Why Do I Hear Phantom or Hallucinatory Sounds?

Your description—radio chatter in octaves, repeated words, lasting 5-10 minutes, primarily at night or early morning—points to auditory hallucinations, which are perceptions of sound when anything is absent that causes those sounds. Given your stroke history, here are the most likely causes:

• Post-Stroke Neurological Changes:

• • Your stroke may have damaged the temporal lobe (where the auditory cortex processes sound) or connected areas, causing the brain to generate or misread sounds like radio chatter or repeated words.

• • Scar tissue or disrupted neural pathways from the stroke can lead to auditory disruptions. The “octaves” suggest involvement of musical or pitch-processing areas, and the repetitive nature may reflect a loop in brain activity.

• • Auditory hallucinations occur in 3 percent of stroke survivors, often linked to temporal lobe damage or hypersensitivity.

• • The timing (night/early morning) could relate to fatigue or sleep transitions, when the brain is more likely to sensory mistakes. Your sensitivity may heighten those sounds.

• Post-Stroke Seizures or Epileptic Activity:

• • Seizures, affecting 5-10% of survivors, can cause complex auditory hallucinations, such as radio-like chatter or repetitive words.

• • Focal seizures in the temporal lobe can produce vivid, structured sounds (e.g., voices, music) lasting minutes. Night/early morning timing is common, as seizures often occur during sleep transitions or low brain waking state.

• • More common in the first few years post-stroke but possible years later, especially with triggers like stress, fatigue, or depression.

• • The 5-10 minute duration, repetitive words, and specific timing strongly suggest seizures, particularly if accompanied by other symptoms like confusion, déjà vu, or a poor sense of reality.

• Psychiatric Conditions Like Depression or Post-Stroke Psychosis

• • Severe depression or post-stroke psychosis (1-5% of survivors) can cause auditory hallucinations, including voices, chatter, or repetitive phrases.

• • Stroke-related injury to emotional regulation areas–frontal lobe–or low neurotransmitter levels like serotonin or dopamine (“happy hormones,” as they both play a role in positive mood and emotions) can produce hallucinations. Depression can amplify, especially if untreated.

• • The noises are are likely profound if the sounds are distressing, involve commentary, or worsen with low mood.

• • The repetitive words and night/early morning timing could tie to depression, as hallucinations often are the highest when the mind is less distracted. Your sensitivity may make the sounds feel more intense.

• Musical Ear Syndrome: 

• • Musical ear syndrome involves the brain generating music, voices, or radio-like sounds due to sensory deprivation or stroke-related changes. 

• • Stroke-related sensory loss (e.g., hearing impairment) or temporal lobe changes can cause the brain to come up with complex sounds. The “octaves” and radio-like quality align with this syndrome.

• • 2-10% of stroke survivors are affected, often benign and non-distressing, but still requires evaluation to rule out serious causes.

• • The 5-10 minute duration leans toward a neurological cause. If the sounds are neutral (not upsetting) and tied to quiet times (night/early morning), this is possible. 

• Medication Side Effects:

• • Medications for depression, spasticity, or other stroke issues (e.g., SSRIs, gabapentin, anti-seizure drugs) can rarely cause auditory hallucinations.

• • These drugs alter brain chemistry, potentially affecting auditory processing, especially in someone with heightened sensitivity.

• • Rare (<1%), but possible if you’ve started a new medication or recently changed doses.

• • Tinnitus (ear ringing or buzzing), hearing loss, or medical issues (that is, electrolyte imbalances or thyroid dysfunction) can mime auditory phantom sounds.

• • Stroke survivors may misinterpret ear sounds as voices or chatter, magnified by sensitivity. Night or early morning timing could relate to quiet environments making subtle sounds more noticeable.

• • It is less likely given the complexity like octaves or repeated words) but possible if you have ear issues.

Should You Be Worried?

The answer is yes. You should be concerned enough to seek medical evaluation promptly, as these phantom sounds are not a normal post-stroke symptom and could indicate a treatable but potentially serious condition. Here’s why and how to monitor urgency:

• Complex auditory hallucinations lasting 5-10 minutes suggest a neurological or psychological issue, all of which need attention.
• The night/early morning timing and duration raise suspicion for seizures, which are a known stroke complication and can worsen if untreated.
• Your depression and sensitivity may amplify the emotional impact, increasing distress or isolation, which leads to depression.
• Even benign causes require evaluation to rule out serious conditions.

When to Act Right Away:

• Sounds are frequent. distressing, or involve commands.
• You experience other symptoms (that is, confusion, seizures, memory lapses, dizziness, visual changes).
• If depression or suicidal thoughts worsen, especially tied to the sounds, call 988 immediately in the US or a local crisis hotline.
• Sounds disrupt sleep or daily life significantly.

Many causes are treatable such as seizures, psychosis, or depression:

• The timing (night/early morning) suggests a link to sleep transitions or fatigue, common in stroke survivors.
• The “octaves” and radio-like quality may reflect your brain’s unique way of processing hallucinations, possibly influenced by your sensitivity.
• Your depression and sensitivity may make this feel more overwhelming, but addressing it can reduce both the sounds and emotional turmoil.

What’s Happening in Your Brain?

Your stroke likely caused lasting changes in areas like the temporal lobe (sound processing) or frontal lobe (emotional regulation), making your brain more likely to generating phantom sounds. The specific features—radio chatter, octaves, repeated words—suggest:

• Temporal lobe involvement produces complex auditory hallucinations, especially if seizures or misfiring (drifting off to sleep and things are shutting down, our neurons can sometimes misfire) occur.
• Night or early morning hallucinations often tie to hypnagogic (falling asleep) or hypnopompic (waking up) states, when the brain is vulnerable to sensory mistakes, magnified by stroke damage.
• Depression and sensitivity lower your brain’s ability to filter or let go of the sounds, making them more prominent and abysmal. The 5-10 minute duration is concerning, as it’s longer than typical, safe hallucinations and aligns with seizures or psychosis.
• See an ENT specialist for tinnitus, hearing loss, or ear issues that might make quiet night sounds seem like talking or chatter.
• Request an ENT referral or hearing test.
  • Ask for blood tests (electrolytes, thyroid, B12) to exclude metabolic causes. Imbalances can worsen stroke-related symptoms.
  • Sleep Assessment: Night or early morning timing suggests sleep-related issues. Poor sleep can trigger hallucinations. Sleep transitions amplify sensory missteps in stroke survivors.
• Manage Sensitivity and Depression While Awaiting Evaluation 
• • Your sensitivity and depression may magnify the sounds or make them more distressing, and coping strategies can help until you see a doctor. (Look up distracting stress balls, for example).
  • Keep your bedroom calm at night (e.g., turn off fans, use soft lighting) to reduce sensory triggers. Earplugs may help if not untolerable. 
  • When sounds occur, use the 5-4-3-2-1 method: Name 5 things you see, 4 you touch, 3 you hear (real sounds), 2 you smell, 1 you taste. Takes 1-2 minutes to support you.
  • Listen to calming music at a low level when sounds start to distract you. 

You used to know what to do, but your senses may not be what they once were. Hallucinatory sounds are f***ing bothersome. I know because it’s the same with me. I hear phantom sounds, too. I have to go back to my blog and read my tips again!