Why You Might Hear Voices at Night

Hearing voices when the world is quiet at night can feel frightening, but it’s not as rare as you might think. Research suggests about 9.6% of people experience hearing voices at some point in their lives, with the rates higher in children and teens. And while hearing voices can sometimes be linked to conditions like schizophrenia, there are far more common and often harmless reasons this can happen.

What Are Auditory Hallucinations?

Auditory hallucinations are sounds or voices that have no external source. They can be positive, neutral, or negative and may include:

• A loved one calling your name

• Music, footsteps, or tapping sounds

• Conversations inside your head

• Voices that offer encouragement or, more rarely, commands

For most people, these experiences are short-lived and tied to specific circumstances, not a mental illness.

Why You Might Hear Voices at Night

Nighttime voices often occur when your brain is in a “half-asleep” state. Here are the most common causes:

• Sleep hallucinations: Known as hypnagogic (while falling asleep) or hypnopompic (while waking) hallucinations, these happen when your brain is partly in a dreaming state. They’re usually brief and harmless.

• Sleep paralysis: During REM sleep, your body is paralyzed to prevent you from acting out dreams. If you wake up before this paralysis wears off, you may feel frozen and experience vivid auditory or visual hallucinations.

• Lack of sleep or insomnia: Fatigue can heighten your brain’s sensitivity to sound and increase the risk of hallucinations.

• Physical illness or fever: High temperatures, especially in children or older adults, can trigger short-term hallucinations.

• Hunger or low blood sugar: Going long periods without eating may lead to sensory disturbances, including hearing voices.

• Bereavement: It’s common to hear or sense a loved one who has passed away. Many people find this comforting rather than distressing.

• Stress or trauma: Severe stress, bullying, or past trauma can bring on hallucinations, including voices that echo those experiences.

• Substance use or medications: Certain prescription drugs, alcohol, or recreational substances and withdrawal from them can cause auditory hallucinations.

Associated Conditions

In some cases, hearing voices is linked to mental health conditions such as:

• Schizophrenia or psychosis

• Bipolar disorder

• Severe depression

• Post-traumatic stress disorder (PTSD)

• Dissociative disorders

However, only about one-quarter of people who report hallucinations meet the criteria for a psychotic disorder, meaning the majority of cases have other causes.

When Children or Older Adults Hear Voices

• Children: Fever, lack of sleep, or stress can trigger hallucinations. Call a healthcare provider if your child has a temperature over 100.4°F and you think they’re hallucinating.

• Older adults: Hallucinations may sometimes be the first sign of an infection, such as a urinary tract infection or pneumonia, even before other symptoms appear.

Treatment Options

Treatment depends on the cause of the hallucinations. A healthcare provider may recommend:

• Medication: Antipsychotics or other targeted drugs can help if the hallucinations are linked to a mental health condition.

• Therapy: “Talk therapy” can provide strategies for managing or reducing distress from hallucinations.

• Lifestyle changes: Improving sleep, reducing alcohol, exercising regularly, and managing stress can lessen how often hallucinations occur.

If the voices are distressing or persistent, or if they command you to do harmful things, seek medical help immediately.

Self-Care Strategies

Along with professional support, these steps may help:

• Keep a regular sleep schedule to reduce nighttime hallucinations.

• Avoid alcohol or recreational drugs, which can worsen symptoms.

• Practice relaxation techniques like meditation or breathing exercises before bed.

• Share your experiences with a trusted friend or family member for emotional support.

When to See a Healthcare Provider

Make an appointment if:

• The voices interfere with your sleep or daily life.

• You experience them frequently or they become more intense.

• You develop other mental health symptoms, such as paranoia, severe mood swings, or thoughts of self-harm.

A medical professional can determine the underlying cause and help you access effective treatment.

Bottom Line

Hearing voices at night is often linked to sleep states, stress, or temporary physical changes not necessarily to a serious mental health condition. Still, if it’s persistent or distressing, reaching out for support is an important step.

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