The 42-year-old Indian woman was in deep slumber last Tuesday night until she awoke around midnight to a "tingling, crawling sensation" in her right nostril.
At first, the woman, a domestic worker named Selvi, brushed off the feeling, assuming she might be catching a cold, the Times of India reported. But she soon felt something move.
She spent the rest of the night in discomfort, waiting for the sun to rise so she could go to the hospital.
"I could not explain the feeling but I was sure it was some insect," she told the New Indian Express. "Whenever it moved, it gave me a burning sensation in my eyes."
As dawn arrived, and with her son-in-law in tow, the woman visited the clinic closest to her home in Injambakkam, in the south Indian state of Tamil Nadu.
She was soon referred to a second hospital, where doctors suspected she might be suffering from a nasal growth. At a third hospital, doctors recommended a scan, and told her the discomfort may be coming from "a foreign body that seemed to be mobile," the Times of India reported.
Finally, in her fourth doctor visit - at Stanley Medical College Hospital - doctors used an endoscope to find the culprit: a blob with a pair of antennae.
"It was a full-grown cockroach," M N Shankar, the head of the ear, nose and throat department, told the Times of India. "It was alive. And it didn't seem to want to come out."
The insect was sitting in the woman's skull base, between the eyes and close to the brain, Shankar said.
Doctors tried to use a suction device to remove the cockroach, but the insect clung to the tissues. After a 45-minute process, using suction and forceps, doctors were able to extract the bug, still alive.
Because of the critter's location, doctors had to first drag it to a place from which it could be extracted. It had been lodged inside for about 12 hours, the Times of India reported.
Doctors placed the insect in a container, its wings spread and its legs moving rapidly.
"If left inside, it would have died before long and the patient would have developed infection, which would have spread to the brain," Shankar added.
Shankar said this was the "first such case" he has seen in his three decades of practice, the New India Express reported. In the past, the hospital's ENT department has removed a leach, houseflies and maggots from patients' nasal cavities.
"But not a cockroach, said Dr S Muthuchitra, "especially not one this large."
This is by no means the first time a cockroach has crawled and nestled into a human body. A 1994 story in the Washington Post described a similar local case involving a 2.5cm cockroach that crawled into a George Washington University graduate student's ear.
Shannelle Armstrong woke up screaming before dawn with a piercing pain in her left ear. She was taken by ambulance to the emergency room, where doctors flushed out the live cockroach.
One ear specialist quoted in the story said hospital doctors are sometimes called upon to remove different kinds of bugs from patients' ears, especially in the summer. In urban areas, he said, roaches are the most common.
The graduate student's medical report added the following advice: "Consider sleeping with hat on."