To be or not to be hallucinating: Implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders.
PNAS Nexus December 19, 2023 DOI: 10.1093/pnasnexus/pgad442 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Lucid dreaming Dreaming |
| Keywords | Vivid perceptions Dream-like perceptions Common "hallucinations" Pathological hallucinations Sleep onset Awakening Sleep phenomena Sleep experiences Neural underpinnings Brain mechanisms Brain function Reality creation Brain disorders Neurological disorders Mental health Parkinson's Psychosis Pathological conditions |
| Citations | 17 |
| Key points | Argues that hypnagogic and hypnopompic experiences are frequently misclassified as psychotic hallucinations, and proposes that metacognitive strategies used by lucid dreamers to gain and confirm dream awareness could help differentiate the two. The author offers testable hypotheses for schizophrenia, narcolepsy, and Lewy-body disorders, and suggests emotionally positive lucid dreams may carry therapeutic value if recognized and guided. |
Abstract
The boundaries between waking and sleeping-when falling asleep (hypnagogic) or waking up (hypnopompic)-can be challenging for our ability to monitor and interpret reality. Without proper understanding, bizarre but relatively normal hypnagogic/hypnopompic experiences can be misinterpreted as psychotic hallucinations (occurring, by definition, in the fully awake state), potentially leading to stigma and misdiagnosis in clinical contexts and to misconception and bias in research contexts. This Perspective proposes that conceptual and practical understanding for differentiating hallucinations from hypnagogic/hypnopompic experiences may be offered by lucid dreaming, the state in which one is aware of dreaming while sleeping. I first introduce a possible systematization of the phenomenological range of hypnagogic/hypnopompic experiences that can occur in the transition from awake to REM dreaming (including hypnagogic perceptions, transition symptoms, sleep paralysis, false awakenings, and out-of-body experiences). I then outline how metacognitive strategies used by lucid dreamers to gain/confirm oneiric lucidity could be tested for better differentiating hypnagogic/hypnopompic experiences from hallucinations. The relevance of hypnagogic/hypnopompic experiences and lucid dreaming is analyzed for schizophrenia and narcolepsy, and discussed for neurodegenerative diseases, particularly Lewy-body disorders (i.e. Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies), offering testable hypotheses for empirical investigation. Finally, emotionally positive lucid dreams triggered or enhanced by training/induction strategies or by a pathological process may have intrinsic therapeutic value if properly recognized and guided. The overall intention is to raise awareness and foster further research about the possible diagnostic, prognostic, and therapeutic implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders.
Comparable studies
Other theoretical and historical papers on lucid dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Varieties of Lucid Dreaming Experience | 2000 | Theoretical or philosophical paper | |
| The Neurobiology of Consciousness: Lucid Dreaming Wakes Up | 2009 | Theoretical or philosophical paper | |
| What I make up when I wake up: anti-experience views and narrative fabrication of dreams | 2013 | Theoretical or philosophical paper | |
| New perspectives for the study of lucid dreaming: From brain stimulation to philosophical theories of self-consciousness | 2010 | Theoretical or philosophical paper | |
| Lucid dreaming: Evidence and methodology | 2000 | Theoretical or philosophical paper |
Citations in the library
Cited by 5
- Electrophysiological Correlates of Lucid Dreaming: Sensor and Source Level Signatures. Journal of Neuroscience May 14, 2025
- The clinical neuroscience of lucid dreaming. Neuroscience & Biobehavioral Reviews January 14, 2025
- Hybrid sleep-wake states in psychosis: Examining a comprehensive array of unusual sleep and dream experiences in patients with psychosis compared to non-clinical controls International Journal of Clinical and Health Psychology July 1, 2026
- Sleep and psychosis: An integrative review of conceptual and neurophysiological associations. Progress in Neuro-Psychopharmacology and Biological Psychiatry August 14, 2026
- A Dynamic Foundation: Aberrations of Sleep Architecture and Its Association With Clinical and Sub-clinical Psychopathology. Cureus February 1, 2024
Cites 69
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Out‐of‐body experience and autoscopy of neurological origin Brain January 15, 2004
- Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Sleep September 1, 2009
- Lucid Dreaming Verified by Volitional Communication during Rem Sleep Perceptual and Motor Skills June 1, 1981
and 64 more in the library