Why am I being woken up by phantom odours?

August 20, 2012 2:48 PM

What might be causing nocturnal phantom odours? For the last couple of months, I have woken up abruptly from deep sleep by a very strong odour (scent varies). My partner is not awoken by these "smells" and I don't think it's worth disturbing his sleep over for corroboration, because the smell goes away right after I wake up, which has led me to believe I am dreaming/imagining it.

The smells have included mint, cinnamon, cigarette smoke, and curry. (Separately, not mixed together!)

I checked previous AskMes and googled "phantom smell" but nothing seemed quite to match this--being woken up and having the smell vanish upon waking.

I don't have this problem during the day, though I am often quite sensitive to smells and can detect faint (but real!) odours more easily than others.

I am leaning toward making a doctor's appointment but I will not be able to get one for a few weeks for something non-urgent like this. So I am wondering if anyone else has experienced this and what the heck it could be.

Other possibly relevant info:

- I am in my late 30s.
- I am in good health.
- I have recently started exercising more.
- I have had sinus issues in the past.
- My partner and I are trying to conceive. I know pregnant women are sensitive to smell, but I've had these phantom night odours when I was definitely not pregnant. However, I am still waiting to find out if I am or not this month. So I don't know if it is linked to hormones.
- I have, in the past, suffered from migraines but have not had one for a couple of years. I always experienced auras with migraine (usually accompanied by pain; however, on rare occasions, aura without pain), but they were the flashing light type of aura, never the odour type.

posted by Secret Sockdentity to health & fitness (16 answers total)

I think I saw something on some medical mysteries-type show on TV a while back where some woman was epileptic, but didn't figure it out for years because her seizures only manifested themselves as unusually strong smells.

To me, this would be a worrisome symptom. I would go to a doctor as soon as possible and ask for a referral to a neurologist.

Also, keep in mind that it's possible your doctor will think you're crazy. If so, I highly recommend you find another doctor. A doctor should never dismiss your concerns, no matter how unusual they may sound--a good doctor will treat everything you say seriously and never belittle you (not to say they're completely humorless--you will be able to tell the difference). Just don't be afraid to get a second opinion.
posted by phunniemee at 2:57 PM on August 20, 2012 [2 favorites]

My dream senses include smell, but it's never woken me up. I agree with phunniemee that this sounds more like an olfactory hallucination (phantosmia).
posted by Specklet at 3:17 PM on August 20, 2012

Have you given your sinuses a rinse with a neti pot or similar? I can sometimes get odd sensations of smell at night, and this clears it up for me. I'm pretty sure for me it's not dysosmia, but something like sneeze smell.

I have also woken myself with an stealth ripe armpit on occasion.
posted by scruss at 3:18 PM on August 20, 2012

This actually happens to me all the time. I've never thought it was unusual. A few nights ago I was having an anxiety dream about cooking spaghetti for a huge crowd of people. I woke up at some point and the smell of marinara sauce was very strong -- almost mouth-wateringly so. For the few seconds after I woke up, I had this panicked instinct to run to the kitchen and turn the stove off. When I realized it was a dream, I sniffed a few times, and then realized that I'd dreamt the smell as well.

I think some people's dreams just include more senses than others' -- like some people say they don't dream in color. I think I must dream in smell-o-vision, and maybe you do too.
posted by mudpuppie at 3:48 PM on August 20, 2012

It can be difficult to determine if sensory disturbances (hearing, smell, sight, touch, taste) are neurological, psychological, or an issue with the system itself (like impacted ear wax causing a hearing loss). Typically, when you seek medical advice about sensory disturbance, the provider with be interested to know:
*when (your example is 'upon wakening')
*how often
*previous medical/psychological history
*more than one sense disturbed
*daily medications
*if disturbance responds to anything palliative
*if disturbance can be provoked (by food, environment, medicines, behavior, sleep deficit, behavior)
*If disturbance is progressive
*if you have have any constitutional symptoms (symptoms of illness) or accompanying symptoms (like disturbance happens with headache)
*how you are recording or noting the disturbance. For example, do you know how many times a week this happens and for how long because you have noted it in a day planner? Are you uncertain? How concerned are you, or how much is this interfering with normal functioning?

If the provider was concerned it was neurological, you'd be referred to a neurologist who has a whole menu of stuff s/he could do--medication trial (like a daily migraine controller, perhaps one that shares a class with seizure medication), central (brain) imaging, sleep studies, EEG. Or, your provider may be concerned that there is a problem with the local system and refer you to an ENT provider. You mention two aspects of your medical history (migraine and sinus) that mean it could go either way. The thinking your provider will do will have a lot to do with your level of function and concern.

All of this is just to say that you should make an appointment, and during this interval, I would suggest keeping a good diary of this disturbance, along with a basic lifestyle diary (noting sleep, medication, food, environmental changes). Well-documented history is basically gold for a provider and his/her decision-making tree. Also, I wanted to give you a sense of the scope of how gathering a differential for something like this is very, very multi-valient and likely not well-suited to much more than speculation on the internet (not that I don't understand your impulse to speculate about it).
posted by rumposinc at 3:49 PM on August 20, 2012 [4 favorites]

All of what rumposinc said, and an anecdote: I also have olfactory hallucinations which are auras for migraines. My auras manifest is lots of weird ways, including Alice in Wonderland Syndrome, olfactory hallucinations, and vertigo. They also don't always resolve into full on migraines ... just a possibility.
posted by mrfuga0 at 3:54 PM on August 20, 2012

A long shot here, but could the smell be coming from somewhere else? I lived in a house that, when the weather was damp or humid, smelled like cigar smoke. (Formerly owned by a smoker, but the whole place had been painted, and we only smelled it when the climate was right.) Are you in an apartment or situation where there might be an air vent or intake pulling in air that could be scented somehow? Just a thought.
posted by LaBellaStella at 4:43 PM on August 20, 2012

Are you in an apartment or situation where there might be an air vent or intake pulling in air that could be scented somehow?

Nope, we live in a single family detached home; the bedroom window (which, it's true, is always open no matter the season for fresh air reasons) is exposed to our big back yard.

A few nights ago I was having an anxiety dream about cooking spaghetti for a huge crowd of people. I woke up at some point and the smell of marinara sauce was very strong -- almost mouth-wateringly so. For the few seconds after I woke up, I had this panicked instinct to run to the kitchen and turn the stove off. When I realized it was a dream, I sniffed a few times, and then realized that I'd dreamt the smell as well.

That's a possibility...I dimly recall perhaps dreaming about a meal with the curry smell.

I think I saw something on some medical mysteries-type show on TV a while back where some woman was epileptic, but didn't figure it out for years because her seizures only manifested themselves as unusually strong smells.

!!! I do actually have a blood relative who was diagnosed with epilepsy in her early 30s.

Thanks for the answers, everyone; I think I will make an appointment with the doc and bring in the list that rumposinc so kindly and helpfully provided. If there's a conclusive answer I'll update!
posted by Secret Sockdentity at 5:02 PM on August 20, 2012

you might want to call the emergency room and ask to talk to a nurse...strange smells (oddly, most often oranges or toast) is one of the few early signs of stroke...and the first couple may not kill you, but...history of migrane, epilepsy in family? yeah, get that checked out asap.
posted by sexyrobot at 10:42 PM on August 20, 2012

Please don't call the ER and ask to talk to a nurse. A nurse really ought not give medical advice over the phone as a de facto representative of the hospital that employs her/him to some random stranger who happens to call during their shift with a question. Think about the liability involved in giving bad advice! Telephone triage is a tricky piece of business for all licensed medical providers, honestly, and unless your job description says something very specific about telephone advice, it's a bad idea to offer it.

If it's a medical emergency, show up at an ER and be seen by the ER team. If it's not an emergency, don't bug the ER staff.
posted by jesourie at 11:36 PM on August 20, 2012

(Sorry for the derail. Professional pet peeve got the better of me.)
posted by jesourie at 11:37 PM on August 20, 2012

FWIW, I am one of those women that get the heightened sense of smell with pregnancy (in all cases before I suspected I was pregnant/late) and the scents were extremely intense.
posted by saucysault at 12:14 AM on August 21, 2012

Just as I'm falling asleep almost every night I smell something for a split second; rosemary, basil, cinnamon; usually a spice. No major health issues, my doctor wasn't concerned. 60 year old male.
posted by jara1953 at 7:37 AM on August 21, 2012

Migraines do raise the risk of stroke.

Not all hospitals are equal in treating strokes. You should see a neurologist or go to a hospital that is "Stroke Certified". For example, in Spokane, Sacred Heart is where you would go if you were having a stroke. Ambulance services would know the best hospital in your area to treat stroke.
posted by cda at 9:55 AM on August 21, 2012

I woke up one night with the powerful aroma of horses - in my bedroom on the top floor of a downtown apartment building. Another time it was fresh-cut hay/alfalfa. Once it was a skunk, so strong it made my eyes burn. And a couple of times I've awakened to the smell of a pipe - the same cherry tobacco that my father used to smoke. The burned toast smell, though, is for real - all old people burn the toast from time to time.

I think you should have an examination by a good neurologist, just to rule out any medical cause for these peculiar olfactory delights you're experiencing, but don't be too uneasy or worried - I'm 66 and have never experienced this type of thing before, but it hasn't become more frequent or severe over the last year or so and I haven't noticed any other strange manifestations, so I'm just accepting it as another weird part of getting old. You, however, are not getting old (just pregnant, hopefully), so yes, get an exam. But not, please, over the phone by an ER nurse - she's busy.

Good luck, dear.
posted by aryma at 12:44 AM on August 22, 2012 [1 favorite]

My apologies for the long lack of update.

So after seeing my doctor, it seems that this is most likely linked to my tendency to migraines, and is likely an example of migraine aura without head pain. In an odd coincidence, my doctor said she suffers from similar symptoms and so does one of her (female) colleagues in her shared practice. Two of my (female) friends have also reported similar symptoms and they also suffer from migraines.

I have not experienced any night-time phantom odours since posting this question!
posted by Secret Sockdentity at 2:54 PM on November 4, 2012 [1 favorite]