What is Sleep Paralysis?
Sleep paralysis is a condition where a person regains consciousness, or wakes up, but is unable to move their body. This happens because the muscles remain in a relaxed state, as they are during the stage of sleep known as REM (Rapid Eye Movement), which is when we usually dream. This immobility can cause a lot of fear and worry for the person experiencing it, as they are unable to move any part of their body.
Individuals experiencing sleep paralysis often report seeing things that aren’t there, specifically imagining that there’s a threatening person or presence in the room. Some people also describe a unique hallucination known as the Incubus phenomenon. This is where the person feels a weight on their chest and images of violent or sexual acts. These hallucinations can lead to feelings of anxiety, a sense of being paralyzed, and the feeling of being suffocated.
Sleep paralysis usually happens during the REM stage of sleep. In a different stage of sleep called Non-REM sleep, the body’s parasympathetic system (the system that is responsible for promoting the body’s rest and digest response) becomes dominant, while the body’s sympathetic system (our fight or flight response) decreases. However, during the REM stage of sleep, the body’s sympathetic system suddenly becomes more dominant. This sudden switch prevents the body from carrying out movements in response to dreams, temporarily paralyzing the muscles. When a person wakes up during this stage, they can feel awake but are unable to move, which is the key trait of sleep paralysis.
What Causes Sleep Paralysis?
Research hasn’t found a direct cause-and-effect relationship between specific risk factors and sleep paralysis. However, several factors have been shown to be somewhat linked to this condition. These factors include anxiety disorders, poor sleep quality, alcohol use, experiencing traumatic events, and having a family history of sleep paralysis. Having family members who’ve experienced sleep paralysis might imply that there’s a genetic component to this condition.
Risk Factors and Frequency for Sleep Paralysis
- Approximately 7.6% of the population experiences sleep paralysis.
- Females tend to have sleep paralysis slightly more often than males.
- While sleep paralysis can start at any age, it usually begins in childhood, adolescence, or young adulthood.
- Frequency of sleep paralysis episodes tends to increase with age after starting in the teenage years.
- Students and individuals with other psychiatric illnesses are more prone to sleep paralysis.
- Non-White populations show a higher prevalence of sleep paralysis.
Signs and Symptoms of Sleep Paralysis
People who undergo sleep paralysis often experience these episodes both before falling asleep and after waking up. These episodes are commonly associated with preceding stress, changes in daily routines, or emotive events. During an episode, a physical check-up can reveal the typical signs of REM (Rapid Eye Movement) sleep pattern. These signs include rapid eye movement, muscle weakening, decreased breathing rhythm, and an increased heartbeat.
Testing for Sleep Paralysis
When evaluating sleep paralysis, many questionnaires can be used to help understand your experience and symptoms better. Some of these include the Sleep Paralysis Experiences and Phenomenology Questionnaire (SP-EPQ) and The Unusual Sleep Experiences Questionnaire (USEQ).
Additionally, other questionnaires help determine potential risk factors for sleep paralysis. These include the Beck Depression Inventory, which helps identify symptoms of depression; the Eysenck Personality Questionnaire, which evaluates different aspects of personality; the Clinician-Administered PTSD scale, which assesses for signs of posttraumatic stress disorder; the Hamington Anxiety Rating Scale, which measures anxiety levels; and the Liebowitz Social Anxiety Scale, which identifies social anxiety symptoms.
Through these questionnaires, doctors can understand potential triggers for your sleep paralysis episodes and develop suitable management strategies.
Treatment Options for Sleep Paralysis
As of now, there’s no direct way to stop sleep paralysis while it’s happening. Medical professionals have tried to manage the mental and physical factors that kick off an episode, but there isn’t a treatment to halt an episode in its tracks. One scientific study did find that a combination of focused-attention meditation, alongside muscle relaxation, showed some positive results in treating sleep paralysis.
There’s a strong link between sleep paralysis and other sleep issues, so one common approach is to improve a person’s sleep habits, often referred to as ‘sleep hygiene’. This is all about your daily practices and routines that affect the quality of your sleep. For instance:
- Having a regular sleep schedule (both bedtime and wakeup time), even on weekends
- Ensuring your bedroom has a comfortable mattress and pillow
- Controlling your bedroom environment so that it has little light or noise distractions
- Maintaining a consistent pre-bedtime routine and keeping your bedroom solely for sleep, rather than watching TV there
- Limiting your consumption of caffeine and alcohol, particularly in the evening
- Avoiding the use of electronic devices, like mobile phones, for at least 30 minutes before you go to bed.
Though we can’t stop an ongoing sleep paralysis episode, these steps can help to reduce the overall occurrence of sleep paralysis by improving the quality of your sleep.
What else can Sleep Paralysis be?
Understanding the difference between sleep paralysis and similar conditions is crucial. These conditions might include:
- Narcolepsy
- Familial periodic paralysis
- Conversion disorder
- Cataplexy.
- Symptoms of PTSD or other mental/psychiatric illnesses
The reason behind this differentiation is that the treatment methods used for these other conditions, which usually involve medication and psychological support, aren’t typically used to manage sleep paralysis.
What to expect with Sleep Paralysis
Research shows that experiencing sleep paralysis doesn’t have any long-lasting effects on a person’s overall health. Though some of the underlying factors that make someone more likely to experience sleep paralysis could potentially lead to health issues later on (for example, anxiety could increase the risk of high blood pressure), there’s no evidence that sleep paralysis itself is directly linked to other health problems.
Interestingly, sleep paralysis episodes are reported to occur in ‘waves.’ This means that they come and go. The outcome is typically good when the triggers for sleep paralysis are well-managed. In other words, if the factors causing sleep paralysis are kept under control, then most people don’t experience serious problems from the condition.
Possible Complications When Diagnosed with Sleep Paralysis
While sleep paralysis isn’t harmful by itself, it can make some people feel very scared, which could lead to anxiety problems. It can also result in poor sleep, which can then increase the chances of experiencing sleep paralysis.
The key points to note:
- Sleep paralysis is often a frightening experience
- This heightened fear can sometimes lead to anxiety disorders
- Poor sleep quality can be a result of sleep paralysis
- Bad sleep increases the risk of sleep paralysis
Preventing Sleep Paralysis
Patients should understand that sleep paralysis is generally harmless even though it can be scary. Doctors often advise the patients to manage their worry and fear using medication and relaxation techniques like meditation. It is also crucial for patients to understand the hallucinations that can happen during sleep paralysis.
These hallucinations can be quite terrifying for the patients and could lead to a lot of fear and panic. Therefore, it’s essential for the patients to know why these hallucinations occur and what they involve. More importantly, they should be aware that these hallucinations are a normal part of sleep paralysis and don’t have long-term harmful effects.
Patients will become less afraid of sleep paralysis episodes once they fully understand what happens during these episodes and why. This can help improve their overall experience and can contribute to a more positive recovery.
