Could these be hypnagogic hallucinations or should I be worried about schizophrenia?

Hi, I’m a 20-year-old male, and for the past few months, every time I try to sleep, I hear voices or find myself in very realistic dreams while being aware that I’m still in bed. These dreams are often disturbing. My sleep quality has worsened over the past couple of years. I work in EMS, which is a high-stress job, and my sleep schedule has been inconsistent because of it. I used to sleep through the night during my teens, but now I wake up several times. I haven’t been bothered by my day-to-day experiences at work before, but perhaps the stress is affecting me subconsciously. I’ve always resisted talking to a therapist because I wanted to handle things on my own, but now I’m thinking it might help to talk to someone and get some advice. I work 40-70 hours a week, and sometimes I hear tones similar to our emergency call tones even when I’m not at work, which makes me think I’m receiving a call. I’m constantly tired. I’m worried that I might develop schizophrenia, but I hope it’s just stress or PTSD. Does anyone have similar experiences or advice?

People with schizophrenia often don’t realize their experiences aren’t typical. The fact that you’re aware these are just dreams is a good sign it might be stress-related. I also have vivid dreams when I’m sleep-deprived. It’s important to talk to a mental health professional for a proper assessment.

@Noel
Should I see a psychiatrist or a therapist?

Harper said:
@Noel
Should I see a psychiatrist or a therapist?

Start with a psychiatrist for a mental health evaluation. They can guide you on what steps to take next. For handling work stress, a therapist can be helpful, or you could look for online resources on managing stress and anxiety. Avoid using substances like alcohol or drugs to cope; they tend to make things worse in the long run.

@Noel
Thanks, I really appreciate your advice. I worked a lot last week and it’s been non-stop. Today was particularly tough because of the cumulative stress and lack of sleep. I think being 20 and not in college adds its own stress too. Maybe I just need to talk some things out, even things I’m not fully aware are bothering me. I’ll start with therapy. Thanks again for your insight, it’s really helpful.

When I started meditating before sleep to manage my sleep schedule, I experienced something similar to what you’re describing. It’s like a form of waking lucid dream, which I found therapeutic. It’s healthy to talk things through with someone, especially someone you respect, not just any random therapist. Maybe someone who shares your values or beliefs would be beneficial.

You’re likely just experiencing anxiety and stress. I had similar experiences until I learned how to calm my nervous system, and then those symptoms mostly disappeared.

Vinnie said:
You’re likely just experiencing anxiety and stress. I had similar experiences until I learned how to calm my nervous system, and then those symptoms mostly disappeared.

I’d love to hear more about your experiences and what worked for you.

@Harper
Sure, ask me anything specific you want to know. I have a normal life with a fiancée and a dog, and I manage stress well now. Remember, it’s usually just stress. Here’s what you need to know about hypnagogia: It’s a normal phenomenon involving vivid sensory experiences as you fall asleep. Common experiences include seeing shapes, hearing voices, feeling like you’re falling, or temporary sleep paralysis. If it becomes too distressing or frequent, consider talking to a professional, but it’s generally not something to worry about too much.

I’ve occasionally had auditory hallucinations when extremely tired. It’s usually a loud noise that wakes me up right as I’m falling asleep. If these experiences are frequent, it’s a good idea to discuss them with a doctor, but given your high-stress job, it’s likely related to stress. I wouldn’t jump to conclusions about schizophrenia, especially if it’s primarily happening around sleep.

@Hadi
I don’t have any family history of mental health issues, but my job is definitely high-stress. Recently, I’ve had dreams about family tragedies, which I think are stress-related. Sharing here has been the most I’ve opened up in years, and it’s really helpful. Thanks for your advice!

@Harper
It sounds like stress might be taking a toll. A therapist could really help, especially if you’re dealing with symptoms similar to PTSD from your job. Take care and good luck managing everything.

Given your age and symptoms, it’s wise to consult with a mental health professional. Psychotic disorders often start in late teens to early 20s, so getting a clear evaluation is important to manage whatever you’re experiencing appropriately. A general practitioner could also refer you to a specialist if necessary.

You should definitely talk to a doctor to ease your mind. Your symptoms might be related to a condition like exploding head syndrome, which involves hearing loud, sudden noises as you fall asleep. It’s typically stress-related rather than a sign of schizophrenia.

Most people with schizophrenia aren’t aware that their delusions aren’t real. However, hearing voices can be concerning, so consulting a psychiatrist could be beneficial.

Frankie said:
Most people with schizophrenia aren’t aware that their delusions aren’t real. However, hearing voices can be concerning, so consulting a psychiatrist could be beneficial.

I appreciate your perspective, but could you clarify what you find concerning?

@Harper
The part about hearing voices is what stands out to me as potentially concerning.

Frankie said:
@Harper
The part about hearing voices is what stands out to me as potentially concerning.

If it’s happening as you’re falling asleep, it’s quite common and known as hypnagogic hallucinations. Be cautious with advice online, though. Many people experience this, and it usually isn’t a serious issue.

@Vinnie
Still, consulting a psychiatrist to discuss these symptoms isn’t a bad idea.

Frankie said:
@Vinnie
Still, consulting a psychiatrist to discuss these symptoms isn’t a bad idea.

Seeing a psychiatrist could be overkill for something like hypnagogia, which is typically benign. There’s a risk of unnecessary medication or misdiagnosis if you go down that path without need.