The child had no prior history of problems in functioning, sleep disorder, or physical illness, and he appeared to be well-adjusted. He made effective use of therapeutic consultations, where he continued to … make sense of what had happened, coming to understand the event as a type of hallucination that commonly occurs following arousal from sleep.
Dr. B. added, “Although there would appear to be a high prevalence of hypnopompic hallucinations among healthy, well-adjusted persons, they are potentially traumatic, and it is crucial to explore the
Experiences so far out of the ordinary constitute a severe challenge to one’s world picture, one’s belief system — how can they be explained? What do they mean? One sees poignantly with this young patient how reason itself can be rocked by such nighttime visions, which insist on their own reality.
1. The Reverend Henslow was a son of the botanist John Stevens Henslow, who was Darwin’s teacher at Cambridge and was instrumental in getting him a position aboard the
2. Feeling that hypnagogic hallucinations could extend and enrich the imagination, Poe would jerk himself suddenly to full wakefulness while hallucinating, so that he could make note of the extraordinary things he saw, and he often brought these into his poems and short stories. Poe’s great translator, Baudelaire, was also fascinated by the unique quality of such visions, especially if they were potentiated by opium or hashish. A whole generation in the early nineteenth century (including Coleridge and Wordsworth, as well as Southey and De Quincey) was influenced by such hallucinations. This is explored by Alethea Hayter in her book
3. Hypnopompic hallucinations are far less common than hypnagogic ones, and some people have hypnagogic hallucinations upon awakening, or hypnopompic ones while falling asleep.
4. Spinoza, in the 1660s, described a similar hallucination in a letter to his friend Peter Balling:
When one morning, after the day had dawned, I woke up from a very unpleasant dream, the images, which had presented themselves to me in sleep, remained before my eyes just as vividly as though the things had been real, especially the image of a certain black and leprous Brazilian whom I had never seen before. This image disappeared for the most part when, in order to divert my thoughts, I cast my eyes on a book or something else. But as soon as I lifted my eyes again, without fixing my attention on any particular object, the same image of this same negro appeared with the same vividness again and again, until the head of it finally vanished.
Sometime in the late 1870s, Jean-Baptiste-Édouard Gélineau, a French neurologist from a wine-making family, had occasion to examine a thirty-eight-year-old wine merchant who had been having attacks of sudden, brief, irresistible sleep for two years. By the time he came to Gélineau, he was having as many as two hundred a day. He sometimes fell asleep in the middle of a meal, the knife and fork slipping from his fingers; he might drop off in the middle of a sentence or as soon as he had been seated in a theater. Intense emotions, sad or happy, often precipitated his sleep attacks and also episodes of “astasia,” in which there was a sudden loss of muscular strength and tone, so that he would fall helplessly to the ground, while remaining perfectly conscious. Gélineau regarded this conjunction of narcolepsy (a term he coined) and astasia (we now call it cataplexy) as a new syndrome — one with a neurological origin.1
In 1928 a New York physician, Samuel Brock, presented a broader view of narcolepsy, describing a young man of twenty-two who was prone not only to sudden sleep attacks and cataplexy but also a paralysis, with the inability to talk or move, following his sleep attacks. In this state of sleep paralysis (as the condition was later to be named), he had vivid hallucinations, which he experienced at no other time. Though Brock’s case was described in a contemporary (1929) review of narcolepsy as “unique,” it soon became apparent that sleep paralysis and the hallucinations associated with it were far from uncommon and should be regarded as integral features of a narcoleptic syndrome.
It is now known that the hypothalamus secretes “wakefulness” hormones, orexins, and that these are deficient in people who have congenital narcolepsy. Damage to the hypothalamus, from a head injury or a tumor or disease, can also cause narcolepsy later in life.
