Sleep Paralysis

Medically Reviewed by Shruthi N, MD on July 21, 2024
Written by Beth Roybal, Sarah Amandolare
7 min read

Sleep paralysis is a feeling of being conscious but unable to move. It happens when you pass between stages of wakefulness and sleep. During these transitions, you may be unable to move or speak for a few seconds up to a few minutes. You might also feel pressure or a sense of choking, or have hallucinations. Sleep paralysis may come with other sleep disorders such as narcolepsy. Narcolepsy is an overpowering need to sleep caused by a problem with the brain's ability to regulate sleep.

Sleep paralysis is not usually something to worry about. But about 10% of people have recurrent sleep paralysis, which can be a symptom of a more serious problem. If you have frequent episodes of sleep paralysis, then you may have a sleep disorder called narcolepsy. There are also serious mental illnesses that can involve sleep paralysis, including posttraumatic stress disorder (PTSD), bipolar disorder, and anxiety or panic disorders. These conditions can disrupt sleep patterns, making sleep paralysis more likely to happen. 

 

Not all episodes of sleep paralysis are the same. There are a range of symptoms, which usually begin in your teenage years and may get worse in your 20s and 30s. Symptoms may include: 

  • Feeling unable to move or speak (atonia) 
  • A hard time breathing 
  • Hallucinations, or seeing or hearing things that aren't there
  • Chest pressure 
  • A sense of suffocation 
  • Feeling separate from yourself, or out-of-body 
  • Feeling in danger 

Sleep paralysis hallucinations

Sleep paralysis hallucinations are very common, occurring in about 75% of episodes. They are different from dreams. You might sense a dangerous presence or feel like your body is moving. Some hallucinations can cause a feeling of suffocation and chest pressure. 

Just why or how it happens isn't clear. Researchers believe sleep paralysis is caused by a disturbed rapid eye movement (REM) cycle because it mostly happens as people are falling into or coming out of REM sleep. During that stage, your brain normally paralyzes your muscles anyway – so they don't act out your dreams. But during sleep paralysis, your mind is awake, or half awake, and so you are aware you can't move.

Studies show that about 20% of people have had sleep paralysis at least once. Sleep experts believe sleep paralysis might be partly genetic.

Other causes include stress and disrupted sleep schedules (think jet lag or pulling an all-nighter). Several studies have also found links between social anxiety or panic disorder and sleep paralysis.

During an episode of sleep paralysis, you might sense or see things that are not actually there. These hallucinations happen in the early stages of non-REM sleep, unlike dreams or nightmares, which happen later in the sleep cycle. Two types of hallucinations can come with sleep paralysis, either as you're falling asleep or waking up.  

Hypnagogic hallucinations

Also known as waking dreams, hypnagogic hallucinations happen as you're falling asleep. About 37% of people have them. Often, people see things: entire scenes, faces, shapes, or kaleidoscopic patterns. It’s less common to hear sounds or have physical sensations, such as falling. Whereas dreams often include stories and conversations, hypnagogic hallucinations do not. 

Hypnopompic hallucinations

These hallucinations happen as you're waking up. Like hypnagogic hallucinations, they are most often visual perceptions, but they sometimes involve sounds or physical sensations. An estimated 12% of people have hypnopompic hallucinations. 

Lucid dreaming and sleep paralysis are not the same. They happen during different stages of sleep and involve different sensations. Both conditions can feel frightening and may interfere with sleep quality. 

Sleep paralysis happens as you enter or exit REM sleep, while lucid dreaming occurs during REM sleep. While lucid dreaming, you may feel aware of yourself and be able to control what happens. Unlike sleep paralysis, you won’t feel unable to move during a lucid dream. You might even think you’ve woken up when you actually haven’t. 

Some people try to have lucid dreams by using wearable devices, playing video games, or keeping a dream diary. This can be dangerous for people who already have a hard time sleeping or have certain mental health conditions, such as feeling disconnected from reality. 

About 20% of people may have sleep paralysis at some time in their life. It often starts in your teen years, and continues into your 20s and 30s. Sleep paralysis may run in families. 

Other things that may be linked to sleep paralysis include:

  • Lack of sleep
  • A sleep schedule that changes
  • Mental conditions, such as stress or bipolar disorder
  • Sleeping on your back
  • Other sleep problems, such as narcolepsy or nighttime leg cramps
  • Use of certain medications, such as those for ADHD
  • Substance abuse

Often there is no need to treat sleep paralysis. But check with your doctor if you have any of these concerns:

  • You feel anxious about your symptoms.
  • Your symptoms leave you very tired during the day.
  • Your symptoms keep you up during the night.

Your doctor may want to gather more information about your sleep health by doing any of the following:

  • Ask you to describe your symptoms and keep a sleep diary for a few weeks.
  • Discuss your health history, including any known sleep disorders or any family history of sleep disorders.
  • Refer you to a sleep specialist for further evaluation.

 

There isn't a lot of evidence to support effective treatments for sleep paralysis. But your doctor may be able to identify and treat conditions that can trigger sleep paralysis, such as sleep disorders and mental health problems. They might also refer you to a specialist for treatment of other issues. 

Improving your sleep hygiene may help prevent sleep paralysis and leave you feeling more rested during the day. Try to follow a routine before going to bed, avoid caffeine and alcohol in the evening, and don’t use screens for at least an hour before falling asleep. Getting 7 to 9 hours of sleep per night is important, as not sleeping enough can trigger paralysis. If you have anxiety and stress around bedtime, cognitive behavioral therapy could help you relax. 

How to stop sleep paralysis in the moment

There aren't proven ways to stop sleep paralysis as it’s happening, but certain techniques may help break people out of episodes. Some people find it helpful to focus on slowly moving one body part at a time, such as one finger or toe. 

For people with narcolepsy, some evidence suggests following certain steps during sleep paralysis. By reminding yourself that the experience is temporary, focusing on a positive object or memory, and relaxing your muscles, you may be able to prevent episodes and have less disturbing hallucinations. 

If you have sleep paralysis now and then, you can take steps at home to control this disorder. Start by:

  • Making sure you get enough sleep
  • Doing what you can to ease stress in your life, especially just before bedtime 
  • Trying new sleeping positions if you sleep on your back. Sleep experts have found a correlation between sleeping on your back and sleep paralysis.

 Be sure to see your doctor if sleep paralysis routinely stops you from getting a good night's sleep.

Sleep paralysis is not dangerous. But for about 10% of people, it's a recurring event that creates bedtime anxiety. This can disrupt your sleep, leading to daytime fatigue and other health problems that could become more serious. Sleep paralysis may also be a symptom of a more serious physical or mental health condition requiring medical treatment, such as narcolepsy or panic disorder. 

Sleep paralysis can be scary and stressful, but it is not usually dangerous. You might have hallucinations as you’re falling asleep or waking up. While there are no scientifically proven ways to end an episode in the moment, some strategies seem to help. Talk to your doctor if sleep paralysis is disrupting your daily life, as it could be a symptom of something more serious.

How do you break out of sleep paralysis?

Try slowly moving one finger or wiggling one toe at a time to end an episode of sleep paralysis. 

Can you wake someone up from sleep paralysis?

Yes, if you touch someone or speak to them, they may wake up from sleep paralysis. 

Is it OK to let sleep paralysis happen?

Yes, it’s OK to allow an episode to play out. 

What is the relationship between sleep paralysis and PTSD?

People with posttraumatic stress disorder may be more likely to have sleep paralysis, because PTSD can disrupt sleeping patterns.