinations that occur while a person is fully awake. Only about 5 percent of the population ever experiences waking hallucinations.

Hypnagogic hallucinations are rare in children, but they can surface in adolescence and into young adulthood. This is also the time when narcolepsy tends to first show up. Hypnagogic hallucinations are most common among individuals with narcolepsy.

Narcolepsy and Other Causes

The causes of narcolepsy aren’t well understood. The most well-known narcolepsy symptoms include sudden, unexpected naps of a few seconds or much longer. But hypnagogic hallucinations and sleep paralysis are also trademark signs of the condition. Sleep paralysis sometimes accompanies hypnagogic hallucinations, and it is characterized by an inability to move or speak as you fall asleep. These two narcolepsy symptoms can be the two most upsetting because they make you feel especially vulnerable and powerless.

If you have no other narcolepsy symptoms, the cause of your hypnagogic hallucinations may be due to stress, insomnia, or drug or alcohol use. Tricyclic antidepressants have been associated with hypnagogic hallucinations, but these medications have been replaced to a great extent by other drugs, such as selective serotonin reuptake inhibitors (SSRIs).

But illicit drugs and excessive alcohol consumption can produce hallucinations. If you (or a loved one) appears to have a problem with drugs or alcohol, seek help from your physician or a treatment program in your community. The health risks to you and those around you include much more than vivid and disturbing dreams.

If stress or anxiety may be at the root of your hypnagogic hallucinations, you should also consult with your doctor or a mental health professional. Techniques in stress relief and therapy to help you cope with anxiety may be able to put an end to bedtime hallucinations and other symptoms.

Hypnagogic Hallucinations: Outlook

If hypnagogic hallucinations occur infrequently and don’t disturb your sleep, no treatment may be necessary. But if they’re a cause of great stress or occur on a regular basis, then by all means seek help.

But understand that hypnagogic hallucinations are not signs of mental illness. It is this fear or misunderstanding that keeps some people from discussing such episodes. If your doctor doesn’t seem knowledgeable or equipped to deal with your concerns, seek out a sleep specialist. You may be advised to avoid bed until you become very sleepy. Sometimes lying awake and worrying about possible hallucinations can make the situation worse.

These hallucinations are common, and with treatment for underlying causes, they may disappear on their own. In addition, while hypnagogic hallucinations tend to develop first in young people, as you age, however, your chances of experiencing these visions declines.



Vivid sleep-related hallucinations usually take one of two forms: hypnogogic or hypnopompic. Unlike standard dreams that often have a story (even if it doesn’t make much sense when you’re recounting it), hypnogogic and hypnopompic hallucinations usually don’t have much of a linear narrative. They are usually just sensations, sometimes so strong that you may feel you’re smelling or hearing something unusual, as well as seeing it.

Hypnogogic hallucinations occur as you’re falling asleep ,and sometimes happen simultaneously with sleep paralysis. You may also experience sleep paralysis as you wake up.

Having hallucinations upon waking is called hypnopompia. It’s much more common to have sleep paralysis during hypnopompia hallucinations than it is during hypnogogia.

Sleep paralysis as you wake up often seems like parts of a vivid dream. If you’ve ever awakened from a lifelike dream in which you dreamed you couldn’t move, you may have been actually experiencing a hypnopompic hallucination and sleep paralysis. Hypnopompic hallucinations often include the sensation of falling or the sense that someone is in the room with you.

A British publication, Journal of Psychiatry, recently covered a survey about dreams and hallucinations that revealed some interesting results. More than 5,000 people responded. According to the results, about 40 percent of the respondents said they’d had hypnogogic hallucinations, while only about 12 percent said they’d had hypnopompic visions. Researchers suggest that hallucinations upon waking were common in people with sleep disorders. If you tend to experience these visions, tell your doctor.

Of course, if you have any type of sleep-related hallucination, it’s not a guarantee that you have a sleep disorder. Hallucinations aren’t a sign of mental illness, either. Worries about how hallucinations will sound to a doctor may keep some people from reporting them. But you shouldn’t worry; they’re fairly common. And if sharing hypnopompic hallucinations or hypnogogic hallucinations helps lead to the diagnosis and treatment of a sleep problem, then consider this your wake-up call.

This article was originally published in 2016 and is regularly updated.

As a service to our readers, University Health News offers a vast archive of free digital content. Please note the date published or last update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Jay Roland

Jay Roland has been executive editor of Massachusetts General Hospital’s Mind, Mood & Memory since 2017. Previously, he held the same position with Cleveland Clinic’s Heart Advisor, since 2007. In … Read More

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  • thanks to this information on this page I have finally diagnosed my disorder as hypnagogic hallucinations.
    immediately upon falling asleep I find myself in a terrifying demon like world it feels like my body is becoming possessed by spirits sounds and feeling of discomfort are intensified.
    I wake up after several minute of this confused and scared. usually to scared to try and go back to sleep again.

  • I was wondering what it was to experience hallucinations when waking up because this morning when I woke up I swear I saw near my desktop computer tower on the wall a spider that looked to be at least a foot or 2 from the end of the front legs to the back legs and then it hid behind my desktop tower. I was scared as hell at first cause I hate spiders but I knew it couldn’t be real and just shook it out of my mind.

  • Every evening in bed before sleep occurs I have great experiences. I see myself chatting with different people in different locations. I direct myself to ask each person where I am. I see the answers come through with descriptions of different towns in different states. One time I saw myself in a bank asking the teller where I was. She held up a newspaper with the name Seattle on it. I love this nightly interactions and will never do anything to change it. Short time after with these interactions I am in full rem sleep.

  • I’ve been having night visions for months now. Although they are often funny when retelling the tale later, they are not funny when having them. Sometimes they are very scary. I see things that aren’t there. Sometimes normal things like my children or dog and sometimes they are doing normal stuff and sometimes they are doing surname or even creepy things. But sometimes I see things like creepy faces with long black hair, something straight out of a horror movie. Sometimes I think I’m in different places and sometimes I’m trying so hard to figure out where I am. I often talk and do things. I knocked over a small dresser near my bed and last night I bashed my head on the corner of it. Have a cut and a lump. That seems concerning. That it’s getting worse. An almost night time occurrence now is my husband telling me “it’s not real” so I can stop whatever I’m doing and lay back down. My psychiatrist doesn’t seem to be too concerned but I’m a new regimen of meds and I really think that might be a contributor. Changing meds seems daunting though cause it took a long time to get them right and it was a rough transition.

  • I’ve had these a few times. it’s always within about an hour of starting to fall asleep and always about spiders. the size varies each time but they are always either yellow or red, usually yellow and they always descend towards me, be it on the wall or on a thread.
    it’s bloody terrifying and I end up flying out of bed to the light and hyperventilating for a while.

    I believe mine are caused by stress as it was either during a heavy workload at uni or a stressful time at work.

    outside of the hallucinations though I usually remember a minimum of 2-3 distinct dreams, but this can go as high as 6. I frequently wake up exhausted as though I haven’t slept at all.

  • I am so tired of being afraid to go to sleep. Sometimes, I stay up all night, I am overweight, irritable and irrational during the day. I see the horrible and scary spider like balls that go up the string and dissipate, scurry across the ceiling and fade away. I have to survey my room and move things that could later in the night look like people. I fear sleep and I love to sleep. I take metropolol for blood pressure and it has a side effect of hallucinatory nightmares… anyone else on it? Why do we all see the same things? I haven’t had any scary black forms lately, but fear them nightly. Sometimes, I stay awake all night and sleep from 4-8. Any one have a remedy for this awful problem and why do we all see the same things? Spider balls? what is that?

  • Replying to : Carly B. September 6, 2018
    Have anyone here experienced their name called, loud noises or whistling upon falling asleep ?
    I just “woke” from what must be a hypnagogic hallucination- I distinctly heard a quiet voice in my left ear only say “we can almost hear you” while my head and chest felt like an electric pulse was pushing through it with a visible pattern and all the time I feel conscious and think “shit, I’m going to have to call the paramedics as my brain is in some kind of seizure “. – so weird and scary – came eventually to the internet to try and reassure myself. Post concussion issues or just stress from not sleeping well?! I don’t want to go back to sleep now, it’s scary in there. I have a history of night screaming too which has been frequent lately. I’d forgotten this horror. Sweet dreams all.

  • I have been waking up constantly and seeing people in my room (or wherever I am) and it’s freaking me out because it is so real. The people are, of course, people I know and usually people I have seen the current day but it’s so real. So I just lay there and like look at them without saying anything and then realize it isn’t true and they’re gone.

  • I’ve been experiencing these for a few years now. I notice they get worse when I am stressed, whether it’s about college or being stressed about having one of these episodes. I also notice that it happens more often if I drink caffeine (which I’m extremely sensitive to). I often see bugs running by me. My old apartment was cockroach infested when I first moved in but soon cleared up but I would have hallucinations of them all over my walls and crawling on me, I would wake up shaking and panicking sometimes running out of bed and hyperventilating. I also often hear whispering voices, sometimes clear and saying things like “you won’t wake up tomorrow” or I have heard an old mans voice many times unintelligibly whispering things in my ear. More often I just hear many people whispering unintelligible things all at once and it gives me feelings over sensory overload and makes me get all panicky. Another common auditory hallucination I have is very loud grinding or consistent banging noises accompanied by the feeling of slowly falling and spinning but never hitting the ground. At this point I try to tell myself in my head during the episodes that it’s not real but that usually just adds to my panic because it’s like I cannot get myself to snap out of it. These are so TERRIFYING because I cant ever distinguish between the hallucinations and reality. Made me feel better reading this and knowing that it happens to so many other people.

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