Hallucinations are a common side effect of narcolepsy. Though these hallucinations are not physically harmful, treatments are available to help you get better sleep.

A hallucinogenic vision of an abstract landscape of colorful clouds and desert terrain, with someone's silhouette in the distance.Share on Pinterest
Image credit: Hayden Williams

Narcolepsy is a neurological disorder that affects the brain’s ability to control a person’s sleep-wake cycles.

The condition is often referenced in pop culture as a joke, showing people who ultimately fall asleep anywhere, even in social settings. But narcolepsy is much more than this.

Along with an uncontrollable need to sleep at certain times, people with narcolepsy often find it difficult to stay asleep during the night. As a result, these individuals may be unable to get adequate sleep at night.

Many also experience hallucinations within their sleep-wake cycle, especially when falling asleep. Here, we look at the types of hallucinations that commonly occur and the treatment options available.

One particular side effect of narcolepsy is experiencing hallucinations or vivid dream-like images. It’s incredibly common and usually accompanies the other hallmark narcolepsy symptom of sleep paralysis. Because of this, it can cause the experience to be more dramatic.

People without narcolepsy can also experience sleep paralysis. The experience can be unnerving and always occurs just as a person is about to fall asleep or awaken from a REM sleep cycle. While most hallucinations are visual, the other senses can also be triggered when this symptom appears.

Are hallucinations common with narcolepsy?

Hallucinations are a very common symptom often experienced by people with narcolepsy. According to research, roughly a third of all people with the condition have hallucinations.

While the events are harmless and pose no risk to the individual, they can be frightening, depending on what a person sees when it occurs.

Hallucinations can feel real and life-like for the person experiencing them. In most cases, they’re limited to visual phenomena, such as seeing a person walk by or an animal in the room. But sometimes other senses can be involved, such as hearing a noise, feeling like they’re being touched, or even smelling scents.

It’s important to keep in mind that these types of hallucinations shouldn’t be compared with the same waking state hallucinations that someone with a mental health condition such as schizophrenia experiences.

While both versions involve seeing or experiencing a scenario that isn’t happening, a narcoleptic hallucination is limited to the blurry and short period when a person is transitioning into or out of REM sleep. By contrast, hallucinations tied to mental health conditions typically occur when a person is fully awake.

A note on sleep paralysis hallucinations

Also, note that many people without narcolepsy can also experience sleep paralysis and related hallucinations as they drift into or out of REM sleep.

According to research, sleep paralysis as a stand-alone condition occurs in roughly 8% of the general population. Often it’s an isolated occurrence and does not mean that a person has narcolepsy or an underlying mental health condition.

There are two types of hallucinations associated with sleep paralysis in narcolepsy.

  • Hypnagogic hallucinations: When hallucinations occur just before a person falls asleep, they’re known as hypnagogic hallucinations. These are much more common.
  • Hypnopompic hallucinations: When hallucinations occur as a person is waking up, they’re referred to as hypnopompic hallucinations.

Note that the primary sense affected by these hallucinations is sight. However, people have reported hearing sounds, smelling scents, tasting flavors, and even feeling like they were being touched during a hallucination.

Research has yet to fully understand how the vivid dream state created by REM sleep manages to cross over during the transitional periods of hypnagogic and hypnopompic hallucinations.

Can you have narcolepsy hallucinations while awake?

Much is still being researched about narcolepsy, how episodes are triggered, and especially in regard to hallucinations. However, since narcoleptic hallucinations are historically tied to transitioning into and out of the REM sleep stage, it’s not believed that you can experience a narcoleptic hallucination while fully awake.

To date, the majority of hallucinations reported occur as someone is beginning to fall asleep. But, anecdotally, some people with narcolepsy have reported experiencing daytime hallucinations.

If you have narcolepsy, experience hallucinations, and want to help researchers better understand your condition — you should check out ClinicalTrials.gov.

Individual treatment solutions for narcolepsy will depend on the severity of a person’s condition, as well as any other underlying health concerns the person has. If narcoleptic hallucinations are inhibiting your ability to get proper sleep, doctors may prescribe antidepressants, depending on your specific situation.

These medications can aid in managing sleep paralysis, which usually precedes a hallucinogenic event. They can also help people with type 1 narcolepsy who are at risk of experiencing cataplexy — a condition in which you have episodes where you lose muscle tone and control of your body while being completely awake.

Learn more about treatment options for narcolepsy.

Living with narcolepsy

To date, there is no cure for narcolepsy. Instead, people can try medications or lifestyle changes that can help reduce symptoms and limit how the condition affects their life. Depression can be a common side effect of narcolepsy because it can greatly reduce a person’s quality of life.

If narcolepsy has altered your life and affected your well-being, consider reaching out to a licensed therapist or counselor to seek help. While you work with medical specialists to help manage your condition, a therapist can help you reframe your mindset, as well as recommend tips to build a support network.

The Narcolepsy Network is a free resource that lists local support groups as well as sleep centers and specialists for people living with narcolepsy.

Although often treated as a punchline by pop culture, narcolepsy is no joke. The condition can greatly interfere with a person’s quality of life and often means that these individuals aren’t getting the recuperative sleep that they need to function properly.

One symptom that can make the condition overwhelming is hallucinations, which are usually triggered as a result of sleep paralysis. While not dangerous, they can add to the confusion that this disorder causes.

A therapist can help you work through the emotions of experiencing a hallucination, and your doctor may be able to prescribe medication to help you fall asleep better.