Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake
Frontiers in Psychiatry July 10, 2018 Flavie Waters, Vivian Chiu, Amanda Atkinson et al. 163 citations
Going without sleep for long periods reliably produces perceptual distortions, hallucinations, and other psychotic symptoms that worsen over time. A systematic review of historical studies covering 760 participants who were kept awake for 24 hours to 11 nights found that visual distortions and illusions were the most common effects, appearing in 90% of studies, followed by somatosensory changes (52%) and auditory hallucinations (33%). Symptoms emerged rapidly: perceptual distortions, anxiety, irritability, depersonalization, and temporal disorientation began within 24-48 hours; complex hallucinations and disordered thinking after 48-90 hours; and delusions after 72 hours, at which point the condition resembled acute psychosis or toxic delirium. A period of normal sleep resolved symptoms in most but not all cases.