Sleep Paralysis: Causes, Symptoms & Treatment

Besides the defined and distinct sleep, dream and wake, a condition like sleep paralysis challenges fixed boundaries.

Sleep paralysis refers to an inability to move the body while the person’s senses and awareness are active and awake. It usually occurs when the sleep cycle shifts between stages.

Moreover, sleep paralysis is associated with visual and auditory hallucinations. And this article reviews the details of the causes and symptoms of sleep paralysis and what a person can do to lessen the risk of experiencing one. Keep reading to find out what happens during sleep paralysis.

What Is Sleep Paralysis?

Sleepers have most emotional dreams during REM sleep, and to stop us from acting out these dreams, the brain keeps us temporarily paralysed. However, sometimes people may wake up while their body is in this relaxed state. This unusual state is known as sleep paralysis. 

Sleep paralysis is one of the most common types of rapid eye movement (REM) parasomnia, where the sleeper temporarily loses muscle movements while sleeping. And it is found that sleep paralysis typically occurs in people who are falling asleep or just waking up. Furthermore, when sleep paralysis occurs, they are classified into two types, hypnagogic and hypnopompic sleep paralysis. They are often accompanied by sleep hallucinations of the intruder or incubus variety. 

Hypnagogic sleep paralysis or predormital sleep paralysis occurs when falling asleep. It is an intruder hallucination. This involves a perception of a dangerous person or presence in the room. Moreover, about 40% to 80% of patients with narcolepsy and cataplexy experience Hypnagogic sleep paralysis.

Hypnopompic sleep paralysis or postdormital sleep paralysis occurs during awakening from sleep. It is accompanied by incubus hallucination, characterised by a hallucination with a feeling of pressure on the sleeper’s body, which tends to be accompanied by anxiety, paralysis, and feelings of suffocation.

Sleepers may experience vivid visual, auditory, tactile, or kinetic perceptions. For example, they may feel someone or something present in the room, someone grabbing or tingling pain, hearing footsteps, explosions, shots, or any unfamiliar sound.

Furthermore, besides the intruder and incubus hallucination, there’s a third factor related to REM parasomnia and cultural narratives: the vestibular. It is a motor experience typically associated with unusual out-of-bodily experiences, consisting of floating/flying sensations, and is related to body position, orientation, and movement.

When Does Sleep Paralysis Occur?

There are five stages of sleep: wake or alert, with three stages of non-rapid eye movement (NREM) sleep (n1, n2, n3), and rapid eye movement (REM) sleep. And sleep paralysis occurs when the sleep cycle shifts between stages.

It occurs at the start of consciousness from REM sleep, when the body is still paralysed from the REM sleep cycle, or when falling asleep. If sleep paralysis occurs when falling asleep, it is a predormital sleep paralysis or hypnagogic sleep paralysis, which happens rarely. And if it occurs during awakening from sleep, it is called postdormital sleep paralysis or hypnopompic sleep paralysis.

Is Sleep Paralysis Dangerous?

Although people express them as a scary experience, they were traditionally defined as “the nocturnal visit of an evil being that threatens to press the very life out of its terrified victim.” They are harmless. Besides, the duration of sleep paralysis is usually a few seconds. 

Sleep paralysis tends to disappear suddenly, either spontaneously, after an intense effort by the sleeper to “break” the paralysis, or after some sensory stimulation. Furthermore, most people may experience it once or twice in their life.

What Causes Sleep Paralysis?

Many factors are related to the cause of sleep paralysis. Some cultural beliefs state supernatural accounts for the hallucinated intruder, while the neurological hypothesis is that it is the mechanisms— which usually coordinate body movements, are activated. Still, there is no actual movement, except the individual feeling and sensing the presence, fear, auditory and visual hallucinations.

So, according to research and studies, sleep paralysis causes are associated with,

• Medical conditions such as narcolepsy, seizure disorders, and hypertension
• Post-traumatic disorder, such as childhood sexual abuse
• Insomnia
• Panic disorder
• Anxiety disorder
• Sleep deprivation
• Disrupted sleeping patterns (for example, shift work or jet lag)
• Fatigue
• Stress
• Bipolar disorder
• Schizophrenia 

Even after all the studies have been done, from hundreds of years ago till date, the term: sleep paralysis has been multifactorial. And though scientific explanations have broken down the causes of sleep paralysis as a symptom of some illnesses and sleep disorders, for others, it’s just a nightmare with the manifestation of evil.

Sleep Paralysis Symptoms

Although eyes and respiratory movements are not affected during sleep paralysis, limb, head, and trunk movements are affected. And though the most common thing during an episode of sleep paralysis is the inability to move, sleepers may also experience other symptoms of sleep paralysis, which include:

• The feeling of fear.
• Unable to sleep.
• Awake but unable to open their eyes.
• Auditory hallucinations include hearing footsteps, explosions, shots, or any unfamiliar sound.
• Visual hallucination, such as feeling someone or something present in the room.

How Is Sleep Paralysis Diagnosed?

Most people only experience sleep paralysis only once or twice in their life. However, suppose a sleeper experiences recurrent sleep paralysis, which causes anxiety, and stress or impacts their quality of life. In that case, it could be because of underlying psychiatric diseases, mental illnesses, or disorders. 

A doctor may assess the symptoms and medical history provided by the sleeper when diagnosing sleep paralysis. If the episodes of sleep paralysis are suspected to be the result of other conditions, they may recommend a sleep study.

A sleep study is when doctors ask patients to stay at the clinic overnight to observe their conditions and symptoms. They observe and record data about the patient’s sleep pattern, which includes breathing rate, heart rate, eye movements, blood oxygen levels, and muscle activity.

Treatment Options for Sleep Paralysis

There seem to be a lot of cultural and religious influences worldwide in cases of sleep paralysis. And interestingly, every different region and cultural background has developed its ways of managing it, although it has yet to be proven if these remedies work.

For example, in Cambodia, rituals are often made to free the ‘victim’ from bad omen. Because their cultural belief is that sleep paralysis is a visitation by a ghost. Some visit leaders who perform curing rituals and some get sprinkled with holy water. 

Similarly, Nigeria has a wide variety of theories of sleep paralysis which is not surprising considering that the nation has a diverse culture. Some may read the Quran and the Bible, and others visit their religious leaders for some special prayers.

But, regarding the medical approach, there are no textbook solutions for sleep paralysis treatments. However, a doctor can prescribe a suitable treatment by identifying the underlying conditions that trigger sleep paralysis, such as insomnia or post-traumatic stress disorder, based on the diagnosis and symptoms. 

If a person suffers from insomnia, then based on the symptoms, doctors or specialists may prescribe medication or therapies such as sleep restriction therapy, cognitive therapy, and relaxation therapy. Similarly, if the person shows signs of stress, anxiety, or post-traumatic disorder, they are prescribed treatment accordingly.

How to Prevent Sleep Paralysis?

Besides approaching a proper treatment for sleep paralysis, a person should also take extra measures and try to completely get rid of sleep paralysis. A study suggests that adequate sleep hygiene may help prevent sleep paralysis. Such as:

• Set a regular sleep schedule; it will help you get better rest and maintain your mental and physical health.
• Allow yourself only 30 or 90 minutes of naps, however, because longer naps during the day can affect the nighttime’s sleep quality.
• Avoid caffeine before 3 to 6 hours of bedtime since it can disrupt a good rest significantly.
• Avoid alcohol before bed; it can affect sleep quality.
• Develop a habit of following your bedtime routine because a bedtime routine such as a relaxing bath, listening to music, or reading can help you unwind and mentally prepare for sleep.
• Keep the sleep environment comfortable: dark, quiet, and at a comfortable temperature.
• Avoid eating before bed; it can negatively impact your health.

Final Words

Sleep paralysis is a common condition, and as mentioned before, people may experience it once or twice in their life. Also, while they aren’t dangerous, it can be scary and unsettling to experience one, primarily if it is caused because of underlying psychiatric diseases, mental illnesses, or disorders.

And if the condition is causing a person distress or affecting their sleep quality, they may want to consult with a doctor. A doctor can prescribe a suitable treatment by identifying the underlying conditions that trigger sleep paralysis based on the diagnosis and symptoms.

Furthermore, along with or without treatment, educate yourself about sleep hygiene. It will help prevent sleep paralysis and other health conditions. Just follow the above prevention tips and tell us about your sleep hygiene or what relaxing activity you prefer before sleep.

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