Sleep Paralysis

What is sleep paralysis?

Sleep paralysis takes place when a person moves between the stages of sleep, either upon falling asleep or waking up, with the feeling of being awake and conscious, but is unable to move or speak. What frightens most people about this condition is they are fully aware because they are awake and unable to move or speak.

In addition to this paralysis, some people experience hallucinations or believe there is another person in the room with them. After an episode, which usually lasts from a few seconds to a few minutes, the paralysis typically disappears on its own. Recurrent episodes of sleep paralysis are referred to as parasomnia.

When you fall asleep you experience “atonia,” which is when your brain tells your muscles to be still and relax as you sleep. Sleep paralysis occurs after atonia sets in, and sufferers wake up while still in this state.

People typically first experience this condition in their teens; however, sleep paralysis occurs most often during the ages of 20–40. Men and women of any age can experience sleep paralysis at some point in their lives. Research has shown that sleep paralysis affects many cultures and groups.

Sleep paralysis has been experienced by approximately 8% of people who have no sleep dysfunctions or psychological conditions. Around 28% experience sleep paralysis if they typically have disruptions within their sleep patterns, and around 34% experience the condition if they suffer from psychiatric conditions such as anxiety and depression.

In order to address the issue of sleep paralysis, it is important to know the causes of this condition.

Symptoms of sleep paralysis

It’s possible you are suffering from sleep paralysis if upon waking or falling asleep you cannot speak or move for a few seconds to a few minutes. This is not severe and typically there is no need to seek medical treatment at this stage. However, if episodes of sleep paralysis cause anxiety, insomnia, or a disruption in sleeping patterns, it may be a good idea to consult a doctor. Disruption of sleep due to sleep paralysis can cause additional episodes.

Some symptoms of sleep paralysis include:

  • Inability to move upon waking or while falling asleep
  • Inability to speak upon waking or while falling asleep
  • A feeling of fear; this feeling could be strong enough to cause a person to struggle to move their limbs.
  • Experiencing a choking feeling
  • Pressure on the chest or difficulty breathing
  • Lying on the back, which is when most sleep paralysis occurs
  • Experiencing visual hallucinations, such as seeing another person in the room
  • Experiencing audio hallucinations, such as footsteps or other noises
  • Experiencing a waking consciousness

When a patient repeatedly suffers from these symptoms, a doctor may refer them to a sleep specialist for evaluation and possibly conduct sleep studies to determine what is causing the episodes of sleep paralysis.

Most people do not need treatment for sleep paralysis but may need to address any underlying conditions, such as stress or disruption in sleep patterns, to resolve the problem. There are several treatment options available to alleviate sleep paralysis.

Causes of sleep paralysis

There are several conditions which can contribute to sleep paralysis. Historical accounts of sleep paralysis from many different cultures have been attributed to an evil presence, such as demons or wicked monsters that come to humans during the night to terrify and frighten them. Today, thanks to scientific research, we know that sleep paralysis is likely due to factors other than the supernatural.

While conditions such as traumatic life events, depression and anxiety could be causes for sleep paralysis, it’s possible that disrupted sleep due to these conditions is what is actually causing the problem.

Sleep disruption is a big factor in people who experience sleep paralysis. In a 2002 study, researchers performed tests to purposely interrupt the sleeping patterns of volunteers by disrupting their REM sleep. Sleep paralysis was induced in volunteers eight times resulting from 184 sleep disruptions.

Sleep disruptions could stem from sleeping on the back, starting shift work, drinking caffeine in the evening, and consuming drugs and/or alcohol.

Traumatic life events, such as Post-Traumatic Stress Disorder (PTSD) and panic disorder can also cause sleep paralysis, according to a 2005 study. The study also found that the more severe the PTSD, the more frequent incidents of sleep paralysis occurred.

Anxiety disorders are also cited as a cause for sleep paralysis. Approximately 20% of patients diagnosed with anxiety disorder suffered from this condition; medication for anxiety disorder was ruled out as the cause. It is believed that severe anxiety causes sleep disturbance, which in turn contributes to sleep paralysis. Various psychological disorders such as depression, bipolar disorder and social anxiety also contributed to a rise in sleep paralysis. Approximately 31% of those with anxiety disorders experience this condition.

Sleep paralysis can also be genetic in nature. Those who have relatives that suffer from sleep paralysis have a higher incidence of suffering from the condition themselves.

Other factors that can cause sleep paralysis are:

  • Narcolepsy
  • Leg cramps while sleeping
  • Medications, such as those prescribed for ADHD
  • Sleep apnea

While we are asleep we experience rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep. NREM sleep comes first and takes up about 75% of our total sleeping time. NREM sleep occurs during the time when the body restores itself and we are in a relaxed state. REM sleep is usually when dreams occur and muscles are “turned off” by the brain. Sleep paralysis is experienced when we wake up during the REM stage of sleep, thus producing the feeling of being paralyzed.

While sleep paralysis is not dangerous, it is frightening to those that experience this condition. However, it’s important to know and understand the symptoms of sleep paralysis in order to address the issue.

Treatment of sleep paralysis

Treatment of sleep paralysis will involve treating the underlying conditions that are causing the paralysis in the first place. In most cases, medical attention is not necessary; however, if sleep paralysis is causing people to lose large amounts of sleep, a doctor’s visit may be necessary.

The doctor will want to discuss medical history and check to see if there is any family history of sleep disorders. They may ask the patient to keep a sleep diary for a few weeks and examine the results. The doctor will also need to know when sleep paralysis began and how long it’s been happening. Also, they will need to know if any medication is involved.

The doctor could refer the patient to a sleep specialist to conduct a sleep study, called a polysomnogram. This test charts your breathing, heartbeat, brainwaves, and body movement while you are sleeping.

The doctor could also prescribe a short-term course of antidepressant medication to help a person return to regular sleeping patterns. Antidepressants can also be very helpful in treating stress and anxiety problems if the sufferer’s symptoms are severe enough for medication.

In most cases, treatment of sleep paralysis can begin at home if it isn’t caused by a serious disorder such as narcolepsy. Narcolepsy is a dangerous condition and, if found to be the cause of sleep paralysis, needs to be addressed immediately. The first line of treatment is an improvement of sleep habits. A typical person needs six to eight hours of sleep in order to have enough sleep. Adopting a sleep pattern of going to bed and waking up at the same time can be very helpful in avoiding sleep disruption.

Also, avoiding caffeine and bright screens (such as a computer, smartphone or TV screen) before going to bed can help in getting a solid night’s rest. If shift work is involved, getting into a regular sleep pattern during the day is essential.

Medications, such as those prescribed for ADHD, could be a contributing factor in sleep paralysis. A doctor will need to be consulted to adjust or change the medication in question.

There are also strategies people can use to cope with an attack of sleep paralysis when it occurs:

  • Some people will struggle to move their limbs until they come out of sleep paralysis
  • Some people disassociate from the attack, perceiving themselves in the third person
  • Staying calm and understanding what is happening is a good strategy for not getting stressed or anxious during sleep paralysis
  • Alerting a partner upon experiencing sleep paralysis
  • Holding their breath or in contrast, breathing heavily
  • Making noise until the paralysis is broken

It’s important to remember that sleep paralysis is a fairly common condition and is not an indication of a severe disorder or illness. Sleep paralysis isn’t a dangerous condition, even if it happens fairly regularly. However, if people are experiencing exhaustion due to sleep paralysis episodes, it’s important to seek medical attention before the lack of sleep starts to cause health issues.

While there is no specific treatment for sleep paralysis itself, there are treatments for the underlying causes. However, there are many steps people can take to prevent episodes of sleep paralysis.

Prevention of sleep paralysis

Sleep paralysis is not a serious condition in and of itself and rarely requires medical treatment. In most cases, sleep paralysis can be prevented at home with a few lifestyle adjustments. In cases where sleep paralysis is disrupting people’s daily routines due to lack of sleep, medication could be administered to prevent further episodes.

Correcting disrupted sleeping patterns is important to preventing episodes of sleep paralysis. This can happen through a more regular sleep cycle of six to eight hours per night of sound sleep. Any bright lights such as through the television or computer should be removed from the bedroom.

Avoiding alcohol, nicotine, and drugs at night goes a long way to preventing episodes of sleep paralysis, particularly in the hours leading up to bed time.

If people have a biological propensity, such as a family history, to sleep paralysis, then it’s essential that taking steps to ensure a good night’s sleep is a priority.

If sleep paralysis is persistent, seeking medical attention could help. A doctor may prescribe a course of antidepressant medication such as clomipramine to prevent further episodes.

Keeping a handle on stress is also essential in preventing sleep analysis.

There are many steps you can take to reduce stress, such as:

  • Meditation
  • Talking about stress with your family or social circle
  • Exercise
  • Breathing exercises

Recognizing disruptions in sleep patterns can help to prevent any negative consequences that may result. Sleep deprivation can impact overall health, and taking steps to sleep better and longer at night, with minimal disruption, will go a long way in preventing conditions such as sleep paralysis.