What is Sleep Paralysis and How It Affects Your Health?
Nothing can replenish your energy like a good night’s sleep, and nothing can deteriorate your life’s quality like the lack of it. Sleep disorders can have a profound negative effect on your physical and mental health. This article has everything you need to know about a particularly scary one. So, read on if you want to know how to stop sleep paralysis?
What is sleep paralysis?
Sleep paralysis is a peculiar state of body and mind in which the affected person is fully conscious but unable to move or speak. This one is as good as any sleep paralysis definition.
Sleep paralysis usually occurs during falling asleep or waking up. Most people describe it as a scary and disheartening experience.
The reasons for this are the hallucinations that often happen during sleep paralysis. They can be visual and auditory, and they often provoke fear (“sleep paralysis demon”).
An episode of sleep paralysis is usually short. No longer than a couple of minutes. However, sleep paralysis episodes can be recurrent. In such cases, sleep paralysis can trigger other sleep-related problems such as fear of falling asleep, fatigue, anxiety, etc.
Experts believe that sleep paralysis could be a glitch in the regular pattern of the four phases of sleep, the:
- NREM (Non-Rapid Eye Movement) Stage 1,
- NREM Stage 2,
- NREM Stage 3, and
- REM sleep
The fourth stage, REM sleep, is characterized by temporary paralysis. So, sleep paralysis could be an error or dysfunction in this stage of sleep.
Additionally, sleep paralysis is also associated with:
- Sleep deprivation
- Insomnia
- Stress
- PTSD (Post-traumatic stress disorder)
- General anxiety disorder
- Panic disorder
- Narcolepsy
Statistics show that around one in every two people is likely to experience at least one episode of sleep paralysis during their lifetime. One in twenty will experience recurring sleep paralysis.
The Experience
Sleep paralysis is a rather unpleasant happening. It feels like waking up paralyzed while facing a great danger. Your muscles do not obey the brain’s signals telling them to move, and you feel helpless.
Imagine being conscious but not being able to move or speak. Then, add to that a creepy, shadowy creature or a demon-like figure moving around you, staring through the window, or pressuring your chest. Last but not least, mix in some screams, hisses, whispers, or roars to spice up the experience. It’s quite an adventure!
All jokes aside, sleep paralysis causes overwhelming emotions, such as fear and panic. The affected person feels unable to do anything to defend from a terrifying and menacing presence.
Some people also report the feeling of numbness and vibrations throughout their bodies. Others say they felt like they were flying.
No wonder that, in the past, people attributed the cause of sleep paralysis to supernatural forces, alien abductors, visitations by dead relatives, demons, witches, ghosts, and other evil creatures. In Japan, the term “kanashibari” describes sleep paralysis. A loose translation would be “buried alive and bound in metal.”
The Old Hag and Night Hag are two well-known names used to describe sleep paralysis in English speaking countries.
Hallucinations
We’ve already explained that your mind is conscious, and your body paralyzed during sleep paralysis. However, all the things you experience during an episode are, of course, not real. The question is: How do you see, hear, and feel non-existing things while being conscious?
Researchers attribute this to hallucinations. They believe that the mechanisms that coordinate body position and movement are highly-active during sleep paralysis. However, since there is no actual movement, they induce a confusing floating sensation responsible for the “out-of-body experience.”
The visual and non-visual presence of an intruder (sleep paralysis demon) attributes to the brain’s hyper-vigilant state activated by the feeling of vulnerability due to paralysis.
Hypervigilance becomes more intense because of the threat response (desire to fight or flee). That is what makes these hallucinations appear so real.
The difference between a dream and sleep paralysis hallucinations is that during REM sleep, the dreaming stage of sleep, you are paralyzed while sleeping (you are not conscious). That explains why the visions in a dream are not as vivid as those experienced during sleep paralysis.
Types of Sleep Paralysis
We are not 100% sure what causes sleep paralysis. But, sleep paralysis episodes occur when the brain fails to manage the transition from wakefulness to sleep. The same thing happens the other way around.
These two transitional phases are similar but not identical. We could say that one is the mirror image of the other.
The transition from wakefulness to sleep is related to rational cognition. Hallucinations in this phase are known as hypnagogic hallucinations. On the other hand, the process of transitioning from sleeping to wakefulness has plenty to do with the emotional perception of reality. Hallucinations in this phase are known as hypnopompic hallucinations.
Both hallucination types can cause fear and panic as they are often accompanied by the inability to move or speak (sleep paralysis).
According to this, we can differentiate two types of sleep paralysis:
- Hypnagogic sleep paralysis
- Hypnopompic sleep paralysis
Hypnagogic Sleep Paralysis
Hypnagogic hallucinations take place during falling asleep. The experience of this transitional “threshold consciousness” is often associated with lucid dreams (you are aware that you are dreaming) and sleep paralysis.
It feels like waking up paralyzed while, in reality, your mind remains aware that your body is falling asleep. Hypnagogic hallucinations are not as scary as their hypnopompic counterparts. Panic may be present due to paralysis, but there are no demons and evil spirits. However, they can be very vivid with many sensory experiences.
These include:
- Visual
- Auditory
- Olfactory
- Gustatory
- Tactile, and
- Thermal hallucinations
People often report seeing some light, geometrical patterns, flat and three-dimensional images, colors, speckles, etc. Sounds, such as loud bangs, knocking, and crashing sounds, are also present.
Hypnagogic hallucinations can be illogic and ridiculous. But, they can also be a source of great ideas. These hallucinations often get accepted as artistic inspiration, problem-solving insights, and visions that can spark creativity.
Hypnopompic Sleep Paralysis
If you cannot move or scream, but you can see a demon sitting on your chest, you are going through hypnopompic sleep paralysis.
Most hypnopompic hallucinations are visual. Simple sounds, melodies, and whispers are not uncommon. The rarest hypnopompic hallucinations are the “out-of-body experiences.”
These hallucinations appear during the transition from REM sleep to the last NREM stage.
Experts believe that a temporary malfunction in brain chemistry can cause hallucinations during this process because the mind wakes up from deep sleep faster than the body. You have to remain still until your brain figures out how to get out of sleep paralysis.
This occurrence is related to low “happiness hormones,” serotonin and dopamine levels. That might be the reason why hypnopompic sleep paralysis is such a nightmarish experience.
Isolated Sleep Paralysis and Recurrent Isolated Sleep Paralysis (RISP)
Sleep paralysis does not affect everyone in the same way. Some people experience only one or two episodes in their lifetime, while others have regular ones over time.
Concerning this, we can differentiate two types of sleep paralysis:
- Isolated Sleep Paralysis (ISP), and
- Recurrent Isolated Sleep Paralysis (RISP)
Isolated sleep paralysis (ISP) episodes happen few and far between. A person can experience only one or several isolated episodes during life. ISP is usually not explained by other conditions, medications, and sleeping disorders such as narcolepsy.
Recurrent Isolated Sleep Paralysis happens more often. Two episodes are usually not more than six months apart. The condition is benign, but it is often associated with stress, insomnia, anxiety, fear of falling asleep, and narcolepsy.
What causes sleep paralysis?
Sleep paralysis equally affects both women and men of all ages. Although, first episodes of sleep paralysis are more common earlier in life.
The definite cause of this disorder is unknown. It seems that people with a family history of sleep paralysis stand a better chance of experiencing episodes. However, there is no genetic evidence for this.
Anyone can experience sleep paralysis. But, people with the following conditions are at a higher risk:
- Narcolepsy
- Insomnia
- PTSD
- Depression
- Anxiety
- Bipolar disorder
Exactly why other sleep disorders such as insomnia and narcolepsy increase the risk of sleep paralysis is also unknown. Researchers presume that is due to a miss-aligned sleeping pattern with the natural circadian rhythm in affected individuals.
That would explain why frequent sleep schedule changes are also one of the causes of sleep paralysis in healthy people.
Other common causes of sleep paralysis are:
- Sleeping on the back
- Obstructive sleep apnea (OSA)
- Nighttime leg cramps
- Substance abuse
- Use of certain medications
Narcolepsy and Sleep Paralysis
Narcolepsy is a chronic sleep disorder. Its main characteristics are sudden attacks of sleep during the day, regardless of the circumstances, and daytime drowsiness.
People with narcolepsy often experience sleep paralysis. They also have an increased risk of recurring episodes.
Sleep paralysis episodes with narcolepsy are not different from those in healthy people. However, if they are frequent, they are more likely to cause other health problems.
Effects on Health
Sleep paralysis cannot directly endanger your physical or mental health. Medically, it is a benign condition.
Most people only experience rare episodes of sleep paralysis. That is usually not enough to cause any problems. However, when sleep paralysis becomes a regular occurrence, some indirect health issues can emerge.
Ten percent of people with sleep paralysis have regular and bothersome episodes. As a result, some of them can develop a fear of sleeping.
They reduce their sleeping time to a minimum to not expose themselves to stress caused by sleep paralysis.
However, this can lead to sleep deprivation and increase the risk of other health consequences related to the lack of sleep, such as:
- Mood swings
- Irritability
- Fatigue
- Difficulty focusing
- Memory loss
- Depression
- Reduced sex drive
- Proneness to accidents
Symptoms
In itself, sleep paralysis is a symptom or a sign that your brain is not transitioning well enough through different stages of sleep. Luckily, it is usually not a symptom of a more serious physical or mental condition.
The symptoms of sleep paralysis include:
- Inability to move
- Inability to speak
- Hallucinations
- Fear
- Panic
- Anxiety
- Paranoia
- Pressure on the chest
- Choking
- Sweating
- Tingling or vibrating sensation
These are the most common reported symptoms. Not everyone will experience all of them during every sleep paralysis episode.
Treatment Options
Very often, treatment for sleep paralysis is unnecessary. After all, it is a common, benign, and relatively normal condition. If there are no mental or physical problems, there is no need to address sleep paralysis.
It is desirable, however, to treat the underlying conditions associated with sleep paralysis, such as:
- Obstructive Sleep Apnea,
- leg cramps,
- anxiety,
- PTSD, and
- Narcolepsy.
Unless you are looking at how to induce sleep paralysis, you will also want to avoid sleeping on your back.
Since sleep paralysis is a sleep disorder, the best way to get it under control is to improve your sleep quality. That means getting enough sleep at the right time.
Some prescription medications can help you to improve your sleep. However, they can have some side effects.
Remember, whatever you choose to do, sleep paralysis is only scary but does not damage your health and leaves no permanent trauma.
The Bottom Line
An occasional episode of sleep paralysis should not worry you. After all, there is no need to fear things that are not real.
If you are looking at how to stop sleep paralysis, there are some steps that you can take to get more nighttime rest. These can help you to relieve stress and, potentially, prevent new episodes of sleep paralysis.
These are some things you can do:
- Set up a pre-bed routine (get in your pajamas and read a book)
- Follow the same sleeping schedule every day
- Avoid sleeping on your back.
- Do not consume coffee, alcohol, or heavy meals late in the day.
- Avoid using computers, smartphones, or watching TV for at least one hour before going to be.
- Make sure that your room is not too warm.
- Eliminate noise and light intrusion
References:
- Denis D. Relationships between sleep paralysis and sleep quality: current insights. Nat Sci Sleep. 2018;10:355-367. https://doi.org/10.2147/NSS.S158600
- Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2018 Apr;38:141-157. DOI: 10.1016/j.smrv.2017.05.005. Epub 2017 Jun 8. PMID: 28735779.
- Farooq M, Anjum F. Sleep Paralysis. 2020 Sep 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 32965993.
- Denis D, Poerio GL. Terror and bliss? Commonalities and distinctions between sleep paralysis, lucid dreaming, and their associations with waking life experiences. J Sleep Res. 2017 Feb;26(1):38-47. DOI: 10.1111/jsr.12441. Epub 2016 Jul 27. PMID: 27460633; PMCID: PMC5245115.
- Jalal B. The neuropharmacology of sleep paralysis hallucinations: Serotonin 2A activation and a novel therapeutic drug. Psychopharmacology (Berl). 2018 Nov;235(11):3083-3091. DOI: 10.1007/s00213-018-5042-1. Epub 2018 Oct 5. PMID: 30288594; PMCID: PMC6208952.
Dr. Rosmy Barrios is a medical doctor and the current Head of the Regenerative Aesthetics department at IM Clinic in Belgrade, Serbia.