Some nightmares are more real than others. Take zombies, for example. Being afraid of zombies isn’t that big a deal because we all know zombies aren’t real. On the other hand, creepy crawlies — including those who have no respect for personal space — are indeed real.

Given the recent reports of a live cockroach pulled from an Indian woman’s skull, it seems like we should be afraid. Very afraid.

First, though, let’s separate the facts from the myths. The cockroach was pulled from the woman’s nasal cavity — not her brain — after entering while she slept. In a video that made the rounds online, the roach can be seen forging its way through the woman’s flesh. Eventually, it’s extracted from her sinuses.

This video is (probably) real. It was filmed by the doctor who performed the extraction at Stanley Medical College Hospital in Chennai, India.

Nightmarish? Yes. But could this actually happen to you? Let’s find out.

Some Bugs Have No Respect For Boundaries

Cockroaches are among the most commonly reported bodily “invaders.” Over a two-year period, a hospital in South Africa recorded 24 cases of insects crawling into people’s ears. Ten were cockroaches, eight were flies, and three were beetles. A single tick, assassin bug, and moth also managed visits to the inner ear.

Back in 1985, the New England Journal of Medicine reported a case in which a man visited an emergency room with a roach in not one, but two ears. According to Coby Schal, an entomologist at North Carolina State University, it’s not “uncommon” for roaches to penetrate the ear. Noses, though, are apparently rarer.

What attracts roaches to ears? The age-old search for food. Apparently, roaches are attracted to the fatty acids found in ear wax. When they start to forage, they end up sticky and stuck. You should be sufficiently grossed out by now.

Remember, Bugs Are Not Parasites

There is, of course, an important distinction to be made between critters that want to make their home inside your body, and those that just want to visit.

Roaches, in particular, aren’t interested in hanging around when you’re awake. That’s why the vast majority of invasions take place when the victim is fast asleep.

And if you’re picturing a giant cockroach à la Mimic, the 1997 science fiction-horror flick, you can scale down your nightmare. Most ear-invading roaches aren’t large. The roach in the Indian video may have seemed hefty, but it was most likely an adolescent.

Are You Freaked Out Yet?

As it turns out, having a roach burrow into your nose or ear isn’t the grossest thing that can happen to you. Other creepy crawlies are more creative. They’ll enter any orifice they can find — including the urethra, vagina, rectum, and sometimes, the eye sockets.

Among the creatures that have turned up in endoscopies? Flies, ants, yellow jackets, ladybugs, and wasps. That’s gotta sting.

But Seriously, Don’t Worry About It

The good news is that even if an insect does crawl into your body, an infection is the worst that can happen. In very rare cases, sinus infections spread to the brain.

Turns out, roaches are not as dirty as we like to think. But exercise caution when trying to extract a roach — if you crush it, you might release the contents of its gut, including bacteria that can trigger an infection.

In most corners of the world, the likelihood that you’ll wake up with a bug inside your body is low. Instances are more common in tropical regions, where home infestations are more common.

Finally, don’t believe every disgusting bug video you see online. A lot of videos — especially those featuring spiders burrowing into skin — are fake. The best thing you can do to prevent bugs from crawling into your body is to prevent them from crawling into your home in the first place. Keep your food stored in airtight containers, and don’t eat in bed.

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