A case of incubus phenomenon
European Psychiatry November 17, 2023 L. Tjokrodipo, A. Sneep, P. Michielsen
The incubus phenomenon is a sleep-related disorder combining sleep paralysis with compound hallucinations, including sensed presence, fear, visual and auditory hallucinations, unusual body experiences, chest pressure, breathing difficulty, and pain. A 29-year-old man with intellectual disability, psychotic disorder, and cannabis use disorder was diagnosed with narcolepsy and cataplexy; his hallucinations included sexual themes, breathing difficulty, moving sensations, and chest pressure. Literature review indicates a lifetime prevalence of 0.11% in the general population versus 0.41% in psychiatric patients, suggesting the phenomenon is four times more common in those with psychiatric history and should not be mistaken for psychotic disorder. Recognizing it is important for proper treatment with anxiolytics, antidepressants, anticholinergics, or anti-epileptics, along with sleep hygiene.