Hypnagogic Hallucinations: What They Are, Causes, & Treatment

What Are Hypnagogic Hallucinations?

Hypnagogic hallucinations can impact all five senses and are hallucinations that can feel completely real. These hallucinations come on when people are first falling asleep, blurring the lines of reality. Hypnagogic hallucinations usually involve seeing things or people who are not there.

These hallucinations can feel intense, which can be variable depending on any other preexisting mental health or sleep disorders. They last a short amount of time but vary based on how long it takes an individual to transition from one stage of sleep to the next. One of the many differences between these hallucinations and hallucinations such as those that occur due to schizophrenia is that hypnagogic hallucinations are often visual and schizophrenic hallucinations tend to be auditory. ¹

Symptoms of a hypnagogic hallucination may include:

• Hearing voices
• Seeing people who are not there
• Seeing the room you’re in as if it is from an abstract lens an abstract lens
• Getting a strong scent, smell, or taste on your tongue
• A sensation as if bugs are crawling on your skin

Hypnagogic Vs. Hypnopompic Hallucinations

Hypnagogic hallucinations and hypnopompic hallucinations are both sleep-related hallucinations. While hypnagogic hallucinations occur as you are falling asleep, hypnopompic hallucinations occur as you wake up in the morning. Hypnopompic hallucinations are marked by hallucinations also experienced in all five senses, however, are also linked with sleep paralysis. ²

Sleep Hallucinations Vs. Other Sleep Disturbances

Hypnagogic hallucinations are different from sleep disorders as these hallucinations are not a cause for concern. They have little risk as the feelings and sensations often dissipate when the individual wakes up or enters the next stage of sleep. Sleep disorders with nightmares as a symptom differ from these hallucinations as nightmares occur in REM sleep and often can be remembered upon waking.

Sleep paralysis and lucid dreaming are also marked by sensing perceptions that are not there, These events are different from hallucinations, but hallucinations can occur as part of these sleep experiences. Anxiety dreams can leave one feeling tense due to the nature of these dreams. If these experiences are distressing for you, it can help to speak with a therapist to help sort out the cause and treatment.³

What Causes Hypnagogic Hallucinations?

The cause of hypnagogic hallucinations is understood as visual or auditory cortex activation during non-REM sleep. Underlying conditions and certain activities are risk factors for hypnagogic hallucinations and may increase their occurrence.

Possible causes of hypnagogic hallucinations include:

• Insomnia: Sleep issues such as insomnia can contribute to the onset of these hallucinations due to frequent waking and coming out of a deeper sleep stage.
• Stress and anxiety: Daytime stress and anxiety are linked with sleep-related disturbances and can contribute to the onset of these hallucinations.
• Mood disorders: Mental health issues such as depression and bipolar disorder are also linked with these hallucinations as these impact daytime alertness and drowsiness, which is associated with a prevalence of hypnagogic hallucinations.
• Drug and alcohol use: These substances can disrupt sleep and predispose to hypnagogic hallucinations.
• Narcolepsy: Hypnagogic hallucinations are a symptom of narcolepsy.⁴

How Are Hypnagogic Hallucinations Diagnosed?

If you or someone you love is experiencing these hallucinations or have issues related to sleep, speaking with a sleep specialist or a therapist is a good way to begin finding out where these issues come from and how to address them. Medical providers, predominantly sleep specialists, will begin with a careful medical history to understand the onset and impact of these hallucinations and other sleep-related symptoms that may be happening.

Causes may also be identified while working with a therapist to address daytime stressors or co-occurring mental health symptoms that may be contributing to these nighttime hallucinations. All of these providers may ask you self-reported questions and have you fill out surveys related to sleep, stress, mood, and health.⁵

Treatment for Hypnagogic Hallucinations

Many people experience sleep hallucinations at least once in their life, and while they may be unsettling, they are not dangerous. However, frequent hypnagogic hallucinations may be associated with underlying conditions, such as anxiety or depression. Therapy can help you understand what else may be contributing to sleep-related issues. There are also many benefits of therapy in these cases, as sleep hygiene and mental wellness have close ties. Unresolved issues that are part of your daytime hours in your daytime hours tend to show up at night time when you are trying to fall asleep.

Learning about how your way of coping can impact your sleep is important to understand and working with a therapist to address mental health and emotional issues can be helpful. To find the right therapist, consider speaking with a sleep specialist and taking recommendations or searching an online therapist directory to see who has experience with sleep issues related to mental health. Therapists specializing in sleep and mental health can also be fond through online therapy options, which make therapy easily accessible. Rarely, these providers may also recommend medications for sleep stability or mood stabilization based on their evaluations.⁶

Treatment options for hypnagogic hallucinations may include:

• Cognitive-behavioral therapy (CBT)
• Eye-Movement Desensitization and Reprocessing therapy (EMDR)
• Medications
• Journaling for mental health

8 Ways to Cope With Hypnagogic Hallucinations

While you can’t necessarily control hypnagogic hallucinations or when they may occur, you can find ways to cope with them. These hallucinations may be distressing, but there are some basic tips to improve sleep and potentially reduce their frequency.

Here are 8 number tips for coping with hypnagogic hallucinations:

1. Follow a regular bedtime routine: Having good sleep hygiene is important for your mind and body to know when to expect rest and can rely on this schedule.
2. Do calming activities before bedtime: Engaging in self-soothing activities such as painting or reading can be helpful and destress your body and brain before sleep, which can limit the occurrences of these hallucinations.
3. Practice relaxation techniques: Relaxation techniques such as breathwork and/or progressive muscle relaxation can be helpful as well as help you slow your heart rate, help you stay present.
4. Seek treatment: Depression and bipolar disorder can contribute to distressing sleep experiences, and seeking therapy for these conditions can improve overall sleep quality.
5. Use healthy coping mechanisms: There are also healthy coping mechanisms you can employ to help you cope if they are impacting your quality of life, such as yoga, meditation, and socializing with friends.
6. Take a social media break: Taking a social media break can also help to improve symptoms of mood disorders or stress which can help limit the prevalence of these hallucinations. Additionally, using screens at night and limiting screens can help to improve sleep quality.
7. Do not use substances: Drugs and alcohol can disrupt sleep, and limiting use can improve your quality of sleep.
8. Journal during the day: Keeping a daytime journal and journaling throughout the day and week can be helpful in managing your stress. To add, it can be helpful to journal the occurrences of these hallucinations during the week to understand if there are any correlations to other parts of your life or a sign of a deeper issue.

Final Thoughts

Hypnagogic hallucinations can be distressing at times, but there are ways to improve sleep and reduce their occurrence. Learning about your life stressors and other factors that may be contributing can be helpful in helping you understand your sleep health. Taking action to come up with sleep routines, following a healthy lifestyle, and working with your providers can make a big difference in how you feel.