Relevance of sleep paralysis and hypnic hallucinations to psychiatry.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists March 1, 2004 Prakash Gangdev
A 25-year-old black South African woman developed paranoid beliefs and sad, anxious mood after her first episode of sleep paralysis and hypnopompic hallucinations. She had no prior sleep-related events. Reassurance, explanation of the physiological basis, and a short course of low-dose diazepam led to prompt improvement in mood and sleep, with no further paranoid beliefs. No further episodes occurred, and improvement was sustained at 6 months. The case highlights the importance of asking about core experiences like sleep paralysis and hypnic hallucinations when patients present with acute, nocturnal-onset psychopathology, and the need for closer study of sleep-related side-effects of psychotropic medications.