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Published on: 2/10/2026

Seeing Things When Waking Up? Causes & When to Worry (65+)

Seeing things when waking up after 65 is relatively common and often benign, typically due to sleep transition hallucinations, fragmented sleep, medication side effects, or vision loss such as Charles Bonnet syndrome, and they usually fade within seconds to minutes. Less commonly, sleep disorders like REM sleep behavior disorder can contribute. Seek medical care if episodes are frequent or daytime, are worsening, follow medication changes, or come with confusion, fever, sudden weakness, speech or vision problems, falls, or memory or behavior changes. There are several factors to consider; see the complete guidance below for what is harmless versus urgent and for next steps like tracking episodes, reviewing medications, and improving sleep.

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Explanation

Seeing Things When Waking Up? Causes & When to Worry (65+)

Seeing things when waking up can be confusing or even frightening—especially for adults over 65. You might notice shapes, people, animals, or lights that seem real for a few seconds or minutes, then fade away. Many people worry this means something serious is wrong. The truth is more balanced: some causes are harmless and temporary, while others deserve medical attention.

This guide explains why seeing things when waking up happens, what is common with aging, and when to worry and speak to a doctor—using clear, everyday language and credible medical understanding.


What Does "Seeing Things When Waking Up" Mean?

Seeing things when waking up is often related to hallucinations that occur during the transition between sleep and wakefulness. Doctors sometimes call these:

  • Hypnopompic hallucinations (happen while waking up)
  • Hypnagogic hallucinations (happen while falling asleep)

These experiences can involve:

  • Seeing people, faces, or shadows
  • Animals or insects
  • Bright lights, colors, or patterns
  • Objects that seem to move or float

They usually last seconds to a few minutes and often disappear once you are fully awake.


Why Is This More Common After Age 65?

As we age, the brain and sleep cycle change. Older adults are more likely to experience:

  • Lighter, more fragmented sleep
  • Changes in REM (dream) sleep
  • Increased sensitivity to medications
  • Vision or neurological changes

Because of this, seeing things when waking up becomes more common after 65, even in people who are otherwise healthy.


Common and Often Harmless Causes

Many causes are not dangerous, especially if episodes are brief, infrequent, and you realize they are not real.

1. Sleep-Related Hallucinations

These are the most common cause and often occur when:

  • You wake suddenly from a vivid dream
  • You are overtired or sleep-deprived
  • Your sleep schedule is irregular

The brain is still partly dreaming, even though your eyes are open.

2. Poor Sleep Quality

Interrupted or low-quality sleep can confuse the brain during waking. Causes include:

  • Insomnia
  • Sleep apnea
  • Frequent nighttime bathroom trips
  • Pain or discomfort

3. Stress, Anxiety, or Grief

Emotional stress can affect sleep and brain chemistry. After a loss or major life change, some people briefly see or sense loved ones when waking.

4. Medications

Certain medications are well-known for causing visual hallucinations, especially in older adults:

  • Sleep aids
  • Pain medications (especially opioids)
  • Parkinson's medications
  • Some antidepressants
  • Anticholinergic drugs

A medication side effect is one of the most overlooked causes of seeing things when waking up.

5. Vision Loss (Charles Bonnet Syndrome)

People with reduced vision (macular degeneration, glaucoma, cataracts) may experience clear visual hallucinations while fully aware they are not real. This condition:

  • Is not a mental illness
  • Does not mean dementia
  • Happens because the brain "fills in" missing visual input

Sleep Disorders That May Play a Role

REM Sleep Behavior Disorder (RBD)

In REM sleep, the body is usually paralyzed while dreaming. In RBD, this paralysis is incomplete.

People with RBD may:

  • Act out dreams
  • Talk, shout, or move in sleep
  • See vivid images when waking

If you're experiencing these symptoms alongside seeing things when waking up, you may want to use a free AI-powered Rapid Eye Movement (REM) Sleep Behavior Disorder symptom checker to assess whether your experiences match this specific sleep disorder pattern and help you prepare for a more informed conversation with your doctor.


Medical Causes That Need Attention

While many cases are harmless, some causes of seeing things when waking up require prompt medical evaluation, especially in adults over 65.

1. Delirium

Delirium is a sudden change in mental status, often caused by:

  • Infection (such as a urinary tract infection or pneumonia)
  • Dehydration
  • Medication changes
  • Hospitalization

Warning signs include:

  • Confusion that comes on quickly
  • Trouble focusing
  • Changes in alertness
  • Visual hallucinations throughout the day

This is a medical emergency and requires immediate care.

2. Dementia-Related Conditions

Certain types of dementia, particularly Lewy body dementia, are associated with:

  • Frequent, detailed visual hallucinations
  • Fluctuating alertness
  • Movement symptoms similar to Parkinson's disease

Hallucinations in these cases often occur during waking hours, not just on waking.

3. Parkinson's Disease

People with Parkinson's may experience visual hallucinations, often related to:

  • The disease itself
  • Parkinson's medications

These hallucinations may begin subtly and increase over time.

4. Stroke or Brain Injury

Sudden onset of hallucinations with:

  • Weakness
  • Speech problems
  • Vision loss
  • Severe headache

requires urgent emergency evaluation.


When Should You Worry?

Seeing things when waking up may be less concerning if:

  • It happens rarely
  • It lasts only seconds
  • You quickly realize it is not real
  • There are no other symptoms

Speak to a doctor promptly if:

  • Hallucinations happen often or are getting worse
  • They occur during the day, not just on waking
  • You feel confused, fearful, or disoriented afterward
  • You have memory changes, falls, or personality changes
  • You recently started or changed medications

Seek urgent medical care if:

  • Hallucinations start suddenly
  • They come with fever, confusion, or weakness
  • There are signs of stroke or infection

What You Can Do Now

Practical Steps to Take

  • Track episodes: note when they happen, how long they last, and what you see
  • Review medications with a doctor or pharmacist
  • Improve sleep habits:
    • Go to bed and wake up at the same time
    • Reduce nighttime noise and light
    • Avoid alcohol before bed
  • Address vision problems with regular eye exams

Talk Openly With Your Doctor

Many people hesitate to mention hallucinations out of fear. Doctors are trained to evaluate these symptoms calmly and respectfully. Seeing things when waking up is a symptom—not a diagnosis.

Be sure to speak to a doctor about anything that could be serious or life threatening, especially if symptoms are new, worsening, or affecting daily life.


The Bottom Line

Seeing things when waking up after age 65 is more common than many people realize. In many cases, it's related to sleep transitions, medications, or vision changes and is not dangerous. However, persistent or worsening symptoms should never be ignored.

Listening to your body, tracking changes, and speaking to a doctor early can make a meaningful difference. If sleep-related symptoms are part of the picture, consider using the free AI-powered Rapid Eye Movement (REM) Sleep Behavior Disorder symptom checker to better understand what may be happening and prepare for a more productive conversation with your healthcare provider.

You are not alone—and help is available.

(References)

  • * Mura P, Carta MG, Cadeddu G, Manchia M, Cugliari ME, Floris G, Medda C, Pompili E, Tocco M, Carpiniello B. Hallucinations and delusions in older adults: A review. Aging Ment Health. 2020 Dec 22:1-12. doi: 10.1080/13607863.2020.1865360. PMID: 32014798.

  • * van der Zande A, Ramele M, Olde Rikkert MGM. Visual hallucinations and Parkinson's disease: A systematic review of interventions. Parkinsonism Relat Disord. 2020 Jul;76:40-49. doi: 10.1016/j.parkreldis.2020.05.021. Epub 2020 May 20. PMID: 32483569.

  • * Breen DP, Duncan GW, Williams GB, Barker RA, Halliday GM, McCarthy A, Duda JE, Burn DJ. Nocturnal visual disturbances in older adults: beyond ophthalmology. J Neurol. 2017 Jul;264(7):1501-1510. doi: 10.1007/s00415-017-8488-8. Epub 2017 Apr 1. PMID: 28362624.

  • * Fereshtehnejad SM, Rösler TW, Hall S, Linder J, Kåreholt I, Ballard C, Aarsland D. REM sleep behavior disorder and visual hallucinations as predictors of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2017 Jul;88(7):602-608. doi: 10.1136/jnnp-2016-315579. Epub 2017 Feb 23. PMID: 28230559.

  • * Kester DS, Cummings JL. Psychiatric Disorders and Visual Hallucinations in Older Adults. Curr Psychiatr Rep. 2019 Jan 10;21(1):5. doi: 10.1007/s11920-019-0979-9. PMID: 30635441.

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