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Published on: 2/10/2026
For women 65+, hallucinations on waking are often sleep related and harmless, caused by normal REM to wake transitions, stress or fatigue, sensory loss, or medication effects, but they can also point to conditions like REM sleep behavior disorder, sleep apnea, infections, or neurodegenerative diseases. There are several factors to consider, including red flags that require urgent care and practical steps you can take now, plus what doctors check and a free REM sleep behavior disorder symptom screener; see below for detailed causes, warning signs, and next steps that could change your care plan.
Experiencing hallucinations when waking up can be unsettling—especially if it's new or unexpected. Many women over 65 worry that these experiences mean something serious is wrong. The truth is more balanced: some causes are harmless and related to sleep, while others deserve medical attention. Understanding what's happening is the first step toward peace of mind and better health.
This guide explains what hallucinations when waking up are, why they happen more often with age, what is normal, what is not, and when to speak to a doctor.
Hallucinations when waking up are experiences where you see, hear, feel, or sense things that aren't actually there as you are transitioning from sleep to being awake. Doctors often call these hypnopompic hallucinations.
They may include:
These experiences usually last seconds to minutes and often fade once you are fully awake.
As we age, the brain and sleep patterns change. Women over 65 may experience hallucinations when waking up more often due to:
Age alone does not cause hallucinations, but it can make the brain more sensitive to disruptions.
Many cases of hallucinations when waking up are not dangerous and do not indicate mental illness or dementia.
During REM sleep, the brain is actively dreaming. Sometimes, the dream state doesn't fully "turn off" when you wake up, causing dream images to spill into waking awareness.
This is especially common when:
Physical exhaustion, emotional stress, grief, or anxiety can increase the likelihood of hallucinations when waking up.
When the brain receives less sensory input, it may "fill in the gaps," leading to visual or auditory hallucinations—especially in dim light.
Some medications commonly used by older adults can contribute, including:
Never stop a medication without speaking to a doctor.
While many causes are harmless, hallucinations when waking up can sometimes be linked to conditions that require evaluation.
In REM Sleep Behavior Disorder, the normal paralysis that occurs during dreaming does not happen. People may:
RBD is more common with age and can be associated with neurological conditions. If you're experiencing these symptoms, you can use Ubie's free AI-powered Rapid Eye Movement (REM) Sleep Behavior Disorder symptom checker to better understand your symptoms and determine if you should consult with a doctor.
Hallucinations can be associated with conditions such as:
In these cases, hallucinations often:
Interrupted breathing during sleep can reduce oxygen to the brain, increasing confusion and hallucinations when waking.
Sudden hallucinations may occur with:
These situations can be serious and should be evaluated promptly.
You should speak to a doctor right away if hallucinations when waking up:
If symptoms feel life-threatening or extreme, seek urgent medical care.
A healthcare provider may:
Being honest and specific about what you experience helps doctors determine the cause.
While medical evaluation is important, these steps may help reduce harmless hallucinations when waking up:
Avoid self-diagnosing or ignoring symptoms that persist.
Many women feel embarrassed or afraid to talk about hallucinations when waking up. These experiences do not mean you are "losing your mind." Sleep-related hallucinations are more common than most people realize, especially as we age.
Talking openly with a trusted doctor can bring reassurance and clarity.
Hallucinations when waking up can feel confusing, but knowledge is empowering. Paying attention, asking questions, and seeking medical advice when needed can protect your health and peace of mind. If something doesn't feel right, trust yourself—and talk with a healthcare professional.
(References)
* Hsieh C, Lai CL, Wu D. Sleep paralysis and hypnagogic/hypnopompic hallucinations in older adults: A systematic review. Sleep Med Rev. 2022 Dec;66:101700. doi: 10.1016/j.smrv.2022.101700. Epub 2022 Nov 3. PMID: 36371720.
* Al-Jawad N, Khouja O, Kanaan RA, Mehta MA. Sleep disorders and hallucinations in older adults: a systematic review. Sleep Med. 2021 Nov;87:210-217. doi: 10.1016/j.sleep.2021.08.016. Epub 2021 Sep 10. PMID: 34560408.
* O'Connell H, Horgan F, Kelly M. Hallucinations in the Older Adult: A Multidisciplinary Approach to Diagnosis and Management. J Am Med Dir Assoc. 2020 Jan;21(1):15-21. doi: 10.1016/j.jamda.2019.07.018. Epub 2019 Sep 6. PMID: 31495679.
* Denis D, French CC, Gregory AM. Prevalence of Sleep Paralysis, Hypnagogic/Hypnopompic Hallucinations and Sleep-Related Eating in the General Population: A Systematic Review and Meta-Analysis. J Sleep Res. 2018 Jun;27(3):e12623. doi: 10.1111/jsr.12623. Epub 2018 Jan 28. PMID: 29377227.
* Mander BA, Winer JR, Jagust WJ, Walker MP. Sleep-Wake Disturbances in Older Adults: Epidemiology, Pathophysiology, and Clinical Implications. Neuron. 2017 Jul 19;95(2):296-309. doi: 10.1016/j.neuron.2017.06.012. PMID: 28728929; PMCID: PMC5547462.
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