Narcolepsy can increase a person’s chances of experiencing hallucinations, often when falling asleep or waking up. Hallucinations with narcolepsy typically involve visualizations, sounds, or touch sensations.

Narcolepsy is a chronic neurological disorder. It affects the brain’s ability to regulate the sleep-wake cycle, which leads to a person feeling sleepy and having difficulty staying awake during daytime hours.

Narcolepsy also affects rapid eye movement (REM) sleep. A person with narcolepsy often enters REM more quickly than someone without the condition, which may contribute to the development of hallucinations when waking or falling asleep.

The condition affects an estimated 135,000–200,000 people in the United States, but it often remains undiagnosed, meaning the number may be higher.

This article reviews how narcolepsy and hallucinations relate, the types of hallucinations, their causes, and more.

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People with narcolepsy can experience hallucinations. Typically, they occur either as a person falls asleep or wakes up. They may also occur with sleep paralysis.

Sleep paralysis is another common symptom of narcolepsy. It occurs at similar times to hallucinations, typically when a person is waking and falling asleep.

During REM sleep, the body relaxes and prevents voluntary muscles from moving. Sleep paralysis occurs when a person wakes up in this state but is unable to move or speak. The sensation can last anywhere from a few seconds to a few minutes.

Narcolepsy is a neurological disorder in which the brain does not properly regulate the sleep-wake cycle. This can lead to daytime sleepiness and falling asleep at inopportune times, such as when talking, driving, or working.

The condition also affects a person’s REM sleep, the sleep stage when most dreams take place.

Most people experience REM sleep about 60–90 minutes after falling asleep. A person with narcolepsy experiences REM sleep within 15 minutes.

Narcolepsy can also cause a person to experience muscle weakness and dream activity when awake. Experts believe these factors may contribute to a person experiencing hallucinations.

Narcolepsy hallucinations typically occur when a person falls asleep or wakes up.

When it occurs as a person falls asleep, it is known as a hypnagogic hallucination. When they occur while a person is waking, they are known as hypnopompic hallucinations.

These two types of hallucinations are not unique to people with narcolepsy. A 2017 article indicates that 3770% of people experience sleep-related hallucinations.

When a person experiences hypnopompic hallucinations, they may be the continuation of a dream sequence.

Hallucinations associated with narcolepsy typically involve:

  • visualizations; seeing lights, shapes, people, and faces
  • auditory hallucinations; hearing noises, sounds, and voices
  • tactile sensations; hallucinations involving touch sensations

When a person experiences hallucinations, either when falling asleep or waking, they commonly experience visual, auditory, or tactile sensations.

According to a 2016 study, the rates of occurrence are:

  • Visualizations: These occur in about 86% of people who experience hypnagogia. They often involve seeing flashing lights or geometric shapes. A person may also see vividly detailed people, animals, or faces.
  • Auditory: About 8–34% of people who have hallucinations hear sounds, animal cries, or people talking.
  • Tactile: A person often experiences tactile hallucinations as they wake as a continuation of a dream. They may feel sensations such as weightlessness, flying or falling, bodily distortion, or a sense of presence in the room.

Hallucinations can be frightening, particularly if paralysis accompanies the hallucinations. They can also vary widely between people and can involve additional senses.

The exact cause of hallucinations while falling asleep or waking is not known. It can affect both people with narcolepsy and those without.

Experts note that about 10–15% of people with narcolepsy experience one or more of the following during their lifetime:

  • hallucinations
  • cataplexy; loss of muscle movement or strength triggered by strong emotions
  • sleep paralysis

Narcolepsy may raise a person’s risk of hallucinations, but a minority of people with the condition will have them.

Experts are unsure what causes narcolepsy. Leading theories include:

People may experience other hallucination types when waking, which experts group under the term “perceptual phenomena.” The phenomena can cause both hallucinations and sleep paralysis. About 30% of people will experience these phenomena throughout their life.

Perceptual phenomena can cause:

  • feelings of floating or flying
  • out-of-body experience
  • inability to move
  • hearing ominous sounds, such as footsteps
  • a sensation of movement in the bed
  • feeling or smell of a creature, animal, unspecified entity, or person climbing on the chest, smothering them or physically or sexually assaulting them

Waking hallucinations are often more vivid and potentially scarier than hallucinations that can occur when falling asleep. People generally know they are awake, which can worsen the experience.

A person may experience hallucinations from time to time, once, or never in their lifetime. They do not indicate an underlying condition and do not occur in all people with narcolepsy.

A person may want to speak with a healthcare professional if they experience excessive sleepiness during the day that:

  • interferes with their daily activities
  • causes them to fall asleep in the middle of activities
  • has no known underlying cause

Healthcare professionals can help diagnose or determine the cause of sleepiness. It is possible another underlying condition may cause excessive tiredness.

Learn more about tests for narcolepsy.

Narcolepsy can increase a person’s risk of having hallucinations when waking or falling asleep. It is a neurological condition affecting a person’s ability to stay awake and alert.

Hallucinations associated with sleep can affect anyone and often involve visual and auditory experiences, though a person may also feel other sensations.