Why You Sometimes Get Horrifying Night Terrors After Doing Too Much Molly

But what comes up must come down, and the crashing lows associated with MDMA binges are well documented: According to a 2001 report published in Human Psychopharmacology, 80 percent of ecstasy users reported "rebound depression and lethargy" in days after taking the drug. But some heavy MDMA users also report another, little-known side effect: sleep paralysis and night terrors. Go online, and you'll find numerous forum posts from MDMA users anxiously discussing their experiences of night terrors and sleep paralysis.

One user describes the difference between regular nightmares and the night terrors and sleep paralysis that follow an MDMA binge: "Regular dreaming feels like playing your Xbox or PlayStation… [night terrors and sleep paralysis] felt like putting on one of those virtual reality helmets [where] you'd see everything right there in first person as if you were really there."

Not to be confused with nightmares, night terrors are most common in children. Health professionals in the UK define them as sleep episodes of up to fifteen minutes in which the individual "may scream, shout, and thrash around in extreme panic, and may even jump out of bed. Their eyes will be open but they're not fully awake." Sleep paralysis, on the other hand, is defined as a temporary inability to move or speak when you are waking up or falling asleep. It can last anything from mere seconds to several minutes.

Combine the two experiences—waking from a night terror to find yourself temporarily paralyzed—and the overall effect is about as pleasant as a recurrent UTI or botched catheter insertion. Although every individual's experience is unique, some drug users experience the two phenomena in tandem or in isolation following a period of heavy MDMA use.

Despite this, there is scant academic literature to suggest a specific causal link between the two. I asked Professor Ron Cowan, an expert in neurophysiology and substance use at Vanderbilt University, to review the evidence around MDMA use and night terrors and sleep paralysis. He tells me that, while there is a "nice [amount of] literature on sleep disturbances in MDMA, particularly linked to sleep apnea [disordered breathing]," there are no published reports using the terms such as "sleep terrors," "night terrors," "sleep paralysis," and "MDMA or ecstasy" in the scientific literature.

Despite her heavy drug use—she'd take around a gram of MDMA on a night out—initially Chloe didn't make the connection between the effects of the drug and her sleep paralysis. "It had never happened to me before, and it was fucking horrible. At the time, I didn't know what sleep paralysis was." Chloe describes fruitless hours spent online, trying to find out what had happened to her. "For quite a long time afterwards, I thought I was a freak. I truly believed that I was going mad and I was really, really scared to fall asleep after that."

Professor Glen Hanson, a neuroscientist at the University of Utah, specializes in researching the neurotoxic effects of MDMA on the brain. "[MDMA] causes a major, physiologically inappropriate release of neurotransmitters in your brain, which cause an exaggerated response in the serotonin and dopamine systems," he explains. That sensation of every pleasure receptor in your brain shunting into light speed? It's caused by a huge dump of three different chemicals in your brain: serotonin, dopamine, and norepinephrine—but mostly serotonin.

Hanson says that sustained or excessive MDMA use can damage the production of serotonin in your brain. "It alters an enzyme that synthesizes serotonin in your brain—tryptophan hydroxylase—so it doesn't work as well. Your serotonin levels disappear, and the other neurotransmitters in your brain take over. Over time a person's brain chemistry shifts from a serotonin-based system to more of a dopamine or norepinephrine-based system."

As serotonin is crucial for regulating sleep, it's possible that MDMA use can cause night terrors and sleep paralysis—although, as specific studies don't exist examining a causal link, this is more informed guesswork than scientific fact. "We still don't understand REM sleep terribly well, but we know that it's critical for well-being," Hanson says. "Serotonin is critical to REM sleep, and when serotonin receptors are altered, you won't have good sleep."

Many of the people I spoke to for this piece reported strong visual components to their dreams. Is there something inherent in the chemical properties of MDMA that might contribute to these kinds of hallucinatory night terrors? "While MDMA is an amphetamine," Hanson responds, "in high doses it can result in hallucinogenic events. You may have these nightmarish sensory experiences that can seem very real. It takes high doses of ecstasy to get there, but that could affect you in your sleep."

Falling asleep on Sunday evening, Nicole felt her vision start to blur. "I'd had night terrors growing up [unrelated to drug use], but they'd always been aural, like sudden loud music or explosions. That night, though, I saw really frightening visual stuff, like a killer with a knife and somebody in a Scream mask looming over my face."

Leila*, 27, has also had her fair share of horror film moments. "The first time I got night terrors was in 2012, a few years after I'd started taking MDMA. I had a very vivid and stressful dream that I can't remember exactly, but it culminated in me shooting myself in the face. Normally you wake up before anything like that happens in a dream, but in this one I didn't." She is confident the terrors are caused by MDMA. "I only ever get them if I've taken MDMA, never if I've taken any other drug in isolation."

The dreams also have a strong physical component. "I feel like my whole body is being compressed as I'm falling asleep," she adds, "like someone is pushing down on me really hard."

Of all the people who shared their experiences of having night terrors with me for this piece, only one was male. Limited research supports the theory that women might be more susceptible to the toxic effects of MDMA than men. One 2013 study found that female ecstasy users were more likely to report having poor quality sleep and experiencing excessive daytime sleepiness. Meanwhile, women are up to three times more likely to be hospitalized for MDMA use in the UK than men, according to the 2016 Global Drugs Survey.

"Say you have two people: one female, one male," Hanson explains. "They take the same amount. The female will probably be smaller, and she'll metabolize it more slowly. The drugs will be more concentrated in her body, for a longer time. The greater the concentration, the greater the effect on the biological system, meaning the greater the physiological and behavioural impact it's going to have."

"It's just basic chemistry," he concludes.

Disturbingly, it is almost impossible to tell whether long-term MDMA users will end up permanently affecting their sleep cycles. While none of the people I interviewed for this piece reported significant changes to their sleep, Hanson warns that everyone will react differently to prolonged MDMA abuse. "If you've damaged your serotonin system—and the damage is extensive and prolonged—it's going to be hard to compensate for that. I don't think [your sleep cycle] will come back to normal as long as those serotonin systems have been disrupted." Hanson highlights how MDMA users might also become reliant on sleep aids to help them sleep.

In the course of writing this piece I reached out to numerous organizations—charities, health services, drug policy institutes—to ask them what advice they'd give to MDMA users concerned that the drug might be affecting their sleep. None were able to provide me with practical recommendations about what might help.

* Names have been changed