What is sleep paralysis?

What is sleep paralysis? | What does sleep paralysis feel like? | Risk factors | Causes | Diagnosis | Treatment

If you’ve ever experienced sleep paralysis or heard stories about it, you might be curious about why and how it happens. It may be a rare occurrence for many people. For others, the experience can be recurring, causing anxiety about future episodes. Still, being aware of sleep paralysis may help you cope and explore it as a life experience. 

Sleep paralysis is a frightening yet fascinating phenomenon that affects many people worldwide. It occurs during the transitions between wakefulness and sleep, leaving a person conscious but unable to move or speak. Episodes, which may happen with hallucinations and feelings of suffocation, typically last no more than a few minutes. Continue reading to learn more about this phenomenon and potential prevention methods.

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What is sleep paralysis?

Sleep paralysis is a phenomenon where an individual temporarily loses the ability to move or speak when falling asleep or waking up. This condition typically occurs during the transition to or from rapid eye movement (REM) sleep when the brain and body are not perfectly in sync. People experiencing sleep paralysis remain conscious while their body remains in a state of atonia, rendering them unable to move.

The main symptoms of sleep paralysis may include hallucinations, a sense of suffocation, and intense fear. These episodes usually occur either when someone is falling asleep or waking up and can last anywhere from a few seconds to several minutes. Sleep paralysis is considered parasomnia, a sleep disorder that disrupts the normal sleep cycle.

Although sleep paralysis can affect people of all ages, it usually starts to show in young adults and teenagers. The condition has been associated with other sleep disorders, such as narcolepsy, a chronic neurological disorder affecting the brain’s ability to control the sleep-wake cycle. In many cases, occasional sleep paralysis may not be related to any other medical conditions.

What does sleep paralysis feel like?

During an episode of sleep paralysis, you might be aware of your surroundings but unable to move your body, speak, or open your eyes. This state can be quite distressing and often come with feelings of dread.

Two types of hallucinations may occur with sleep paralysis: hypnagogic, which occurs during the process of falling asleep, and hypnopompic, which takes place while waking up. Both types can involve hallucinations that may intensify feelings of fear and vulnerability. Some common hallucinations experienced during episodes of sleep paralysis include:

• Seeing shadowy figures
• Sensing an evil presence in the room
• Hearing strange noises or voices
• Feeling touched or physically restrained

The experience of sleep paralysis typically lasts for several seconds up to a few minutes. Even though it may seem much longer due to intense fear and helplessness, sleep paralysis is generally brief. As distressing as these episodes can be, sleep paralysis is a common and harmless phenomenon that can affect people from all walks of life at some point.

What are the risk factors for sleep paralysis?

Sleep paralysis is a relatively common experience. Around 8% of the general population and up to 32% of people with mental health disorders are believed to experience sleep paralysis. Several factors may increase a person’s risk of sleep paralysis.

One key risk factor for sleep paralysis is a family history of the condition. Individuals with a parent or sibling who has experienced sleep paralysis are more likely to experience it themselves. Other factors related to sleep habits may also increase the likelihood of sleep paralysis, such as daytime sleepiness, lack of sleep, or sleep deprivation. Sporadic sleeping patterns and poor sleep habits may disrupt the sleep cycle and make a person more susceptible to sleep paralysis episodes.

Certain health conditions and mental health disorders can also increase the risk of experiencing sleep paralysis. For example, individuals with anxiety disorders, panic disorder, or post-traumatic stress disorder might have a higher chance of experiencing sleep paralysis due to increased stress levels or irregular sleep patterns. In addition, people with obstructive sleep apnea, a condition that causes breathing disturbances during sleep, may also be at a higher risk of sleep paralysis. 

What causes sleep paralysis?

Sleep paralysis occurs when a person experiences a brief loss of muscle control, known as atonia, during the transition between sleep and wakefulness. This phenomenon typically happens as people are either falling into or coming out of REM sleep. During this stage, the brain prevents the muscles in the limbs from moving, which protects the person from acting out their dreams and potentially injuring themselves.

The main cause of sleep paralysis is believed to involve the sleep cycle, particularly the transitions between REM and NREM (non-rapid eye movement) sleep. This problem could be caused by sleep schedule changes, stress, sleep deprivation, or other underlying sleep disorders. When the transition process is not working as it should, a person’s consciousness may be awake, but their body remains in a paralyzed state.

Although the exact way sleep paralysis occurs is still unclear, some studies suggest that certain factors may increase the likelihood of experiencing episodes. As mentioned above, a family history of sleep paralysis, other sleep disorders like narcolepsy and insomnia, emotional stress and anxiety, or other factors may cause an increased risk of sleep paralysis.

How is sleep paralysis diagnosed?

Diagnosing sleep paralysis involves a thorough exam by a healthcare provider, who may ask about your sleep habits, medical history, and any related symptoms. There is no specific sleep study or test for sleep paralysis, but some tests can help rule out other sleep problems or conditions.

To diagnose sleep paralysis, a healthcare provider may also ask about possible symptoms of narcolepsy, as sleep paralysis is often linked to this sleep disorder. Key signs and symptoms of narcolepsy may include excessive daytime sleepiness, cataplexy (a sudden loss of muscle tone often triggered by emotions), and a history of vivid, dream-like hallucinations.

Sleep paralysis can occur without being related to a medical problem, referred to as isolated sleep paralysis. However, if sleep paralysis is found to be linked to narcolepsy, a healthcare provider could help find the right treatment and management.

In some cases, a mental health clinician or psychiatrist may be involved, especially if you’re managing stress, anxiety, or other psychological factors in addition to sleep paralysis. A healthcare professional might review your sleep experiences and symptoms to see if they overlap with other conditions. As everyone’s experience and situation may be different, a healthcare professional will look at each case individually. 

Diagnostic criteria for sleep paralysis may include:

• Episodes of being unable to move or speak while falling asleep, waking up, or during brief awakenings
• Conscious awareness during these episodes
• Duration of episodes typically less than a few minutes
• No alternative explanation for the episodes, such as a medical condition or medication side effect
• Recurrent episodes or a pattern of sleep paralysis experiences

Diagnosing sleep paralysis often requires an analysis of your sleep problems, especially any particular symptoms and potential links to other conditions. After a proper diagnosis, a healthcare provider can provide the appropriate treatment and support if you’re experiencing sleep paralysis.

Sleep paralysis treatment

Treating sleep paralysis involves a combination of lifestyle modifications, behavioral therapy, and possibly medication. It may be helpful to work with your healthcare provider to find the most appropriate course of action for your situation.

You may be recommended lifestyle modifications to help prevent future episodes of sleep paralysis. Some key lifestyle changes may include:

• Maintaining a consistent sleep schedule, which helps regulate the body’s sleep-wake cycles
• Getting an adequate amount of sleep each night, as sleep deprivation can worsen symptoms
• Creating a relaxing sleep environment, free from distractions and noise
• Limiting exposure to screens, caffeine, and other stimulants close to bedtime
• Using relaxation techniques, such as meditation or deep breathing exercises, to reduce stress levels

In addition to lifestyle changes, some people may benefit from behavioral therapies, such as cognitive behavioral therapy (CBT). This therapy focuses on identifying and changing negative thought patterns that may be causing sleep disturbances. CBT may be particularly helpful in treating the anxiety or stress surrounding sleep paralysis.

For recurrent isolated sleep paralysis, a healthcare provider might consider prescribing medication, such as antidepressants. These medications may help regulate sleep cycles and reduce the occurrence of sleep paralysis episodes. 

Everyone’s needs and circumstances vary, so discussing medication options and potential side effects with a healthcare provider can be a good idea. Ultimately, treatment aims to improve overall sleep quality and reduce any complications caused by sleep paralysis.

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The bottom line

Sleep paralysis can be a scary but harmless event that happens when you’re falling asleep or waking up. During this time, you’re aware of what’s going on but can’t move or speak. Sometimes, you might also see things that aren’t there or feel like you can’t breathe. Although it may seem like these episodes last forever, the experience usually only lasts from a few seconds to several minutes. 

People with family members with sleep paralysis or who don’t have regular sleep habits might experience it more often. Being aware of sleep paralysis may help you cope with the experience better if it happens. If you’re struggling with sleep paralysis, try keeping a regular sleep schedule and ensuring you get enough sleep. If you still have problems, talking to a healthcare provider or healthcare provider may help. They might suggest some strategies or medications to help reduce how often you experience sleep paralysis.