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 usually lasts no longer than a few minutes, and many others encounter the same phenomenon.

Sleep paralysis is often linked to 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 is a brief inability to move or speak while you’re falling asleep or waking up. It’s classified as a parasomnia, and it often comes with fear, a feeling of pressure on the chest, or hallucinations. During REM sleep, your muscles are normally relaxed to the point of temporary paralysis (called atonia). In sleep paralysis, that atonia carries over for a moment after your mind becomes aware1Verified Source American Academy of Sleep Medicine (SleepEducation.org)The professional society for sleep medicine physicians and researchers in the U.S.View source.

That muscle atonia is a normal part of REM sleep. Sleep paralysis happens when it overlaps with wakefulness. It can occur in otherwise healthy people, and it’s also a common symptom of narcolepsy2Verified Source Cleveland ClinicA nonprofit academic medical center known for patient care, research and medical education.View source.

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.

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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 when your body is unable to move can be frightening, and many people also experience hallucinations.

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 that sleep paralysis is temporary and usually lasts no more than a few minutes2Verified Source Cleveland ClinicA nonprofit academic medical center known for patient care, research and medical education.View source.

Who’s at Risk

About 7.6% of people in the general population have had at least one episode of sleep paralysis, along with about 28% of students and 32% of psychiatric patients3Verified Source Sleep Medicine Reviews (Elsevier)A peer-reviewed journal of reviews in sleep medicine.View source. It can start at any age and can run in families. It’s also linked to stress, trauma, poor sleep, and some sleep and mental health conditions4Verified Source Sleep Medicine Reviews (Elsevier)A peer-reviewed journal of reviews in sleep medicine.View source.

Traumatic Life Events

Research reviews have found sleep paralysis is particularly common in people with post-traumatic stress disorder (PTSD)4Verified Source Sleep Medicine Reviews (Elsevier)A peer-reviewed journal of reviews in sleep medicine.View source.

In one study of 100 Cambodian refugees at a psychiatric clinic, 49% had at least one episode of sleep paralysis in the previous 12 months, and episodes were much more common in those with PTSD5Verified Source Depression and Anxiety (Wiley)A peer-reviewed psychiatry journal.View source.

Psychological Disorders

A review of 35 studies found that 34.6% of people with panic disorder reported having had sleep paralysis3Verified Source Sleep Medicine Reviews (Elsevier)A peer-reviewed journal of reviews in sleep medicine.View source.

Researchers have also linked the “sensed presence” some people feel during sleep paralysis with social anxiety6Verified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source.

Some researchers have theorized that people with social anxiety may be more likely to experience a threatening presence during sleep paralysis, and that these images may relate to past experiences, but more research is needed.

In a U.S. community sample, researchers7Verified Source National Library of Medicine (NIH)World’s largest medical library, making biomedical data and information more accessible.View source found that depression was associated with sleep paralysis, and that link wasn’t explained by anxiety. This suggests depression may be a separate risk factor.

Sleep Paralysis Symptoms

Shelley Adler’s book Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection describes a collection of common features. Not everyone experiences all of them during an episode.

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 comes from the muscle atonia of REM sleep, which normally keeps you from acting out your dreams.

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.

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 person is lying on their back8Verified Source Journal of Sleep Research (Wiley)The peer-reviewed journal of the European Sleep Research Society.View source. Researchers don’t know why back sleeping is linked to more episodes.

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

Keep a regular sleep schedule. An irregular schedule or shift work is linked to sleep paralysis, so try to go to bed and wake up at the same times each day2Verified Source Cleveland ClinicA nonprofit academic medical center known for patient care, research and medical education.View source.

Get enough sleep. A lack of sleep can make you more likely to have sleep paralysis1Verified Source American Academy of Sleep Medicine (SleepEducation.org)The professional society for sleep medicine physicians and researchers in the U.S.View source. Most adults need 7 or more hours a night9Verified Source Centers for Disease Control and PreventionThe U.S. federal public health agency.View source.

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:

• Keeping your bedroom cool, around 60 to 67°F, can help you sleep better10Verified Source Cleveland ClinicA nonprofit academic medical center known for patient care, research and medical education.View source.

• Taking a warm bath raises your body temperature so it can drop afterward, mimicking the way body temperature decreases when you sleep. A review found that a warm bath or shower 1 to 2 hours before bed helped people fall asleep faster11Verified Source Sleep Medicine Reviews (Elsevier)A peer-reviewed journal of review articles on sleep science and sleep medicine.View source. 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.

Try sleeping on your side. Research has linked sleeping on your back to more episodes of sleep paralysis8Verified Source Journal of Sleep Research (Wiley)The peer-reviewed journal of the European Sleep Research Society.View source. Side sleeping can also help keep the airway open for people with sleep apnea12Verified Source National Heart, Lung, and Blood Institute (NIH)Part of the National Institutes of Health, focused on heart, lung, blood, and sleep disorders.View source. 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 happen often, or you’re very sleepy during the day, see a sleep specialist. Excessive daytime sleepiness with sleep paralysis can be a sign of narcolepsy13Verified Source National Institute of Neurological Disorders and Stroke (NIH)Part of the National Institutes of Health, focused on brain and nervous system disorders.View source. 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, shift work, and an inconsistent sleep schedule are linked to sleep paralysis. It’s most common in teens and young adults, and it can also be linked to conditions like narcolepsy, anxiety, PTSD, and sleep apnea.

Why is sleep paralysis so scary?

Sleep paralysis is especially alarming because it immobilizes you, and if you’ve never experienced it before, the feeling of being unable to move is particularly scary. Plus, many people hallucinate or see “figures” during 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?

Sleep paralysis usually ends on its own within a few seconds to a couple of minutes, so there’s usually no need to try to wake someone from it. It’s different from a night terror, where the person isn’t aware of what’s happening and trying to wake them can make things worse.

How long does sleep paralysis last?

This will vary from person to person and episode to episode, but sleep paralysis usually lasts from a few seconds to a couple of minutes. These episodes often feel longer because they’re so frightening.

Is sleep paralysis life-threatening?

While sleep paralysis is certainly scary, it isn’t dangerous on its own. However, frequent episodes can disrupt your sleep, and ongoing sleep loss can affect your health and how you function during the day. If sleep paralysis happens often or you’re very sleepy during the day, talk with your doctor.

Conclusion

Some people may experience an episode of sleep paralysis once in their lifetime. One incident isn’t a cause for worry. Getting enough sleep and practicing good sleep hygiene may reduce episodes. If they happen often, a physician can look for an underlying cause and get you the treatment you need.

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