- Visual hallucinations usually consist of simple forms such as colored circles or parts of objects that may be constant or changing in size. A formed image of an animal or a person may appear and it is often in color.
- Auditory hallucinations are common but other senses are seldom involved. Auditory hallucinations can range from a few sounds to an elaborate melody. Threats or criticism are also reported.
- Another type of hallucination that is sometimes reported at the onset of sleep involves elementary cenesthopathic feelings (such as experiencing picking, rubbing, or light touching), changes in location of body parts (such as an arm or a leg), or feelings of levitation or extracorporeal experiences (like moving the body in space or floating above the bed) that may be quite elaborate.
- There may be a history of narcolepsy with the ability to fall asleep if at all tired or bored, often with social embarrassment. It may lead to the inability to hold down a job.
- Schizophrenia can cause hallucinations including derogatory auditory remarks. In people who experience hypnagogic or hypnopompic images but do not have narcolepsy, the tendency towards psychosis is greater than in others.
- Musical release hallucinations are complex auditory phenomena, affecting mostly the deaf elderly population, in which individuals hear vocal or instrumental music. Progressive hearing loss from otosclerosis disrupts the usual external sensory stimuli necessary to inhibit the emergence of memory traces within the brain, thereby "releasing" previously recorded perceptions.
- There may be drug abuse.
- Sleep terrors in children.
- Partial seizures.
- Absence seizures.
- Referral to a special sleep laboratory may be required to diagnose narcolepsy.
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