Sleep Paralysis: My Daily Battle Against An Unseen Foe

Sleep paralysis is a frightening but harmless condition that affects many people. It occurs when you are conscious but unable to move or speak while falling asleep or waking up. While the exact cause of sleep paralysis is unknown, it is linked to various factors such as irregular sleep schedules, sleep disorders, mental health conditions, and genetics. If you experience frequent episodes of sleep paralysis, it is important to seek medical advice as it may be a symptom of an underlying condition. Treatment options include medication and cognitive behavioural therapy.

Sleep paralysis is a parasomnia, or abnormal behaviour during sleep

During an episode of sleep paralysis, you are aware of your surroundings but unable to move or speak. Episodes can last from a few seconds to 20 minutes, with an average length of around six minutes. You may also experience hallucinations, a feeling of suffocation, or a sense of pressure on your chest. Sleep paralysis can be a frightening experience, but it is generally not considered dangerous. However, recurrent episodes can cause bedtime anxiety and sleep deprivation, leading to excessive daytime sleepiness and other health issues.

The exact cause of sleep paralysis is unknown, but it is often linked to sleep disorders and certain mental health conditions. These include obstructive sleep apnea, chronic insomnia, circadian rhythm dysregulation, and mental health disorders such as post-traumatic stress disorder (PTSD), anxiety, and panic disorder. Sleep paralysis may also be associated with sleep deprivation, irregular sleep schedules, and jet lag.

While there is no treatment available to stop a sleep paralysis episode once it has started, there are ways to reduce the frequency of episodes. Improving sleep hygiene by establishing a consistent sleep schedule, optimising your sleep environment, and curbing substance use can help prevent sleep paralysis. Additionally, addressing underlying sleep disorders or mental health issues with the help of a healthcare provider can reduce the occurrence of sleep paralysis.

It occurs during the REM stage of the sleep cycle

Sleep paralysis is a parasomnia, or abnormal behaviour during sleep, that occurs when you're stuck between sleep phases. It happens when you're entering or exiting the REM stage of the sleep cycle. During REM sleep, your brain normally paralyses your muscles so that you don't act out your dreams. However, during sleep paralysis, your mind is awake, or half-awake, and you become aware that you can't move.

Sleep paralysis involves a mixed state of consciousness that blends both wakefulness and REM sleep. The atonia and mental imagery of REM sleep persist into a state of being aware and awake. This is why people often experience hallucinations during sleep paralysis.

During an episode, you might sense or see things that aren't there. These hallucinations can be hypnagogic, occurring as you're falling asleep, or hypnopompic, occurring as you're waking up.

Hallucinations during sleep paralysis can be categorised as:

• Intruder hallucinations: 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 or the sensation that someone is sitting on your chest. These often occur with intruder hallucinations.
• Vestibular-motor (V-M) hallucinations: These can include feelings of movement, such as flying, or out-of-body sensations.

It can be linked to sleep deprivation and disrupted sleep schedules

Sleep paralysis is a temporary condition that occurs when you're stuck between sleep phases. It can be linked to sleep deprivation and disrupted sleep schedules.

Sleep paralysis occurs when you're unable to move or speak as you're falling asleep or waking up. It's usually harmless and not dangerous, but it can be a frightening experience. Episodes typically last a few seconds to a few minutes.

Sleep deprivation and irregular sleep schedules are known risk factors for sleep paralysis. Not getting enough sleep can trigger sleep paralysis. This is especially common for shift workers, who often have irregular sleep schedules. Jet lag and pulling all-nighters can also disrupt sleep patterns and contribute to sleep paralysis.

Additionally, sleep paralysis has been linked to certain mental health conditions, such as anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), and panic disorders. These conditions can disrupt sleep patterns, making sleep paralysis more likely to occur.

To reduce the risk of sleep paralysis, it's important to improve sleep quality and maintain a consistent sleep schedule. This includes getting adequate sleep, typically 7 to 9 hours per night, and sticking to a consistent sleep and wake schedule, even on weekends. Creating a relaxing bedtime routine, limiting substance use, and reducing screen time before bed can also help prevent sleep paralysis.

It can be treated with medication and therapy

Sleep paralysis is a temporary condition where you are conscious but unable to move right before falling asleep or upon waking up. It is not dangerous but can be a frightening experience. Sleep paralysis is linked to sleep disorders and certain mental health conditions.

While there is no treatment available to stop an episode of sleep paralysis once it starts, there are ways to reduce the frequency of episodes. Treatment depends on the reason for your sleep paralysis, and a healthcare provider can help you identify this.

Medication

Your healthcare provider may recommend medication to prevent you from reaching the REM stage of sleep. They may also prescribe medication to treat an underlying mental health condition or sleep disorder, such as antidepressants.

Therapy

Talking to a mental health provider can be beneficial if you experience frequent stress or anxiety. Cognitive behavioural therapy (CBT) can help you relax and manage negative thoughts and emotions that interfere with sleep. A specific form of CBT has been developed for sleep paralysis, but more research is needed to validate its effectiveness.

Sleep Hygiene

Improving your sleep hygiene is a common focus in preventing sleep paralysis. This includes:

• Establishing a routine: Following a consistent sleep and wake schedule, including on weekends, and creating a soothing pre-bed routine.
• Optimising your sleep space: Using the best mattress and pillow for your needs, and limiting light and noise in your bedroom.
• Curbing substance use: Reducing alcohol and caffeine intake, especially in the evening.
• Removing distractions: Putting away electronic devices at least one hour before bed.

It is not dangerous but can cause emotional distress

Sleep paralysis is a temporary condition that is not dangerous but can cause emotional distress. It occurs when you are conscious but unable to move or speak as you are falling asleep or waking up. This happens when you are stuck between sleep phases—your body is in rapid eye movement (REM) sleep, but your mind is awake or half-awake. While it is not dangerous, it can be a frightening experience and cause anxiety.

Sleep paralysis is often accompanied by hallucinations, which can be very disturbing. These hallucinations can include a sense of a dangerous presence in the room, feelings of suffocation, or out-of-body sensations. About 75% of sleep paralysis episodes involve hallucinations.

While sleep paralysis itself is not dangerous, it can have negative effects on a person's health if it leads to sleep deprivation. People who experience recurrent or frightening episodes may develop unhealthy sleep habits to avoid sleep, which can result in sleep deprivation and impact their overall health.

Additionally, sleep paralysis may be a symptom of a more serious underlying condition, such as a sleep disorder or a mental health issue. It has been linked to conditions such as narcolepsy, post-traumatic stress disorder (PTSD), anxiety, and panic disorders. If you are experiencing frequent episodes of sleep paralysis, it is important to consult a healthcare professional to rule out any underlying causes and receive appropriate treatment.

To help manage sleep paralysis, it is recommended to improve sleep hygiene and sleep habits. This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, reducing substance use, and finding ways to manage stress.

Frequently asked questions