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Thursday, June 20, 2013
Wake Up Screaming and Seeing Someone
About 6 or 7 times a year I wake up shortly after I go to sleep thinking I see someone standing over my bed. The figure is always the same. This causes me to scream. I feel like I am awake, but perhaps I am really asleep. My heart races with fear. I have also woken up thinking that my husband had his hands around my throat (he swears he didn`t). I saw something about sleep paralysis. Could this be what it is? Please help.
Your description of seeing, feeling and hearing things that appear very real at the onset of sleep sounds consistent with what are known as sleep-onset hallucinations or “hypnagogic hallucinations.” These episodes at times can be terrifying and anxiety producing.
There are a number of conditions that can be associated with sleep-related hallucinations. These include sleep disorders, such as narcolepsy, medication side effects, illicit drug use, past alcohol use, anxiety and sleep deprivation. Narcolepsy is comprised of: excessive daytime sleepiness, cataplexy (loss of muscle tone after an emotional stir); sleep paralysis; and sleep-related hallucinations (either at the onset of sleep or at awakening). It’s also important to recognize that they occur as normal sleep-related phenomena in a certain percentage of adults (known as isolated hypnagogic hallucinations).
Sleep paralysis is also a symptom that can be associated with narcolepsy and is described as the complete inability to move upon awakening due to paralysis. Individuals often report an inability to speak or move the limbs, trunk or head. Most individuals will recall the events. These spells can last several seconds to minutes and can be very frightening. Occasionally, the episode will end if the person is touched or spoken to. Some people have sleep paralysis at the same time they have a hypnagogic hallucination but they are distinct symptoms.
You may want to discuss these symptoms with your primary caregiver. They will need to do a history and physical to assess for any other signs or symptoms that may require further evaluation. If you have any significant daytime sleepiness, cataplexy, snoring or other relevant symptoms, they may decide to refer you to a Sleep Specialist to determine if testing is needed.
Aneesa M Das, MD
Assistant Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University