Is Sleep Paralysis a Symptom of a Serious Problem?
Sleep researchers conclude that, in most cases, sleep paralysis is simply a sign that your body is not moving smoothly through the stages of sleep. Rarely is sleep paralysis linked to deep underlying psychiatric problems.
Over the centuries, symptoms of sleep paralysis have been described in many ways and often attributed to an "evil" presence: unseen night demons in ancient times, the old hag in Shakespeare's Romeo and Juliet, and alien abductors. Almost every culture throughout history has had stories of shadowy evil creatures that terrify helpless humans at night. People have long sought explanations for this mysterious sleep-time paralysis and the accompanying feelings of terror.
What Is Sleep Paralysis?
Sleep paralysis is a feeling of being conscious but unable to move. It occurs when a person passes 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. Some people may also feel pressure or a sense of choking. Sleep paralysis may accompany 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 Causes
Just why or how it happens isn't clear. Researchers believe sleep paralysis is caused by a disturbed rapid eye movement cycle because it mostly happens as people are falling into or coming out of REM sleep. During that stage, their brains normally paralyze their muscles anyway -- so they don't act out their dreams. But during sleep paralysis, the sleeper is awake, or half awake, and so is aware they cannot move.
Studies show that between 25% and 50% of Americans have had sleep paralysis at least once. Many people who have it also have narcolepsy, in which they fall asleep uncontrollably. 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.
Clearly, an episode of sleep paralysis can be scary, which has led to some unorthodox theories. Research shows that people in places as diverse as China, East Africa, Mexico, Newfoundland, and the United States have long believed that paralysis is caused by demons, witches, or other supernatural creatures.
Often the experience is accompanied by noises (like loud buzzing), sensations of being dragged out of bed or flying, and difficulty breathing. In fact, some researchers believe sleep paralysis is what's really going on with stories of alien abductions.
When Does Sleep Paralysis Usually Occur?
Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep, it's called hypnagogic or predormital sleep paralysis. If it happens as you are waking up, it's called hypnopompic or postdormital sleep paralysis.
What Happens With Hypnagogic Sleep Paralysis?
As you fall asleep, your body slowly relaxes. Usually you become less aware, so you do not notice the change. However, if you remain or become aware while falling asleep, you may notice that you cannot move or speak.
What Happens With Hypnopompic Sleep Paralysis?
During sleep, your body alternates between REM (rapid eye movement) and NREM (non-rapid eye movement) sleep. One cycle of REM and NREM sleep lasts about 90 minutes. NREM sleep occurs first and takes up to 75% of your overall sleep time. During NREM sleep, your body relaxes and restores itself. At the end of NREM, your sleep shifts to REM. Your eyes move quickly and dreams occur, but the rest of your body remains very relaxed. Your muscles are "turned off" during REM sleep. If you become aware before the REM cycle has finished, you may notice that you cannot move or speak.
Who Develops Sleep Paralysis?
Up to as many as 4 out of every 10 people may have sleep paralysis. This common condition is often first noticed in the teen years. But people of any age can have it. Sleep paralysis may run in families. Other factors that may be linked to sleep paralysis include:
- Lack of sleep
- 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
How Is Sleep Paralysis Diagnosed?
If you find yourself unable to move or speak for a few seconds or minutes when falling asleep or waking up, then it is likely you have isolated recurrent sleep paralysis. Often there is no need to treat this condition.
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.
- Conduct overnight sleep studies or daytime nap studies to make sure you do not have another sleep disorder.
How Is Sleep Paralysis Treated?
Most people need no treatment for sleep paralysis. Treating any underlying conditions such as narcolepsy may help if you are anxious or unable to sleep well. These treatments may include the following:
- Improving sleep habits -- such as making sure you get 6 to 8 hours of sleep each night
- Using antidepressant medication if it is prescribed to help regulate sleep cycles
- Treating any mental health problems that may contribute to sleep paralysis
- Treating any other sleep disorders, such as narcolepsy or leg cramps
What Can I Do About Sleep Paralysis?
If you have occasional sleep paralysis, you can take steps at home to control this disorder. Start by:
- Making sure you get enough sleep.
- Do what you can to ease stress in your life, especially just before bedtime.
- Try 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.