Sleep Disturbances: Hallucinations and Breathing Issues

Q: Sleep Disturbances: Hallucinations and Breathing Issues

Hello： Based on your description, it is recommended that you seek assistance from a sleep specialist at a hospital (such as a pediatric psychiatry or neurology department). <br>It is important to consider whether there may be narcolepsy or depression involved. <br>Additionally, y

Hallucinations upon falling asleep, difficulty breathing, and a feeling of pressure?

Hello Doctor: I am currently a senior high school student preparing for the university entrance exam, and I often feel a lot of pressure from studying, which leads to feelings of inexplicable sadness and lack of motivation.
Since the first year of junior high, I have experienced ongoing sleep issues.
During my afternoon naps, I frequently dream and can feel myself entering a dream state within five minutes, where I can control the dream and wake up easily.
I often experience sensations of rolling, falling, and being touched all over my body, and these episodes are always accompanied by the same recurring nightmare about falling into a black hole (with a physical sensation of falling).

Since high school, when I fall asleep, I sometimes feel shortness of breath, heart pain, numbness in my limbs, a feeling of pressure in my abdomen, facial twitching, and even sensations of many hands crawling on me.
I also experience hallucinations, auditory hallucinations, and false awakenings, along with frequent nightmares, but I do not suffer from insomnia; I can almost fall asleep immediately.
Currently, these symptoms occur 3 to 5 days a week, often multiple times in a single day, but they all happen within the first hour of falling asleep.
Once I am asleep, I do not experience these symptoms and do not wake up until morning.
Sometimes, I wake up due to difficulty breathing, and other times I force myself to wake up due to a near-death feeling (often feeling very difficult to wake up and unable to move).

I suspect I might have sleep apnea.
I occasionally experience nasal congestion and runny nose, but I rarely snore.
However, I do toss and turn and talk in my sleep within the first hour of sleep.
I have had a check-up with a pediatric cardiologist, and everything was normal.
I usually go to bed at 12:30 AM and wake up at 5:50 AM, and I consistently drink a cup of coffee in the morning to help me wake up.
Occasionally, I experience shortness of breath, and I feel that the frequency of these symptoms increases when I go to bed later.
Because I often wake up, I find it difficult to concentrate in class.

Could you please explain the causes of these symptoms and whether I need to go to the hospital for an examination? Thank you, Doctor.

Ss, 10~19 year old female. Ask Date: 2022/11/13

Dr. Hong Weibin reply Neurology

Hello: Based on your description, it is recommended that you seek assistance from a sleep specialist at a hospital (such as a pediatric psychiatry or neurology department).
It is important to consider whether there may be narcolepsy or depression involved.
Additionally, your sleep duration is insufficient for a typical 17-year-old and needs to be adjusted.

Reply Date: 2022/11/13

More Info

Dear Student,
Thank you for sharing your concerns regarding your sleep disturbances. It sounds like you are experiencing a complex array of symptoms that can significantly impact your daily life, especially as you prepare for your exams. Let's break down your symptoms and explore potential causes and solutions.

Understanding Your Symptoms
1. Sleep Disturbances: You mentioned experiencing vivid dreams, feelings of falling, and sensations of being touched, which can be indicative of sleep-related phenomena such as hypnagogic hallucinations. These often occur during the transition from wakefulness to sleep and can be exacerbated by stress and anxiety.

2. Breathing Difficulties: The sensations of breathlessness, heart pain, and feelings of pressure in your abdomen could be linked to anxiety or panic attacks, especially given the high levels of stress you are under as a student. However, they could also suggest a potential sleep disorder, such as sleep apnea, particularly if you experience nasal congestion and other respiratory symptoms.

3. Physical Sensations: The feelings of paralysis, inability to move, and the sensation of multiple hands touching you could be related to sleep paralysis, which often occurs during transitions between sleep and wakefulness. This condition can be frightening and is often associated with disrupted sleep patterns.

4. Nightmares and Sleep Quality: The recurring nightmares and the fact that you wake up feeling as if you cannot breathe or are in a near-death experience are concerning. These experiences can lead to a cycle of anxiety around sleep, making it even harder to achieve restful sleep.

Potential Causes
Your symptoms may stem from several factors:
- Stress and Anxiety: As a high school student facing exams, it’s natural to feel overwhelmed. Stress can significantly affect sleep quality and lead to various sleep disturbances.

- Sleep Hygiene: Your sleep schedule (going to bed at 12:30 AM and waking at 5:50 AM) may not provide enough restorative sleep. Most adolescents require 8-10 hours of sleep per night for optimal functioning.

- Physical Health: Conditions like sleep apnea can cause breathing interruptions during sleep, leading to fragmented sleep and daytime fatigue. Nasal congestion can exacerbate these issues.

Recommendations
1. Consult a Healthcare Professional: Given the complexity of your symptoms, it would be wise to consult a sleep specialist or a healthcare provider. They may recommend a sleep study (polysomnography) to monitor your sleep patterns and assess for conditions like sleep apnea.

2. Improve Sleep Hygiene:
- Regular Sleep Schedule: Aim for a consistent bedtime and wake time, even on weekends. Try to go to bed earlier to increase your total sleep time.

- Create a Relaxing Bedtime Routine: Engage in calming activities before bed, such as reading or practicing relaxation techniques, to help ease the transition to sleep.

- Limit Stimulants: Reduce caffeine intake, especially in the afternoon and evening, as it can interfere with your ability to fall asleep.

3. Manage Stress: Consider incorporating stress-reduction techniques into your daily routine, such as mindfulness meditation, yoga, or deep-breathing exercises. These can help alleviate anxiety and improve your overall well-being.

4. Physical Activity: Regular exercise can promote better sleep quality. Aim for at least 30 minutes of moderate exercise most days, but avoid vigorous activity close to bedtime.

5. Monitor Your Environment: Ensure your sleeping environment is conducive to rest—dark, quiet, and cool. Consider using earplugs or a white noise machine if noise is an issue.

Conclusion
Your symptoms are significant and warrant further investigation. While lifestyle changes can help improve your sleep quality, a thorough evaluation by a healthcare professional is essential to rule out any underlying conditions. Remember, prioritizing your mental and physical health is crucial, especially during this demanding time in your life. I wish you the best in your studies and hope you find relief from your sleep disturbances soon.

Take care!

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