What is Sleep Paralysis?

If you suffer from sleep paralysis, then you’re probably familiar with hearing or seeing things that aren’t there while you sleep, or worse, feeling like you can’t move or run away from your own imagination. Don’t worry—what you’re experiencing lasts no longer than a few minutes, and many others encounter the same phenomenon. Sleep paralysis is often caused by stress or sleep deprivation.

This article discusses what sleep paralysis is, what it feels like to undergo an episode, symptoms leading to a diagnosis, and who is at risk. We will also explore the causes of sleep paralysis and how to prevent the disorder.

What Is Sleep Paralysis?

Sleep paralysis, or sleep atonia, is a term used to describe a parasomnia disorder. The condition is accompanied by temporary paralysis and difficulty breathing, hypnopompic (upon awakening) hallucinations, and feelings of fear.

Interesting Fact: REM sleep is the last stage of sleep—characterized by rapid eye movement and dreaming. The body’s heart rate increases and breathing becomes short and shallow. Brainstem neurons don’t communicate with the body, which reduces body movement, preventing you from acting out your dreams.

All across the world, people experience sleep paralysis and have had wide-ranging theories about its causes and underlying meaning.

What Sleep Paralysis Feels Like

Sleep paralysis is experienced differently from person to person; however, its symptoms remain consistent for most people.

During sleep paralysis episodes, you cannot speak or move, as your body is in a state of relaxation but your mind is awake. Waking up before a completed REM cycle can cause you to hyperventilate and hallucinate.

Sleepers can hear haunting sounds such as approaching footsteps or smell odors akin to something decomposing.

If you find yourself in a sleep atonia attack, remember, sleep paralysis is temporary and lasts no more than a few minutes.

Who’s at Risk

About 8% of the population experiences sleep paralysis. Most cases appear in teenagers, although it can occur at any age even in those who are healthy. It can run in families. Sleep paralysis is also often triggered by sleep disturbances, psychological distress, or abnormal sleep cycles.

Traumatic Life Events

A medical paper discusses how panic disorders and post-traumatic stress disorder (PTSD) increase the risk of sleep paralysis due to higher physiological distress.

A study conducted with Cambodian refugees proved traumatic life events increase the chance of sleep paralysis. The researchers found 49 out of 100 refugees suffered at least one sleep paralysis attack within the prior 12 months. In comparison, people with clinically diagnosed PTSD had a 65 percent increase chance of a sleep paralysis attack compared to the 15% risk of those who did not have PTSD.

Mental Illness

In 2006, a research team discovered 20% of anxiety disorder patients experienced sleep paralysis due to stress and sleep deprivation.

In 2008, a study determined sleep paralysis and social anxiety sufferers experienced extreme distress levels, including anxiety, feelings of being observed, and fears of death in non-threatening situations—all of which are sleep paralysis-related symptoms.

Sigmar and Nielsen looked deeper into the connection between social anxiety, sleep paralysis, and depression. They found high levels of social anxiety in sleep paralysis sufferers with sensed presence symptoms. The scientists suggested people with social anxiety generate threatening hallucinations of a harmful presence during sleep paralysis. These hallucinatory images may stem from past trauma.

Researchers Szklo-Coxe, Young, Finn, and Mignot found depression is strongly associated with sleep disturbances and sleep paralysis. The removal of antidepressants, daytime sleepiness, and insomnia cemented depression as a sleep paralysis risk factor, separate from anxiety.

Sleep Paralysis Symptoms

Shelley Adler’s book Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection list a collection of symptoms. Someone doesn’t need to endure all of these symptoms to have a sleep paralysis episode—only three of them need to occur.

Being Awake

Most people feel consciously awake as they experience sleep paralysis. You are awake and aware of the area around your bed and distinctive elements, such as furniture and others in the room.

Inability to Move

Aside from realizing they’re awake, body paralysis is the first element noticed by the affected person. The paralysis stems from the body remaining in REM sleep when brainstem neurons don’t communicate with the body. Body immobility prevents them from acting out their dreams, which keeps them from sustaining injuries in their sleep.

During sleep atonia, sleepers often assume the state of paralysis is due to an outside force, either holding the sleeper down or sitting on them.

Overwhelming Fear and Dread

People can feel afraid during a sleep paralysis episode. The fear can stem from realizing they are immobile or another symptom of sleep atonia.

Sometimes these feelings are too intense, and people struggle to comprehend them. These feelings of fear may follow individuals into wakefulness and progress into a sense of foreboding connected to sleep.

Sense of Presence

Some people may sense or see a “presence” in the room with them. If seen, the presence can take the appearance of a shadowy human-like creature standing near the bedside or sitting on top of the sleeper.

Difficulty Breathing

Pressure on the chest is a common sensation associated with sleep paralysis. The sensation is due to the body adopting a shallow breathing pattern needed for REM sleep.

Many people report they experience difficulty breathing due to the “presence” in their bedroom sitting on their chest or restricting their airways.

Supine Position

Most episodes of sleep paralysis happen while the individual is lying on their back. We don’t know why lying on the back increases the risk of sleep paralysis, though.

Unusual Sensations

People commonly report hallucinations accompanied by auditory, olfactory, and physical symptoms.

Individuals said they heard the sound of doors opening and closing, animal growls, footsteps, scratching, beeping or buzzing, whisperings of malevolent intent. People can smell dampness, mold, and feel as though they are drifting, rolling, floating, and being moved. Other people report out-of-body experiences.

Prevention and Treatments

Skip nap time. Sleep specialist Clete Kushida, MD, Ph.D., says, “nappers seem more prone to sleep paralysis than non-nappers.”

Get as much sleep as possible. Sleep-deprived individuals have a higher sleep paralysis risk. Putting yourself on a sleep schedule prevents you from staying up too late and ensures you will get 7 to 9 hours of sleep.

Practice good sleep hygiene or sleep habits. Sometimes sleep disturbances are caused by a poor bedtime routine and sleep environment. Other times, you can improve your sleep quality by adding a few relaxing bedtime rituals:

• Adjusting your room temperature to 67 degrees improves your sleep quality.

• Taking a warm bath raises your body temperature so it can drop, mimicking the way body temperature decreases when you sleep.

• A clean bedroom can prevent distraction from sleep and help you maintain a calm mindset.

• Drinking a warm cup of tea or milk is a calming bedtime ritual that induces better sleep.

Don’t sleep on your back. Sleep experts found sleeping on your back can cause more instances of sleep paralysis. Besides, side sleeping opens the airways to reduce sleep apnea symptoms and reduces instances of sleep atonia.

Seek a physician’s help. Sleep paralysis is sometimes linked to other sleep disorders: sleep apnea, narcolepsy, insomnia, or sleep deprivation. If sleep paralysis episodes often occur, see a sleep specialist. If you’re dealing with high levels of anxiety, we suggest speaking with a psychiatrist about your worries.

Frequently Asked Questions

What triggers sleep paralysis?

Stress, sleep deprivation, jet lag, and a wonky sleep schedule can trigger sleep paralysis. Sleep paralysis does occur most commonly during adolescence, and if you’re somebody younger who experiences sleep paralysis, it may have more to do with puberty than with actual triggers. However, if you’re in your teens and older, there may be an underlying cause of sleep paralysis.

Why is sleep paralysis so scary?

Sleep paralysis is especially alarming because it immobilizes you, and if you’ve never experienced sleep paralysis before, the feeling of being unable to move is particularly scary. Plus, many hallucinate or see “figures” during sleep paralysis episodes—and unknown shadowy figures are bound to scare anybody. (Don’t worry, though, they’re not real!)

 Can someone wake you up during sleep paralysis?

Someone may be able to somewhat wake you, but it may not be enough to completely snap you out of the sleep paralysis episode. Many still experience temporary paralysis upon waking. While waking somebody from a night terror might seem like the right and helpful thing to do, doing so usually doesn’t help. In fact, it may make the sleep paralysis worse, causing further disorientation, confusion, and fear.

How long does sleep paralysis last?

This will vary from person-to-person and episode-to-episode, but sleep paralysis usually only lasts a couple of minutes. Some only experience sleep paralysis for a couple of seconds. However, these episodes usually seem longer in our heads because we are still partly unconscious and dreaming.

Is sleep paralysis life-threatening?

While sleep paralysis is certainly scary, it is not life-threatening. What’s more life-threatening is sleep deprivation, which can stem from disturbed sleep caused by these episodes. If sleep paralysis is impeding your nightly rest and causing chronic daytime fatigue, you should talk with your doctor about possible solutions for easing stress and getting better rest.

Conclusion

Some people may experience an episode of sleep paralysis once in their lifetime. One incident isn’t a cause for worry. Getting better sleep and practicing good sleep hygiene prevents the sleep disorder from recurring; however, if this condition happens often, a physician can diagnose the underlying cause and get you the treatment you need.

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