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Sleep Disorders

Weird sleep problems

07/06/2011

Question:

I have a sleep disturbance because of listening to sounds of music and seeing violent games which are not good. Well, it starts like this. When I was trying to sleep, there was a music playing but when I checked outside the room, there was no music playing and when I closed my eyes and tried to sleep, there was an imagination that I was in a scary video games which frightened me. I was cautious at night and I was reported by my parents that I had been behaving weirdly. I was always asleep when like 11 to 3 and slept till to 6 am. I asked most experts but did not reply and that I was too overacting. Can you also type to me what kind of sleep disorder or it’s just that I played to much games?

I went to bed at 9 at night and closed my eyes to go to sleep. When suddenly there was an image that I was in a game, a really violent one that scared me and when I got over it and there was a song played in my mind which prevented me to sleep. I checked outside, no one was playing music. I need an answer on what I am dealing. Addiction or Sleep disorder?

Answer:

Based on the information you provided in your question, it sounds as though you are experiencing sleep-related hallucinations upon falling asleep, also known as hypnopompic hallucinations. However, to be sure, more sleep history would be needed as other conditions can present with similar symptoms (such as nightmare disorder, narcolepsy, sleep apnea, psychiatric disease, and rarely seizure disorders). A visit to a Sleep Specialist would probably be worth considering toclarify what exactly the problem is and what can be done about it.

The sleep-associated symptom of feeling, hearing or seeing things that are not present often represents sleep-related hallucinations. Sleep-related hallucinations can be a sign of a primary sleep disorder or possibly a psychiatric condition.

Sleep-related hallucinations are usually visual (seeing things), though they can be auditory (hearing things), tactile (sensation of feeling something) or kinetic (feeling of motion or movement). They more commonly occur with sleep onset (known as hypnagogic hallucinations) but can happen with morning awakenings (hypnapompic hallucinations) as well. Sleep-related hallucinations can be frightening and may, at times, be associated with other sleep behaviors such as sleep walking or sleep talking.

The underlying cause of sleep related hallucinations is not always clear. Factors known to bring these about or increase the frequency of occurrences include younger age, current drug use, past alcohol use, anxiety, mood disorders, insomnia and lack of sleep. Certain medications may also cause this as a side effect. In addition, these hallucinations may be a sign or symptom of another sleep disorder, such narcolepsy, a primary nightmare disorder, migraine headaches, or, rarely, they could be part of sleep-related seizures (epilepsy). Psychiatric disease (such as schizophrenia) should also be included as a possibility, though assuming these hallucinations occur only with sleep, then this would be less likely to be the cause. However, you do mention that you have been behaving strangely lately, so this may still be a consideration.

Depending on the underlying cause or factors associated with the hallucinations, they may decrease or resolve with age. Identifying factors associated with the hallucinations (such as alcohol use or lack of sleep) and avoiding these may help to decrease the frequency or intensity of the problem. Reducing your playing of violent video games may also be beneficial in reducing the events. In cases where this does not occur, specific treatments are available, though the type of treatment will depend upon the underlying cause of the hallucinations.

It certainly sounds as though your symptoms are significant. A careful review of you history, medical problems and medications would be helpful. Further evaluation by a Sleep Specialist and/or a Neurologist may be needed, depending on specifics in your history and examination. Additional testing may be required to help sort out the cause of the hallucinations.

To learn more about sleep or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. The website Sleep Education.com also provides plenty of good consumer friendly information. Good luck and here's to better sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University