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Hypnagogic hallucinations may be present in up to 50% of patients with narcolepsy. Hypnagogic hallucinations are dream-like experiences that occur during the transition from wakefulness to sleep, whereas hypnopompic hallucinations occur during the transition from sleep to wakefulness. These hallucinations may involve hearing, vision, touch, balance, or movement. They often incorporate images of the patient's environment into the dream-like images. The hallucinations are frequently vivid, bizarre, frightening, and disturbing for the patients. As a result, the patients may become fearful that they have or will develop a mental illness.