Sleep Paralysis

Last updated: May 31, 2019

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The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

Parasomnias are undesirable events that come along with sleep. A parasomnia can make sleeping uncomfortable and can result in unrefreshing sleep. Sleep paralysis is one example of a parasomnia. Sleep paralysis causes a patient to lose the ability to move his or her body while asleep.

What is sleep paralysis?

When a person sleeps the brain causes the muscles of the body to relax. This is why a person is still while asleep. They call this state “atonia”. Sleep paralysis happens when a person experiences atonia while awake.

There are two types of sleep paralysis. The types depend on when sleep paralysis occurs. When sleep paralysis occurs while a person is falling asleep, it is a hypnagogic or predormital form. It is hypnopompic or postdormital form if sleep paralysis occurs while a person is waking up from sleep.

A hypnagogic experience often accompanies sleep paralysis. These are visual, auditory, and sensory sensations or hallucinations. Most of the time these visions occur while a person transitions between sleeping and waking. They often fall into three categories:

  • Intruder: a person hears sounds of doorknobs opening or approaching footsteps. There might be an image of a shadowy figure or a sense of an impending threat.
  • Incubus: This is a feeling of pressure on the person’s chest. The patient also experiences difficulty in breathing. Aside from these a person may experience a sensation of getting smothered, strangled or sexually assaulted by an evil presence. Oftentimes the patient feels as if he or she is about to die.
  • Vestibular-motor: This is a sense of falling, floating, or hovering over one’s own body. It’s a type of out of body experience.

What causes sleep paralysis?

When a person sleeps he alternates between non-rapid movement (NREM) and rapid eye movement (REM). A cycle between NREM and REM usually lasts around 90 minutes. Non-rapid eye movement sleep makes up the largest portion of sleep. This is the stage of sleep where the body relaxes. When a person is in the REM stage his eyes move quickly. However, his body is still in a relaxed state.

When a person experiences sleep paralysis his body’s transition to or from REM sleep is not in sync with the brain. This means that while he is awake the body remains in a paralyzed sleep state. This part of the brain responsible for detecting threats becomes active. As a result the patient becomes overly sensitive.

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What are the signs and symptoms of sleep paralysis?

The signs and symptoms of sleep paralysis include:

  • Unable to move the body while waking
  • Being consciously awake
  • Loss of speech during an episode
  • Experiencing visions that cause fear
  • A feeling of pressure on the chest area
  • Breathing difficulties
  • A feeling of dread

How is sleep paralysis diagnosed?

A patient should seek medical attention if the symptoms result in excessive daytime sleepiness. It is also recommended that a patient seek help if sleep paralysis causes anxiety. The doctor may ask the patient to keep a sleep diary to keep track of the patient’s sleep patterns and habits. It is also possible to prescribe a sleep study. This will allow the doctor to rule out another sleep disorder which may be affecting the patient.

How is sleep paralysis treated?

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

There is no treatment for sleep paralysis. A patient can manage stress and observe good sleeping habits to help reduce the likelihood of experiencing sleep paralysis.

Here are some things that can help improve sleep hygiene:

  • Sticking to a regular bedtime and wake-up time. Follow this schedule even on weekends and holidays
  • Ensuring a sleep environment conducive for sleeping
  • Limiting the exposure to light especially in the evenings or close to bedtime
  • Getting enough daylight exposure throughout the waking hours
  • Not taking naps in the late afternoon
  • Not working, studying or playing in the bedroom
  • Avoiding heavy meals at least 2 hours before bedtime
  • Avoiding alcoholic beverages near bedtime
  • Avoiding caffeinated drinks in the late afternoon or in the evening
  • Avoiding the use of electronic devices at least an hour before bedtime

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