Why might someone experience auditory hallucinations during sleep?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Auditory hallucinations during sleep—hearing sounds, voices, or noises that aren't real—are typically harmless and most often occur while falling asleep (hypnagogic) or waking up (hypnopompic). These experiences are linked to transitions between wakefulness and REM sleep, when the brain is partially active but not fully alert. Common triggers include sleep deprivation, stress, anxiety, and irregular sleep schedules.

While usually benign, frequent or distressing episodes may point to underlying issues like a sleep disorder, migraine, or mental health condition. Because causes vary widely, understanding your specific symptoms is the fastest way to know whether self-care is enough or if you should see a doctor. Take a free, instant, online symptom check to get personalized insights and clear next steps in just a few minutes.

Reviewed for medical accuracy: 07/14/2026

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Explanation

Auditory hallucinations during sleep can occur when you are falling asleep or waking up. These experiences are often linked to the REM sleep stage, where dreaming happens. During this time, your brain is very active, and sometimes it can create sounds that seem real, like voices or music.

Types of Sleep-Related Hallucinations

Hypnagogic Hallucinations: These occur as you are falling asleep. They are common and usually not a cause for concern.
Hypnopompic Hallucinations: These happen when you are waking up. They can be part of the normal sleep cycle.

Why They Happen

REM Sleep: During REM sleep, your brain is very active, and you might hear sounds that are not actually there.
Transition States: When your brain transitions between sleep and wakefulness, it can sometimes mix dream elements with reality.

If you or someone you know is experiencing distressing hallucinations or other concerning symptoms, you can use this free AI symptom checker to better understand what might be happening and whether you should seek professional care.

(References)

Bless JJ, Hugdahl K, Kråkvik B, Vedul-Kjelsås E, Kalhovde AM, Grønli J, & Larøi F. (2021). An epidemiological study of sleep-related hallucinations. Comprehensive psychiatry, 34062377.
Sobanski T, Sieb JP, Laux G, & Möller HJ. (1997). [Acoustic hallucinations as a symptom of a REM sleep- .... Psychiatrische Praxis, 9490447.
Kompanje EJ. (2008). 'The devil lay upon her and held her down'. Hypnagogic .... Journal of sleep research, 18691361.

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