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

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.

But What Is Sleep Paralysis?

Sleep paralysis, or sleep atonia, is a term used to describe a sleep disorder in the class known as parasomnia disorders. It is an episodic event that happens during your sleep cycle that typically involves temporary paralysis and/or difficulty breathing, hallucinations, and feelings of fear. Atonia literally means loss of muscle movement; however, in the case of sleep paralysis, you haven’t lost muscle movement; rather the mechanics of your sleep cycle temporarily stops the muscle movement from happening.

Sleep paralysis is a normal part of REM sleep. However, it is considered to be a disorder when it occurs outside of REM sleep. It can occur in otherwise healthy people, as well as in those presenting symptoms of narcolepsy, cataplexy, and hypnagogic hallucinations.

Interesting Fact: REM sleep is the stage of sleep that increases in duration throughout the night and, therefore, dominates the second half of a person’s nighttime sleep cycle. It is characterized by rapid eye movement and dreaming. The body’s heart rate increases and breathing becomes short and shallow. Brainstem neurons communicate differently with the body during the REM sleep stage which reduces body movement, preventing you from acting out your dreams.

What Sleep Paralysis Feels Like

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

During sleep paralysis episodes, you cannot speak or move, as your body is in a physiological state that prohibits movement even though your mind is awake. Being aware or awake when your body is unable to move can naturally cause you to hyperventilate and hallucinate.

Sleepers who experience these episodes can hear sounds or smell odors. Oftentimes, these hallucinations have a sinister context, such as approaching footsteps or smell odors akin to something decomposing.

If you find yourself in one of these episodes, remember, sleep paralysis is temporary and lasts no more than a few minutes.

Who’s at Risk

About 8-10% of the population experiences sleep paralysis. Most cases appear during your teen years, although it can occur at any age. It can run in families and is not correlated with other health concerns. Sleep paralysis is also often triggered by stress and trauma.

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 showed a significant connection between traumatic life events and increased chance of sleep paralysis. The researchers reported that almost half of the refugees suffered at least one sleep paralysis attack within the prior 12 months. Similarly, people with clinically diagnosed PTSD had increased risk – almost four times more than people who do not have PTSD.

Psychological Disorders

Studies in the past few decades have shown that 20% of people with a diagnosed anxiety disorder experienced sleep paralysis. This is often thought to be due to increased levels of stress and sleep deprivation.

More specifically, people with social anxiety who also have sleep paralysis experience extreme distress levels, including anxiety, feelings of being observed, and fears of death in non-threatening situations.

Canadian researchers Sigmar and Nielsen looked deeper into the connection between social anxiety, sleep paralysis, and depression. They found sleep paralysis sufferers with sensed presence symptoms often also had high levels of social anxiety. The scientists have theorized that people with social anxiety generate threatening hallucinations of a harmful presence during sleep paralysis and these hallucinatory images may stem from past trauma.

Researchers in the U.S. Szklo-Coxe, Young, Finn, and Mignot found that depression is strongly associated with sleep disturbances and sleep paralysis. The study showed that sleep paralysis was not associated or caused by other possible factors, such as use of antidepressants, daytime sleepiness, and insomnia. This leads to the conclusion that depression is a separate risk factor from anxiety for sleep paralysis.

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 to meet the criteria.

Awareness or Sense of 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 can often erroneously 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 often 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 can help to prevent 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 a comfortable temperature (the average recommendation is 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. The timing of heat before bed is unique to each person so keep track of how well this works. Sleep expert, Dr. Colleen Ehrnstrom recommends experimenting with a warm bath or light exertion a few hours before bedtime for optimal support for falling asleep.

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

• Drinking a warm cup of tea or milk can be a calming bedtime ritual that induces better sleep. Limit the intake of fluids so it doesn’t increase waking up to use the bathroom.

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. Dr. Ehrnstrom notes, “It can be helpful to tape a tennis ball to your nightclothes to help train your body to sleep on your side.”

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 an inconsistent 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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