FIRST CONTACT

         I wake up at 5am to go to the bathroom. A rote routine: roll to my left to tap and shut down the CPAP pump, then lift off my mask. Switch on the bedside lamp to make sure I don’t stumble over slippers with my gimpy knee. Lower my feet to the floor and sit up briefly on the edge of the bed to steady my balance before setting off for the john.

         Except not this morning. There’s a man standing by the side of my bed. Twenty-something, dressed in black. Still and silent, breathing calmly, as if he’s been monitoring my sleep. I feel no hostile threat from him but I’m shocked by this intruder’s presence and proximity in my retirement-community bedroom. I blurt out a shout and flail with my arms. The figure decomposes in an instant, leaving no trace. Elapsed time: 5 to 10 seconds since my first awakening.

         A weird nightmare, you say. What had I eaten for dinner? This is where I tell you I’ve experienced two dozen similar encounters within the ensuing two months. The most recent, last night.

NOTES AND PATTERNS

         I want to share this true tale with you in the same order I’ve been experiencing it. As soon as I realized the initial intrusion was being followed by similar sequels, I began taking notes. To record my immediate perceptions before they blended or blurred. But also to discern patterns as a basis for seeking explanations.  What the hell was going on? What was triggering these vivid impressions? (I hadn’t had a glass of wine in a year, on doctor’s instructions. No alcohol-inspired fantasies in play.) Where were these mid-night observers coming from? Where did they go back to when they disappeared? Why target me and why now? Most important, how could I terminate these disturbing invasions?

 Here’s a synthesis of my journal entries, brought up to the present:

         The recurring “visits” are continuing, as frequently as two per night and as rarely as one per week. The frequency appears to be recently intensifying. Only at night, most commonly in the transitions from sleeping to waking. Never during the reverse change-over from waking to sleeping.  

         The encounters never occur during or after my daytime naps. They do occur whether or not I’m wearing my CPAP device (used nightly to control sleep apnea.)

         Only one “visitor” appears per incident. All of them are adults, never children or adolescents. Males and females, multi-ethnic, ranging in age from perhaps 25 to 85. Their clothes are informally American, in mostly somber styles and colors. No hats, caps or other headgear. Each visitor remains completely silent. The standees are all stationary. None reaches out or touches me. Their manner is subdued, as if data-collecting. No inkling of aggression, much less violence. No apparent interest in objects or possessions in my room, as one might expect of a burglar or thief.

         Their most common position is standing close by my bed: usually to the side, near my torso. But sometimes up against the bed’s head or foot. What makes these locations startling is that my bed is placed flush in a corner, with two walls above and next to it. So in fact there is inadequate space for a real adult to stand between the bed and those two walls. Yet these figures do so, repeatedly and apparently effortlessly.

         None of the dozens of stationary observers has ever reappeared. Each individual’s visit is one-time-only. In contrast, two moving figures have repeatedly turned up: a short, shuffling elder woman in an orange dress; and a fit young man pushing a Housekeeping cart in front of him. I call them “the crossers.” Both walk across my bedroom, always separately. They act as if they’re uninterested in me but familiar with the room. (If so, their acquaintance with it would have to have occurred five or more years ago, before Nancy and I took occupancy.) Both these figures are smiling and cheerful. What’s more remarkable, the young man and his cart pass freely through furniture as if it presents no barrier.

         Whether standing or walking, these figures share key characteristics. All are intensely real, three-dimensional and animated. Living persons, not still photos or video clips. None is familiar to me: not from my waking hours, not from a dream or nightmare, TV, movies or reading. I do not believe I have “summoned” them, recognize them or have ever seen them before. To the contrary, their appearances in my most private space invariably take me by surprise. These are independent, uninvited, unsettling strangers.

STYMIED SELF-DIAGNOSIS

         As episodes have intensified and my field notes have accumulated, I’ve shifted most of my focus from recording what I’ve been witnessing to analyzing what can explain it. Hypotheses seem to fall into two general categories: either the incidents and impressions are internally stimulated, by my own consumption or conduct; or they are externally initiated by independent influences. Internal sources seem more scientific and rational but are so far producing no convincing fit. External sources seem more fanciful but more closely match my experience of the actual encounters.

         Internal Explanations

         The most direct and simple explanation for my nightly disturbances is that they are hallucinations: artefacts of my subconscious imagination stimulated by one of my heart medicines. There’s a close precedent for this hypothesis: my prior hallucinations immediately following my 2022 heart failures. (Agile Aging subscribers may remember this saga from my blog post of January 31, 2023.) My cardiologist at that time prescribed metoprolol, a popular beta-blocker. This medication was selected to help my heart recover by slowing my heart rate and lowering my blood pressure. Though not common, metoprolol’s side effects can include hallucinations, especially in elders. When I soon began experiencing hallucinations including exotic persons, documents and furnishings, my cardiologist swapped out this medicine for another beta-blocker. The side effects promptly disappeared and I enjoyed a two-year respite. 

         Unfortunately, my current siege appears more elusive. This time there’s been no triggering change of heart medications. And nothing I’m now taking is associated with hallucinatory side effects.  

         As a secondary hypothesis also attributing the current episodes to internal imagination, I do have a lifetime history of occasional nightmares. But those dreams by definition occur when I am asleep, not during awaking transitions. They are frightening stories usually trapping me in some threatening situation, identifiably traceable to some same-day stress. They tell a story, with conflict and confrontation. In the new scenerios, there’s no story, no conversation and no threats.

         As referenced above in my journal entries, an overarching objection to internal explanations is that these visits and visitors feel so externally generated. Surprise appearances, unfamiliar intruders, in no way creations of my imagination or experience.

         External Explanations

         One convenient explanation relying on external forces would be to treat these visitors as real persons. And in fact, they seem intensely animated, un-exotic and credible. That said, it’s not plausible that dozens of intruders could penetrate our retirement community’s security cordon undetected. And no real adults can stand in a one-inch-wide space, much less walk through furniture. So this appealing hypothesis has to be discarded out of hand.

         As an alternative external influence, it occurred to me that my visions might be connected with my CPAP device. What if it were malfunctioning to impair regular breathing and sleep? But as a challenge to this hypothesis, my encounters occur equally when I’m not connected to this equipment.

         It does seem to me that location is playing a definite role in these repeated visitations. As recorded in my journal entries, field notes, all the episodes thus far are occurring in my retirement-community apartment bedroom. None in hotel rooms, none in the community’s Health Center where I resided for seven recent weeks. Somehow, this venue is anchoring my encounters.

         More broadly, when considering external influences, I am willing to look beyond the medical to the mystical. I don’t fully believe in “ghosts” but I don’t unequivocally disbelieve. Especially not after having lived and worked for decades in Asia and Africa. (My maternal grandfather’s ethereal vision in colonial southern Africa provided the prologue to my memoir, FAR & AWAY. To his dying day, he insisted this vivid encounter had been factual.) Not jiving skeletons or grinning jack-o-lanterns, despite this time of year, but presences and spirits. Only partly in jest, I have wondered, for example, if the cheery old lady in orange might not be the spirit of a predecessor tenant in our apartment.

         Indulging further open-mindedness, I should acknowledge that a single visitor out of dozens has been exotic: a green-skinned, bedside observer with a lozenge-shaped head and deer-muzzled face. This countenance truly did rattle me, although its seeming attitude was empathetic. I envisioned an extraterrestrial explorer taking vital signs of an unwitting earthling. But would that make all the other mundane monitors camouflaged commandoes?

         Bottom Line: After two months of nightly visits and nearly as long a period of solo study, I remained no closer to a convincing explanation. I felt unnerved, baffled and stymied.

MOBILIZING MEDICAL DETECTIVES

         Time to appeal to medical professionals. Taking advantage of periodic monitoring appointments, I raised my encounters predicament with my primary care physician, my new cardiologist and my sleep-clinic specialists. The cardiologist confirmed my understanding of my past heart-medicine history and the lack of any current hallucination-provoking side effects. In his expert opinion, heart medications were not sponsoring my intruders. Fortunately, the other referrals led my search into a more promising direction.

         Our Intrepid Family Doctor

         My dedicated primary care physician is the hero of this drama. She launched her own inquiry into my continuing predicament, inspired by an incongruous source.

         One evening, she was reading aloud to her young son in a popular children’s book. It was the second volume in a hugely successful national series: The Mysterious Benedict Society and the Perilous Journey. In the passage that caused her to pause, the eponymous mentor, Mr. Benedict, is confiding to a protégé:

I am often beset by nightmares, strange fits of waking paralysis, and even hallucinations, which can be quite terrifying….I sometimes awake to the vision of a hunched figure at the end of my bed…Unable to cry out, it’s rather inconvenient…

         My doctor later reported to me that several simultaneous impressions spontaneously occurred to her as she read and then reread these sentences:

• First, she was struck by the points of congruence between this scene and my own emailed vignettes: hallucinations when transitioning from sleeping to waking, a bedside intruder, and the narrator’s mixed sentiments of alarm and equanimity.
• Next, the points of incongruence, since I was experiencing neither narcolepsy (as Mr. Benedict names his own condition) and sleep paralysis.
• And, most notable, the fact that a hallucination involving a bedside intruder was being imported by author Trenton Lee Stewart as far back as 2008, a signal that this symptom was probably widely known.

         My doctor did some informal quick research. She confirmed that narcolepsy was irresistible, daytime collapse into sleep – not my predicament. And that sleep paralysis encompassed an inability to move or speak during a nightmare; again not my problem.

         Then she reached out to her Stanford Medicine colleagues at the Sleep Clinic, reconfirmed that I was still one of their patients for sleep apnea and that I had already made an appointment to come and see them.

         When we soon met and spoke, we were both delighted that bedside reading was informing bedside intrusion. Life imitating art!

         Sleep Expertise

         We’d traced my intruders to their source: hypnopompia. I thought it sounded like an exotic orchid. Turns out it refers to the state of semi-consciousness when waking up from sleep. For etymologists, the mirror term is hypnagogia, when falling asleep.

         I was sitting in Stanford Health’s Sleep Clinic for a brief tutorial with a specialist nurse-practitioner. I’d summarized my intruder saga to the best of my abilities and now she was gracefully leading me through diagnoses, causes and treatment options.

         For my purposes, the key connection is that hypnopompia is often associated with hallucinations taking the form of bedside figures. These may or may not be threatening.

         These hallucinations may be caused by a variety of sleep-interruption conditions. As mentioned in the literary precedent above, two I do not have are Narcolepsy and Sleep Paralysis. Other common causes may be medications’ side effects. But none are indicated in my case.

         Given my prior history of sleep disorders, my more likely cause is Obstructive Sleep Apnea, which the Clinic has been treating me for with CPAP therapy. This might seem the end of the story. In fact, the prognosis is more complicated. CPAP-device monitoring results, made available by the device supplier to the Clinic, indicate I have not been using the device with sufficient efficiency to consistently curb fragmented sleep. (Together, these defects explain why my intruders often appeared when I was wearing the mask.) In part, this is because CPAP hoses, while light-weight and flexible, routinely spring leaks. In addition, I’ve developed a bad habit of taking off my mask during the night whenever it irritates my face (i.e., frequently). Even with disciplined use, CPAP wearers with mustaches and beards have difficult achieving a tight mask seal. And unfortunately, sleep apnea is particularly problematic for elder patients.

         Insatiably curious, I wanted to learn much more from our first conversation. Why and how are bedside figures generated? Why do mine appear only in my apartment bedroom? Why don’t they speak? Why and how do they instantaneously disappear? However, the nurse-practitioner was on a tight professional schedule. And romantic mysticism was clearly not part of her interview scope. She did address one interesting connection: the reason most of my intruder encounters occur around dawn is probably that my Stanford sleep test indicated my REM sleep is particularly disrupted by apnea. REM sleep is most concentrated in the day’s earliest hours. On another practical note, I learned that weight loss through diet and exercise can significantly reduce sleep fragmentation. Beyond that, my interlocutor subtly encouraged me to be grateful my hallucinations, unlike many associated with sleep interruptions, are not causing fear or even terror. In her encouragement, I also heard an implicit corollary: if we don’t get my sleep fragmentation under control, the intruders may remain with me forever.

         After our meeting, the nurse practitioner generously arranged an appointment for me with the Clinic’s mask-fitting technician on an urgent timeline. Following that, I’ll have a follow-through strategic-planning consultation with the physician supervising my Clinic team.

         I emerged better informed but somehow disappointed that my condition and its remedy are mostly mechanical.

CROSSING BORDERS

         When I debriefed Nancy on my Sleep Clinic consultation, she sensed my sadness at signing up for mask-tightening extermination of intruders. “Will you miss your ghosts?”

         “No and yes. For sure, I won’t miss the nightly invasions. Even without the green man, the standees are rattling. I never know whether one will be there when I wake up.

         “But to be honest, I’ll also miss the assertive irrationality of their presence. There’s something enticing about being forced to confront what can’t quite be explained away. How can I resist a smiling guy who pushes his cart through the wall?”

         On another occasion but in the same vein, as I’ve struggled to navigate uninterrupted transitions between sleeping and waking, Nancy diplomatically wondered whether my receptivity to current intrusions may not be intensified by a lifetime of fertile imagination.

         We both remember one incident early in our marriage when we backpacked into the Sierras with another couple. After a long day of climbing and a simple campfire supper, we all collapsed into our mummy bags under the stars. Hours later, I startled my companions by shouting and thrashing in my cocoon. It took all of them long minutes to calm and wake me. So vocal was my performance that flashlights were switching on in campsites around the lake. I almost slugged Marshall when he finally succeeded in unzipping my bag. Conscious at last, I was momentarily confused why everyone was concerned. Then I quickly remembered the full terror of my nightmare. A giant grizzly bear had been trying to rip my head off and I couldn’t free my arms to defend myself because of the confining bag.   

         Earlier still, when dating before marriage, I confided to Nancy how thrilled I was to be able to fly in my sleep. She replied that she had comparable sensations in her dreams.

         “No, no!” I insisted, “Not a dream. I can really fly.” I proceeded to demonstrate the prone position I assumed when airborne.

         “Just like body-surfing. Except I keep my arms out in front for better balance and turning. Would you like to see how I land?”

        Fifty-five years later, I’m still glad she didn’t trade me in for another model with both feet on the ground.