Sleep Paralysis and Hallucinosis
Behavioural Neurology January 1, 1998 DOI: 10.1155/1998/649278 (opens in new tab)
Summary
AI-generated from the abstractSleep paralysis, a common condition in the general population, can involve terrifying visual, auditory, and somatic hallucinations at sleep onset, along with a sense of evil presence. These dramatic auxiliary symptoms may mimic a psychotic state, causing diagnostic confusion. A case of a young man with severe bipolar disorder who experienced such episodes independently of his psychiatric condition is presented. Past misdiagnoses included nightmares and night terrors. After ruling out other sleep disorders and physical causes, a diagnosis of predormital isolated sleep paralysis was made and appropriate treatment recommended. Less common forms are part of narcolepsy or are familial. Breathing difficulty during sleep paralysis features prominently in folklore.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Young man with severe bipolar affective disorder |
| Key finding | Sleep paralysis can present with dramatic psychotic-like symptoms independent of a patient's primary psychiatric disorder, leading to diagnostic uncertainty. |
Abstract
Background: Sleep paralysis is one of the many conditions of which visual hallucinations can be a part but has received relatively little attention. It can be associated with other dramatic symptoms of a psychotic nature likely to cause diagnostic uncertainty. Methods and results: These points are illustrated by the case of a young man with a severe bipolar affective disorder who independently developed terrifying visual, auditory and somatic hallucinatory episodes at sleep onset, associated with a sense of evil influence and presence. The episodes were not obviously related to his psychiatric disorder. Past diagnoses included nightmares and night terrors. Review provided no convincing evidence of various other sleep disorders nor physical conditions in which hallucinatory experiences can occur. A diagnosis of predormital isolated sleep paralysis was made and appropriate treatment recommended. Conclusions: Sleep paralysis, common in the general population, can be associated with dramatic auxiliary symptoms suggestive of a psychotic state. Less common forms are either part of the narcolepsy syndrome or (rarely) they are familial in type. Interestingly, sleep paralysis (especially breathing difficulty) features prominently in the folklore of various countries.