False awakening

Symptoms

Realism and non-realism

Certain aspects of life may be dramatized or out of place in false awakenings. Things may seem wrong: details, like the painting on a wall, not being able to talk or difficulty reading (reportedly, reading in lucid dreams is often difficult or impossible).

Types

Celia Green suggested a distinction should be made between two types of false awakening:

Type 1

Type 1 is the more common, in which the dreamer seems to wake up, but not necessarily in realistic surroundings; that is, not in their own bedroom. A pre-lucid dream may ensue. More commonly, dreamers will believe they have awakened, and then either genuinely wake up in their own bed or "fall back asleep" in the dream.

A common false awakening is a "late for work" scenario. A person may "wake up" in a typical room, with most things looking normal, and realize they overslept and missed the start time at work or school. Clocks, if found in the dream, will show time indicating that fact. The resulting panic is often strong enough to truly awaken the dreamer (much like from a nightmare).

Another common Type 1 example of false awakening can result in bedwetting. In this scenario, the dreamer has had a false awakening and while in the state of dream has performed all the traditional behaviors that precede urinating – arising from bed, walking to the bathroom, and sitting down on the toilet or walking up to a urinal. The dreamer may then urinate and suddenly wake up to find they have wet themselves.

Type 2

The Type 2 false awakening seems to be considerably less common. Green characterized it as follows:

The subject appears to wake up in a realistic manner but to an atmosphere of suspense. ... The dreamer's surroundings may at first appear normal, and they may gradually become aware of something uncanny in the atmosphere, and perhaps of unwanted [unusual] sounds and movements, or they may "awake" immediately to a "stressed" and "stormy" atmosphere. In either case, the end result would appear to be characterized by feelings of suspense, excitement or apprehension.

Charles McCreery draws attention to the similarity between this description and the description by the German psychopathologist Karl Jaspers (1923) of the so-called "primary delusionary experience" (a general feeling that precedes more specific delusory belief). Jaspers wrote:

Patients feel uncanny and that there is something suspicious afoot. Everything gets a new meaning. The environment is somehow different—not to a gross degree—perception is unaltered in itself but there is some change which envelops everything with a subtle, pervasive and strangely uncertain light. ... Something seems in the air which the patient cannot account for, a distrustful, uncomfortable, uncanny tension invades him.

McCreery suggests this phenomenological similarity is not coincidental and results from the idea that both phenomena, the Type 2 false awakening and the primary delusionary experience, are phenomena of sleep. He suggests that the primary delusionary experience, like other phenomena of psychosis such as hallucinations and secondary or specific delusions, represents an intrusion into waking consciousness of processes associated with stage 1 sleep. It is suggested that the reason for these intrusions is that the psychotic subject is in a state of hyperarousal, a state that can lead to what Ian Oswald called "microsleeps" in waking life.

Other researchers doubt that these are clearly distinguished types, as opposed to being points on a subtle spectrum.

Experimental descriptions

The clinical and neurophysiological descriptions of false awakening are rare. One notable report by Takeuchi et al., was considered by some experts as a case of false awakening. It depicts a hypnagogic hallucination of an unpleasant and fearful feeling of presence in sleeping lab with perception of having risen from the bed. The polysomnography showed abundant trains of alpha rhythm on EEG (sometimes blocked by REMs mixed with slow eye movements and low muscle tone). Conversely, the two experiences of FA monitored here were close to regular REM sleep. Even quantitative analysis clearly shows theta waves predominantly, suggesting that these two experiences are a product of a dreaming rather than a fully conscious brain.

The clinical and neurophysiological characteristics of false awakening are

1. One does not feel paralysed.
2. One feels that the surroundings are familiar.
3. Frequently associated with anxiety.
4. The EEG shows low Alpha and beta bands but high delta and theta bands.
5. The EOG shows the presence of spontaneous REMs.