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What Is Sleep Paralysis? Exploring The Causes And Triggers

Sleep paralysis, which may last anywhere from a few seconds to a few minutes, usually happens while a person is falling asleep or waking up. Episodes that last for a long time may cause anxiety and other negative emotions.

Alexander McCaslin
Jan 25, 20249 Shares9146 Views
Sleep paralysis, which may last anywhere from a few seconds to a few minutes, usually happens while a person is falling asleep or waking up. Episodes that last for a long time may cause anxietyand other negative emotions.
Despite experiencing suffocation and disturbing hallucinations, individuals remain cognizant during episodes.
A greater understanding of sleep paralysis and its prevention may be achieved by studying about the illness's kinds, symptoms, causes, effects, and treatment. Much remains unknown about the disorder, but this knowledge can help.
Conditions such as narcolepsy, sleep loss, high levels of stress, and alcoholism have all been associated to sleep paralysis.
Education on sleep stages and atonia is usually the extent of treatment, although sleep experts may assess for narcolepsy if episodes continue.

What Is Sleep Paralysis?

A brief inability to move or talk upon awakening or while falling asleep is known as sleep paralysis. It might be brief or it could be many minutes long.
Sleep paralysis affects about 8 out of every 100 individuals. This could happen once in a while or very often. It typically begins in adolescence and peaks between the ages of 20 and 40.
While it poses no real danger, it certainly has the potential to frighten.
'Rapid eye movement (REM)' sleep is characterized by a transient paralysis of the muscles and joints. So, you're basically paralyzed with pain. That might be your body trying to tell you that it doesn't want you to act out your fantasies.
It is common to feel immobilized when sleeping, although most people don't realize it happens since they are asleep.
You will be acutely aware of being paralyzed if the effects of rapid eye movement (REM) sleep on your muscles persist after you awaken.

Types Of Sleep Paralysis

Medical professionals typically divide sleep paralysis cases into two main categories.

Isolated Sleep Paralysis

This category encompasses singular sleep paralysis episodes that occur independently, without any underlying connection to narcolepsy.
Narcolepsy is a neurological disorder that disrupts the brain's ability to regulate wakefulness, often resulting in sleep paralysis. However, isolated sleep paralysis instances are standalone occurrences.

Recurrent Sleep Paralysis

In this category, individuals experience multiple episodes of sleep paralysis over an extended period. Recurrent sleep paralysis can be linked to narcolepsy, indicating a broader neurological concern.
It's worth noting that these categories are sometimes combined to characterize a specific condition known as recurrent isolated sleep paralysis (RISP). RISP involves persistent occurrences of sleep paralysis in individuals without narcolepsy, emphasizing the recurrent nature of these episodes.

Symptoms And Signs

When you wake up after a sleep paralysis episode, you won't be able to move or talk. In cases of sleep paralysis, patients may have auditory hallucinations like humming, hissing, static, zapping, and buzzing. Additionally, one may hear roars, murmurs, and voices.
During an episode, some people have reported feeling pressure on their chest and severe headache pain. Experiencing strong feelings like terror and panic is common with these symptoms.
Additionally, some people report feeling pulled out of bed or as if they are being propelled through the air, while othersreport feeling numb and experiencing electric tingles or vibrations all over their bodies.
One symptom of sleep paralysis is hallucinations, which may manifest as anything from a shadowy figure or invading presence in the room to a sensation of suffocation or panic, chest pain, and trouble breathing.

What Causes Sleep Paralysis?

Nobody knows what causes sleep paralysis. Data analysis efforts to identify risk factors for sleep paralysis have shown conflicting conclusions in the scientific literature. These results lead experts to suspect that sleep paralysis has a complex etiology.

Sleep Issues

There is significant evidence that some sleep disordersand other forms of sleep disturbance are associated with isolated sleep paralysis. Obstructive sleep apnea (OSA) is characterized by brief interruptions in breathing while sleeping.
People with this disease are more likely to have sleep paralysis, with a rate of 38% in one research. Chronic insomnia, disruption of the circadian cycle, and overnight leg cramps are all risk factors for sleep paralysis.

Led Sleep Disorder

Narcolepsy may be associated with a pattern of recurrent episodes of sleep paralysis. Narcolepsy's effects on the brain's neurotransmitters may result in sleep paralysis and other issues during rapid eye movement (REM) sleep.
While sleep paralysis does affect around 20% of the population on occasion, narcolepsy patients tend to have more regular episodes.
If you notice any of the following symptoms of narcolepsy: involuntary nodding off at odd hours, excessive daytime drowsiness, or weak muscles, it may be time to see a medical professional.
Research has linked sleep paralysis to certain mental healthissues. Those who have experienced or seen extreme emotional or physical trauma, as well as those who suffer from post-traumatic stress disorder (PTSD), tend to have stronger connections.
As far as anybody can tell, the illness is more common among those who already suffer from anxiety disorders, this includes panic disorder. REM rebound, which can occur after stopping alcohol or antidepressants, may be the cause of sleep paralysis.
People with a historyof sleep paralysis in their family are at a greater risk, according to studies, although the exact genetic cause is yet unknown.

Patterns In Dreams

Sleep paralysis is more common in those who exhibit characteristics of being creative and disassociated from their immediate surroundings, including daydreaming, according to some research.
Additionally, lucid dreaming or severe nightmares may have a connection to sleep paralysis. To learn more about the many possible causes of sleep paralysis and to look into these connections, further study is required.
View of a man sleeping in bed while scary thing is holding him.
View of a man sleeping in bed while scary thing is holding him.

How Is Sleep Paralysis Diagnosed?

If you experience episodes of temporary paralysis, rendering you unable to move or speak for brief durations during the transition into or out of sleep, you may be dealing with isolated recurrent sleep paralysis. In many cases, this phenomenon does not necessitate specific treatment.
However, it becomes advisable to consult your healthcare provider under the following circumstances:
  • Anxiety Concerns:If you find yourself feeling anxious or distressed about these episodes, it's prudent to seek professional advice. Discussing your concerns can provide reassurance and insights into managing anxiety related to sleep paralysis.
  • Daytime Fatigue:Persistent fatigue during the day resulting from these episodes should not be ignored. Fatigue can impact your overall well-beingand daily functioning, making it essential to explore potential solutions or interventions.
  • Sleep Disruption:If the episodes significantly disrupt your sleep patterns, leading to prolonged periods of wakefulness during the night, it's crucial to address this issue. Quality sleep is vital for overall health, and consistent disruptions can have long-term consequences.
In the event of these concerns, your doctor might take the following steps to understand your sleep health:
  • Symptom Description and Sleep Diary:Your doctor may request a detailed description of your symptoms and ask you to maintain a sleep diary for a few weeks. This diary can offer valuable insights into patterns and triggers associated with sleep paralysis.
  • Health History Discussion:A comprehensive discussion about your health history, including any known sleep disorders or family history of such conditions, can aid in understanding the context of your symptoms.
  • Referral to a Sleep Specialist:Based on the assessment, your doctor might refer you to a sleep specialist for a more in-depth evaluation. Sleep specialists are equipped to delve into specific aspects of sleep disorders and provide tailored recommendations.
  • Sleep Studies:To rule out the presence of any other sleep disorders, your healthcare provider may recommend overnight sleep studies or daytime nap studies. These diagnostic tools can help identify potential contributing factors to your experiences.

Sleep Paralysis Treatment

Initiating medical treatment for sleep paralysis starts with a comprehensive understanding of sleep stages and the specific occurrences during REM sleep, where muscle movement is temporarily restricted. In cases where symptoms persist, evaluating individuals for narcolepsy becomes a crucial step in determining appropriate interventions.
The primary emphasis, however, is placed on adopting healthier sleeping habits as the safest treatment for sleep paralysis. Despite ongoing research and prescription of medications such as tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs), a definitive drug that consistently interrupts sleep paralysis episodes remains elusive.


While comprehensive trials on the treatment of sleep paralysis are limited, there are promising indications from case studies. Trials involving GHB for individuals with narcolepsy have shown reductions in sleep paralysis episodes. Pimavanserin is also being considered as a potential candidate for future studies focused on treating sleep paralysis.

Cognitive-Behavior Therapy

Early efforts in addressing sleep paralysis involved cognitive-behavior therapy, specifically CA-CBT. This therapeutic approach centers on psycho-education and the modification of catastrophic cognitions related to sleep paralysis attacks.
Despite its historical use in Egypt, clinical trials validating its efficacy are currently lacking. A notable development in psychosocial treatment is cognitive-behavior therapy for isolated sleep paralysis (CBT-ISP).
This method involves self-monitoring of symptoms, cognitive restructuring to address maladaptive thoughts, and psychoeducation about the nature of sleep paralysis.
Prevention techniques encompass ISP-specific sleep hygiene and the preparatory use of relaxation methods like diaphragmatic breathing, mindfulness, progressive muscle relaxation, and meditation.
Episode disruption techniques are introduced and practiced during sessions, later applied during actual sleep paralysis attacks. Although controlled trials are needed to prove that CBT-ISP works, it is a big step forward in the field of psychosocial treatment for recurrent isolated sleep paralysis.

Is Sleep Paralysis Dangerous?

Sleep paralysis is usually not thought to be hazardous for the majority of individuals. Although it may lead to emotional discomfort, this condition is generally benign and does not occur often enough to have serious health consequences.
But for almost 10% of the population, sleep paralysis is a chronic, debilitating condition. Consequently, individuals can start to dread going to bed, cut down on the amount of time they set aside for sleep, or experience worry in the hours leading up to bedtime, all of which can make it difficult for them to achieve a good night's sleep.
Lack of sleep has several negative effects on health, including making people too drowsy throughout the day.

Cultural Significance And Priming Of Sleep Paralysis

Atonia, a distinct sensorium, and frequent hallucinations are the hallmarks of sleep paralysis, although how these symptoms manifest varies between cultures and eras.
The symptoms of sleep paralysis—atonia, a transparent sensorium, and recurrent hallucinations—can vary in presentation depending on the individual, the setting, and the culture.
Some believe it could explain spiritual and paranormal events such as ghosts, extraterrestrial visitation, demons, abduction experiences, night hags, and shadow people hauntings; more than a hundred phrases have been associated with these encounters.
A culture's dread of sleep paralysis, for example, may cause conditioned fear, which in turn would make the experience more difficult and increase the prevalence of the disorder.
For example, there have been reports of high rates and extended periods of immobility in Egypt, where sleep paralysis is linked to intense terror and the dread of death.
In a study that evaluated the prevalence and features of sleep paralysis in Egypt and Denmark, researchers discovered that the former had a threefold higher prevalence rate than the latter.
This is because in Denmark, where the phenomenon is not associated with any strong supernatural beliefs, it is often seen as a strange physiological occurrence.

FAQs - Sleep Paralysis

Can Sleep Paralysis Be Treated With Medication?

Yes, certain medications like tricyclic antidepressants or SSRIs may be used, but there is currently no drug that completely interrupts sleep paralysis episodes.

Is Cognitive-behavior Therapy Effective In Treating Sleep Paralysis?

Cognitive-behavior therapy, specifically CBT-ISP, has shown promise in addressing recurrent isolated sleep paralysis. However, controlled trials are needed to establish its effectiveness conclusively.
Narcolepsy is associated with excessive daytime sleepiness and sudden muscle weakness (cataplexy). It is evaluated if individuals experience persistent sleep paralysis episodes.

Are There Ongoing Trials For Medications To Treat Sleep Paralysis?

While no large trials have taken place, there are indications from case studies that drugs like GHB and Pimavanserin hold promise in reducing sleep paralysis episodes.

How Does Episode Disruption Technique Work In Cognitive-behavior Therapy For Sleep Paralysis?

In CBT-ISP, episode disruption techniques are practiced during sessions and later applied during actual sleep paralysis attacks. The specifics involve implementing techniques learned in therapy to interrupt and manage episodes effectively.

Final Words

While isolated recurrent sleep paralysis may not always necessitate immediate action, seeking medical advice is essential when anxiety, daytime fatigue, or significant sleep disturbances are present.
Collaborating with healthcare professionals can lead to a better understanding of your sleep health and the development of appropriate strategies for improvement.
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