Sleep paralysis is a temporary inability to move that occurs in the process of falling asleep or waking up. During this time, individuals maintain awareness during episodes, which frequently involve troubling hallucinations and a sensation of suffocation.
Episodes of sleep paralysis involve elements of both sleep and wakefulness, which is partly why they can lead to distressing symptoms. While much is still unknown about the condition, learning about types, symptoms, causes, impacts, and treatment can enable a better understanding of the condition and ways to prevent it.
Sleep paralysis is considered a parasomnia. Parasomnias are abnormal behaviors during sleep. Because it is linked to the rapid eye movement (REM) stage of the sleep cycle, the condition is considered to be a REM parasomnia.
Standard REM sleep involves vivid dreaming along with atonia, which usually helps prevent acting out dreams. Atonia typically ends upon waking up, so a person never becomes conscious of this inability to move. As a result, researchers believe that sleep paralysis involves a mixed state of consciousness.
An estimated 75% of sleep paralysis episodes also involve hallucinations that are distinct from typical dreams. As with atonia, these can occur when falling asleep (hypnagogic hallucinations) or waking up (hypnopompic hallucinations).
Hallucinations during sleep paralysis fall into three categories.
- Intruder hallucinations: These hallucinations involve the perception of a dangerous person or presence in the room.
- Chest pressure hallucinations: Also called incubus hallucinations, these episodes may incite feelings of suffocation. These frequently occur in tandem with intruder hallucinations.
- Vestibular-motor (V-M) hallucinations: V-M hallucinations can include feelings of movement, such as flying, or out-of-body sensations.
What Causes the consition?
The exact cause of this condition is unknown. Studies have analyzed data to determine what heightens one’s risk of sleep paralysis, and have found mixed results. Based on those findings, researchers believe that multiple factors are involved in the onset of sleep paralysis.
Sleep disorders and other sleeping problems have shown some of the strongest correlations with isolated sleep paralysis. The condition has also has been found to be more common in people with nighttime leg cramps.
Insomnia symptoms like having a hard time falling asleep and excessive daytime sleepiness have been found to be linked with sleep paralysis. People whose circadian rhythms are not aligned with their local day-night cycle, such as people with jet lag and shift workers, may also be at higher risk of developing the condition.
What Are the Treatments?
The first step in treating this condition is speaking with a doctor in order to identify and address underlying problems that may be contributing to the frequency or severity of episodes. For example, this could involve treatment for narcolepsy or steps to better manage sleep apnea.
Overall, there is limited scientific evidence about the most effective treatment for of the condition. Many people are unaware that the condition is relatively common and thus feel ashamed after episodes. As a result, even just an acknowledgment and normalization of their symptoms by a doctor can be beneficial.
Because of the connection between sleep paralysis and general sleeping problems, improving sleep hygiene is a common focus in preventing it.
There are a number of sleep hygiene techniques that can contribute to better sleep quality and more consistent nightly rest.
- Establish a routine: Follow the same schedule for going to bed and waking up every day, including on weekends. A soothing pre-bed routine can help you get comfortable and relaxed.
- Optimize your sleep space: Outfit your bed with the best mattress and best pillow for your needs. It is also useful to design your bedroom to have limited intrusion from light or noise.
- Curb substance use: Reduce alcohol and caffeine intake, especially in the evening.
- Remove distractions: Put away electronic devices, including cell phones, for at least an hour before bed.
