Written by Rachael Gilpin, Content Writer
What Is Sleep Paralysis?
Sleep paralysis is a widely mysterious but medically recognized condition that blurs the boundary between wakefulness and sleep. Sleep paralysis is classified as the temporary inability to move, typically occurring soon after falling asleep or waking up.
Individuals who struggle with these instances remain aware of what’s happening as they experience this “frozen” sensation. These accounts could be paired with disturbing hallucinations and even feelings of suffocation, making them considerably frightening.
While there remains an abundance to learn about the condition, understanding types, causes, symptoms, personal accounts, and prevention strategies could help you gain more insight into how to treat your issue.
Types of Sleep Paralysis
Hypnagogic Sleep Paralysis happens as you’re drifting off to sleep. Typically, individuals become less and less aware, eventually falling unconscious as they slip into the first non-REM stage of sleep. However, Hypnagogic Sleep Paralysis keeps your brain conscious while your body is in a paralytic state.
Hypnopompic Sleep Paralysis occurs when you’re waking up; your mind becomes awake before your muscles are “switched on” as you near the end of your REM sleep cycle.
Symptoms of Sleep Paralysis
Symptoms include brief loss of muscle control, called atonia1, and excessive daytime drowsiness. Additionally, an irregular circadian rhythm, anxiety, and PTSD2 appear to correlate with sleep paralysis.
Other symptoms may include:
- Conscious wakefulness while paralyzed
- Inability to speak
- Difficulty breathing
- Sense of doom or death
- Headaches or muscle pain
- Paranoia
- Sweating
- Chest pressure
- Hallucinations or a feeling of foreboding
If you are someone who has experienced any of these symptoms as a result of this condition, it’s normal to feel frightened. Fortunately, sleep paralysis episodes3 are largely temporary, typically lasting a few seconds to a few minutes. Understanding why and how this occurs, which we explain below, could be helpful in managing anxiety or fear when episodes strike.
Why Does Sleep Paralysis Occur?
Normal Sleep vs. Sleep Paralysis
A regular sleep cycle will include REM sleep and non-REM sleep. When you’re first drifting off, you experience non-REM, which consists of three stages. As you move through each phase, your breathing grows more rhythmic, and you’re less likely to wake up4 from disturbances.
After you’ve moved through the non-REM stages, you enter REM (rapid-eye movement) sleep, which is when dreams occur. According to Aneesa Das, MD, of Ohio State University Wexner Medical Center, a neurotransmitter called glycine releases into your body during the REM stage.
The glycine puts you into a temporary state of paralysis, including all of the skeletal muscles, leaving the smooth muscles including those critical for breathing, digestion, and other involuntary processes functioning. Interestingly, the eyes are also able to function, as some have been able to communicate with their eyes while experiencing sleep paralysis.
The Brain During Sleep Paralysis
According to Dr. Roth of Cleveland Health Clinic, Sleep Paralysis occurs when your brain moves through the stages of sleep but experiences a misstep when it transitions from one stage to the other, particularly between REM sleep and wakefulness.
REM sleep is particularly relevant to this condition because this is the stage where we dream and when our brains are most active. Brain activity during this stage is often significantly lively compared to previous stages and will appear almost as though you’re awake.
In this mentally active stage, to protect ourselves from acting out whatever is occurring in our dreams, our bodies incite paralysis using glycine. Sleep paralysis happens when there’s a transitional disruption between REM sleep and consciousness, making it so you’re at least semi-conscious, but the protective paralysis prevents movement or has yet to subside.
Common Sensations of Sleep Paralysis
Occasionally individuals experience heavy chest pressure and difficulty breathing. These symptoms could be attributed to the way the body shifts into shallow, rhythmic breaths during REM sleep, which is unlike how you breathe when you’re awake. As your brain suddenly becomes aware of your experience, you might try to control your breath and find that you cannot, leading to feelings of panic, chest pressure, or the inability to inhale deeply.
Fortunately, though it may feel overwhelming and scary, your breathing will carry on as usual. As sleep paralysis wears off, you regain control over your breath, and feelings of anxiety should subside.
Hallucinations during sleep paralysis, known as hypnopompic hallucinations5, are known to occur just as someone is emerging from sleep. These confusing experiences can feel like vivid dreams or frightening realities. According to Wexner Medical Center, some researchers attribute personal accounts of alien abduction or ghostly demons to these hypnopompic hallucinations.
Conversely, hypnagogic hallucinations occur as one is in the process of falling asleep. As most people without narcolepsy take 90 minutes after they have fallen asleep to enter the REM phase, these types of hallucinations may signify an association with sleep disorders, however, they may also be common in teens and younger children without narcolepsy.
Causes of Sleep Paralysis
Sleep paralysis is rarely caused by any directly life-threatening conditions. While reasons are debated, the issue could rarely be attributed to genetics6 but is most likely related to any of the following:
- Changes in sleep schedule
- Anxiety or bipolar disorder
- Sleeping on your back
- Narcolepsy or nighttime leg cramps
- Medications, particularly treatments for ADHD
- Substance abuse
- Sleep deprivation
Is Sleep Paralysis Serious?
Sleep paralysis could cause anxiety, but it is not a severe risk. However, it can happen concurrently with other disorders like narcolepsy, which can be life-threatening under certain circumstances and treated by a professional. The issue commonly begins in adolescence and can recur throughout life, particularly during one’s 20s and 30s.
Who’s at Risk?
While the condition often reoccurs in individuals in their 20s and 30s, sleep paralysis can strike any person at any age. Typically the first symptoms are seen between the ages of 14 and 177 years old.
However, research is still inconclusive regarding the percentage of the population in which it afflicts. Estimates vary between 5 and 40 percent; the high variation could be attributed to the fact that many individuals who have an episode never get diagnosed.
According to the American Academy of Sleep Medicine, some experts believe that genetics play a role, so if you have a family member who experiences symptoms, you might as well. Mental stress could also be a factor as stress often affects our sleep and other aspects of our health like blood pressure. The issue also appears to occur more commonly in individuals who sleep on their back.
Additionally, a lack of sleep is believed to incite symptoms, as is enduring a frequently shifting sleep schedule due to parenthood or professional obligations. Other factors that appear to be related include bipolar disorder, sleep-related leg cramps, and the use of certain medications.
Sleep Paralysis Prevention & Treatment
Sleep paralysis occurs so rarely that often no special treatment is necessary. Getting enough sleep is often vital as it could significantly reduce the likelihood8 of occurrences.
Methods to prevent sleep paralysis include:
- Keeping a regular sleep routine
- Going to bed and waking up at the same time each day
- Reducing alcohol intake
- Regular exercise
- Reducing caffeine intake
- Creating a soothing environment
Keep in mind that if your condition is severe, or you’re concerned your episodes could be linked to an underlying health condition, seeking professional treatment is always essential.
When treatment is necessary, it’s typically aimed at the root of the issue. If you’re sleep-deprived, you may require more rest as well as regular bedtimes and wake times.
Psychiatric problems can also trigger9 sleep paralysis, such as bipolar disorder. Those who suffer from this condition may experience intense or “manic” highs in which an individual may not sleep for days at a time. In this case, a professional would need to oversee ongoing medication.
According to the American Academy of Sleep Medicine, narcoleptics often experience sleep paralysis. These individuals may require medication to reduce or eliminate REM sleep, which is thought to trigger paralytic episodes.
Diagnosing sleep paralysis is occasionally done through overnight sleep studies called polysomnograms, which chart brain waves, breathing, heartbeats, and limb movement. Further, your doctor may have you do a daytime nap study if you frequently experience excessive daytime drowsiness called a Multiple Sleep Latency Test (MSLT). The MSLT will measure how quickly you fall asleep, what kind of sleep you experience, and help draw connections between narcolepsy and sleep paralysis.
Accounts of Sleep Paralysis Demons and Evil Presences
Similarly to how sleep paralysis happens when there’s a disruption in the transition between sleep stages, it’s also possible to have your sleep cycle interrupted in a way that you interpret dream-like hallucinations as actual occurrences.
According to Dr. Roth of Cleveland Health Clinic, “these hallucinations aren’t dreams,” rather, you’re conscious, but suspended between sleep and wakefulness in an unusual overlap. These hallucinations aren’t necessarily visual. They could be auditory, olfactory, kinetic, or tactile.
Many cultures contain ancient accounts of these “demons,” and they’re not necessarily easy to recollect. Sometimes it’s an unsettling or scary feeling of knowing something is in the room, appearing as a kinetic hallucination. According to Dr. Roth, many individuals who experience hallucinations also experience sleep paralysis, and it’s difficult to predict why or when it occurs.
Sleep paralysis is a condition that many experts still don’t fully understand. However, the more we know, the better we may be at preventing an occurrence and keeping ourselves calm in an episode.
Rachael Gilpin
Content Writer
About Author
Rachael is a content writer for Sleep Advisor who loves combining her enthusiasm for writing and wellness.
Back Sleeper
References:
- Brooks, Patricia L., Peever, John H. “Unraveling the Mechanisms of REM Sleep Atonia”. Associated Professional Sleep Societies, LLC. 2008.
- “Sleep Problems in Veterans with PTSD”. U.S. Department of Veterans Affairs. 2015.
- “Sleep Paralysis”. Stanford Health Care (SHC) – Stanford Medical Center. 2017.
- Das, Aneesa. “What’s Happening to the Body during Sleep Paralysis?”. The Ohio State University Wexner Medical Center. 2018.
- Waters, Flavie., et al. “What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences?”. Schizophrenia Bulletin, Oxford University Press. 2016.
- “Sleep Paralysis”. National Health Service. 2019.
- “Sleep Paralysis – Symptoms & Risk Factors”. Sleep Education. 2021.
- “Sleep Paralysis”. Healthdirect Australia. 2019.
- “Sleep Paralysis – Diagnosis & Treatment”. Sleep Education. 2021.