Do you start hearing vivid music (your inner music, if you like) that is reminiscent of the 13-minute intro of “Apostate” by Swans just as you are at the phase of sleep onset? Or do you start hearing voices and sounds that are not really there, such as white noise you’d hear at a crowded kindergarten or the confused bleeps and bloops of an android who cannot decide whether to serve humanity or lead a war of independence for robots? If you do, I have to tell you that you are neither a musical genius in the making (sorry!) nor someone who can see into the future. What you are experiencing are some sleep-related hallucinations.
Namely, you are suffering from hypnagogic (auditory hallucinations before sleeping) or hypnopompic hallucinations (if it’s right before you wake up), which can also create visions, tastes, and other sensations that are not there. It is understandable why you would feel worried upon a tactile hallucination in which a bug is crawling over your body and immediately seek advice, concerned that you might have some sort of a neurological condition or a mental illness.
Let me relieve you by saying that it’s not always the case and these hypnagogic hallucinations are experienced by more than a quarter of the general population. Only a very limited number of those experiences is actually a symptom of pathological phenomena that might require the involvement of psychiatry or neurology.
Still, to be on the safe side, let’s see in detail how these auditory hallucinations occur, what might be causing them, and how you can deal with them.
Symptoms of Auditory Hallucinations
The main and probably only symptom of auditory hallucinations is hearing sounds that are not there as clearly as if they are actually there. The specific character of these sounds doesn’t have any significance, as they can vary depending on the audio memory we have stored in our brains.
In general, they are meaningless sounds surfacing from our subconscious for no clear purpose, but sometimes they can even be disguised as a beautifully composed musical piece.
Hypnagogic hallucinations, which are the hallucinations before bed, might be accompanied by lifelike visual images and other sensations as well. They might have all the qualities of a dream without you yet reaching REM sleep or even surrendering your consciousness. Therefore, you might think you have just entered a new stream of reality and have racing thoughts due to all these strange stimulants.
That is where the symptoms might take a more serious turn and have side effects. If the hallucinated objects make sense, like something evil entering your bedroom to harm you, you might try to fight them due to the life-likeness of the experience and it may lead to you unwittingly harming yourself.
Possible Causes of Auditory Hallucinations
As with the majority of medical conditions, stress and anxiety are also the main underlying cause behind sleep disorders – especially those that occur in between sleep and wakefulness, like auditory hallucinations. However, research indicates that there might be more causes that range from addictions like alcohol and drug abuse to temporary side effects of a medicine (please read the prospectus carefully) and to an even more serious cause like schizophrenia or Parkinson’s disease.
Before delving into that territory, however, I would like to remind you once more that hypnagogic hallucinations mostly are not symptoms of a pathological ailment.
- Stress and Anxiety: There is no stopping our brains – whether we are conscious, unconscious, or completely surrendered to the merciless activities of our subconscious, our brains will find ways to create chemical reactions. It is the same when we are just about to slip into that sleep we badly long for. Due to an event, person, or a responsibility that might be causing us stress, our brains take it upon themselves to warn and stimulate us in admittedly indecipherable ways – they just won’t rest and let your body rest until the cause of anxiety is recognized or even dealt with. Especially teens and young adults who couldn’t yet learn to sleep the stress off like us adults are more likely to suffer from this phenomenon.
- Alcohol and Drug Use: There is no denying the fact that addictions can dramatically change how a person feels and experiences the world, and the presence of alcohol and drugs or the lack thereof will certainly lead to certain sleep problems. However, there is no research that makes a clear connection between alcohol and drug use to hallucinations or that explains how the two are related. Given that people who have fallen prey to such addictions are already suffering from stress and anxiety, though, it’s not difficult to see the outlines of a vicious cycle that leads to the prevalence of auditory and visual hallucinations.
- Chronic Insomnia: People who suffer from chronic sleep deprivation are quite prone to experiencing lots of hallucinations that just jolt them back to wakefulness when trying to fall asleep.
- Mental Health Issues: Needless to say, mental health issues mean that our brains are not working as they should. As a result, we suffer from hallucinations, and research suggests that people with bipolar disorder, borderline personality disorder, postpartum psychosis, post-traumatic stress disorder, or schizophrenia are the ones who suffer the most from auditory hallucinations. However, the type of hallucination experienced by people with such conditions is not necessarily hypnagogic, as they (especially those with schizophrenic disorders) are prone to experiencing those during their daily life when they are fully awake as well. Therefore, it should not be cause for alarm unless there is such a disorder in your mental health history.
- Narcolepsy: Narcolepsy often comes with four horsemen under its heel: excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations (not all of them might be observed in kids with narcoleptic problems).
When Should I Be Concerned About Auditory Hallucinations?
Most of the time, an auditory or hypnagogic hallucination will have the decency to remain where and when you left them, and if they don’t have a particularly scary character, you won’t even remember them when you wake up.
At least, that is the case shown in the results of research conducted with this question in mind. Most people don’t even consider them as hallucinations before doing proper research on the topic or until they’re asked by a professional, and as a person who had their share of auditory hallucinations, you should take my word as gospel for that.
However, there are certain other criteria that accompany auditory and visual hallucinations, and if you have those, I recommend you seek medical advice from professionals:
- If you experience hallucinations so vividly that you unintentionally harm yourself and on a regular basis. When the experience is not consistent or scary, it can even be fun as an interesting topic of conversation you can convey to your Tinder date the next day. You might theorize whether you are being contacted by aliens and that might lead to an interesting conversation (it should, but what do I know?). A recurring experience, on the other hand, may cause sleep disorders in the long term and self-inflicted harm to your body, and it might in fact be a messenger of something more serious lurking in the shadows. If that’s the case, seeing a professional is the recommended course of action.
- If the experience is not limited to the time when you are falling asleep. You might start experiencing auditory hallucinations only when falling asleep, but then find yourself hearing and seeing things that are not there in your waking life as well. In that case, see a psychiatrist immediately since it might be a symptom of a serious mental disorder.
- If you are also suffering from excessive daytime sleepiness and sleep paralysis. Add these two to hypnagogic hallucinations, and you have all the passing symptoms associated with narcolepsy. Narcolepsy by itself might not sound like a serious health issue to you, but it can have dire consequences for your daily activities – especially if you have to operate a car or machine, or if you are doing manual labor to sustain your life. Therefore, seeking advice from a health professional is urgently necessary.
How to Treat Hypnagogic Hallucinations?
Hypnagogic hallucinations are a type of sleep disorder that can cause vivid and often frightening images or sounds during the transition from wakefulness to sleep. Treatment for hypnagogic hallucinations typically involves addressing any underlying conditions that may be causing them.
For example, if the hallucinations are caused by a mental health disorder such as anxiety or depression, then treating the condition with therapy and/or medication may help reduce the frequency of the hallucinations.
In addition to treating any underlying conditions, it is important to focus on getting enough quality sleep. The National Sleep Foundation recommends 8–10 hours for teens ages 13–18 and 7–9 hours for adults ages 18–64.
Getting enough restful sleep can help reduce stress levels and improve overall mental health, which in turn can help reduce the frequency of hypnagogic hallucinations. In some cases, simply focusing on getting enough restful sleep may be enough to reduce or even eliminate hypnagogic hallucinations over time.
How to Prevent Auditory Hallucinations When Sleeping
I told you that these auditory experiences might take the form of a beautifully composed musical piece and I also told you how they might be a symptom of something more serious that would require professional consultation. However, most people just experience them as a powerful jolt which makes them jump (sometimes even literally) in fear and alacrity just as they are falling asleep.
Mine is like that. Just as I am peacefully gliding into a realm of bliss, a telephone from a Hitchcock movie starts ringing right in my ear, and I am suddenly wide awake and afraid to go back to sleep because it might happen again. Even if it’s aliens ringing me to hear my thoughts about destroying the earth, at least they should pick a more decent time to call, right? I mean, what should I do? I cannot put a “Do not disturb” sign on the door of my mind palace, can I?
What I mean is, it’s quite annoying even when it’s completely harmless and something should be done to prevent that. What professionals advise for the prevention of hypnagogic hallucination is as follows:
- Put your life in order. As I mentioned earlier, stress and anxiety are the main underlying causes for these hallucinations, but as there are many responsibilities in our lives that wear us down, it might not be easy to recognize the cause of stress and anxiety with pinpoint accuracy. Even if we do recognize and diagnose it, we might not be able to annihilate it since it could easily be our job or family. Still, there are things we can do to put that life in order. Meditation and exercise are some healthy coping mechanisms. Also, having a healthy diet, cutting off caffeine intake, and developing a consistent sleep schedule will help prevent annoying hallucinations.
- Stay away from drugs and alcohol. Of course, having a drink out with friends for a night every now and then won’t harm you even if you lose yourself in the music. The moment you make alcohol an addiction, though, they may cause strange reactions in your brain. That is even more of a reality for drugs. Staying away from them and seeking professional help when and where you fail will also elevate the quality of your sleep.
- Therapy. I am going to say it despite the fact that I know it’s a cliché: we are living in an age in which the pace of life cannot be matched by our inner clocks, and there are so many stimulants inside our big cities, our big plazas, our shopping malls, and on our social media accounts that we are losing track of our own selves and our own feelings. Sometimes, we are stressed, but due to that pace and the abundance of stimulants, we cannot allow or admit to that fact. That’s probably why our brains deem it feasible to send us jolts: for us to reclaim our feelings and selves. Then, making time for therapy might pay dividends.
Are Sleep Paralysis and Lucid Dreams or Nightmares Hypnagogic Experiences?
This question is understandable on many levels since they have a lot in common: all of them can be quite scary, you are or you think you are conscious of all of them, and after an experience with any one of them, you might suspect that there is something wrong with you. However, neither sleep paralysis, nor lucid dreams and nightmares are hypnagogic experiences.
Now let’s see what might be mistaken for a hypnagogic experience but actually has another name and definition:
Sleep paralysis: Sleep paralysis is mostly an auditory experience. You cannot move or open your eyes, yet you hear and feel the presence of something or somebody, scratching, crawling, or breathing, and coming near you in subdued footsteps as though trying to induce extreme fear. It happens when your body is asleep but your mind is in between sleep and wakefulness. In that sense, it’s more of a hypnopompic experience converging on a nightmare, but the experts label it under parasomnia along with sleepwalking.
Lucid dreams and nightmares: Lucid dreams and nightmares are not really only auditory experiences as they mostly have a more picturesque quality than the latest Marvel sensations, but the similarity is there. You think that you are conscious and everything in the dream is so intense and has such a lifelike quality that you end up thinking you opened up the gates to an alternate realm. However, those dreams and nightmares happen only when you are fully asleep and in the cycle of rapid eye movement (REM stage).
- Bless, J. J., Hugdahl, K., Kråkvik, B., et al., (2021). In the twilight zone: An epidemiological study of sleep-related hallucinations. Comprehensive Psychiatry, 108:152247. https://www.researchgate.net/publication/351679731_In_the_twilight_zone_An_epidemiological_study_of_sleep-related_hallucinations
- McCarty, D. E., & Chesson Jr, A. L. (2009, February 15). A case of sleep paralysis with hypnopompic hallucinations. Journal of Clinical Sleep Medicine, 5(1):83-84. https://jcsm.aasm.org/doi/full/10.5664/jcsm.27398
- Waters, F., Chiu, V., Atkinson, A., & Blom, J. D. (2018). Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake. Frontiers in psychiatry, 9:303. https://pubmed.ncbi.nlm.nih.gov/30042701/
- Choong, C., Hunter, M. D., & Woodruff, P. W. R. (2007, July 3). Auditory hallucinations in those populations that do not suffer from schizophrenia. Current Psychiatry Reports, 9(3):206-212. https://link.springer.com/article/10.1007/s11920-007-0020-z
- Ohayon, M. M. (2000, December 27). Prevalence of hallucinations and their pathological associations in the general population. Psychiatry research, 97(2-3):153-164. https://www.sciencedirect.com/science/article/abs/pii/S0165178100002274
- Yu, M., Du, Y., Liu, K., et al., (2021, August 1). Sleep duration and auditory hallucinations: Genetic correlation and two-sample Mendelian randomization study. Journal of Affective Disorders, 291:409-414. https://www.sciencedirect.com/science/article/abs/pii/S0165032721003700