Sleep Paralysis: Explaining A Terrifying Phenomenon And How You Can Manage It.

We’ve all had the experience of feeling like we can’t move during a dream, that trapped and frozen fear or impending doom. However, if this has happened while you’re either falling asleep or awakening, this phenomenon has a name: sleep paralysis. During sleep paralysis, you are conscious but unable to move your body.  You may also hallucinate, hear voices, or feel as though you can’t breathe, and you may even feel as if someone were choking you. Pretty terrifying.

It can be a terrifying ordeal, but understanding what’s causing it can empower you and make you feel much less stress about it. We’re going to discuss what causes sleep paralysis during REM (rapid eye movement) sleep and how you can reduce the chances of it happening to you.

The Experience

As you begin to fall asleep, your muscles relax, and become less responsive to neurological signals from your brain. During a sleep paralysis event, your body begins to pass through this relaxation curve but your mind is awake just enough to notice that your conscious brain is no longer controlling your ability to move or speak.

Likewise, sleep paralysis can occur when you are in the process of awakening. In this case, your mind slips from sleep mode to near total consciousness before your last REM sleep cycle is finished. During REM sleep, your body is essentially paralyzed, and your muscles are unresponsive so that you don’t physically act out your vivid dreams.  Perhaps this phenomenon was an evolutionary response to keep humans quiet and calm during the night so that predators could not hear rustling or disturbances from our “nests”, which would reveal our whereabouts.

Further, waking up before the final stage of REM sleep is finished can cause you to hyperventilate and hallucinate also, which adds enhanced terror to the event. Fortunately, sleep paralysis is only a temporary event and usually lasts only a few seconds.

How many people experiencing sleep paralysis?

Sleep paralysis most commonly happens to people with narcolepsy, although it can happen to those without it as well. It affects men and women equally, and is more likely to occur in teenagers or younger adults.  It is often inherited, and it is most common in individuals with post traumatic stress disorder or panic disorder.  Sleep deprivation or a shifting sleep schedule (shift work) can also cause sleep paralysis.

How To Prevent Sleep Paralysis

Although there is no recognized treatment for sleep paralysis, you can take practical measures to help prevent it. First and foremost, make sure you’re getting enough sleep each night plan a consistent sleep routine. Try sleeping on your side or your belly since back sleepers are more prone to the conditions. 

It’s important to  speak with your healthcare provider if you are suffering from underlying depression or mood disorders that might be contributing to your experiences with sleep paralysis.  Keep in mind though, that while frightening, sleep paralysis is not inherently dangerous and typically lasts only a few seconds.

Facts About Sleep Paralysis

  • Sleep paralysis is the sensation of being unable to move, generally at the onset of sleep or upon awakening. A person’s senses and awareness are intact, but they may feel as if there is pressure pressing down upon them, or as if they are choking, and the experience may be accompanied by hallucinations and fear.

  • Although sleep paralysis is not life-threatening, it cancreate extreme anxiety. It can occur concurrently with other sleep disorders, such as narcolepsy. It often starts during adolescence, and it can become frequent during the 20s and 30s. It is not a serious risk.

  • Sleep paralysis is most likely to occur during adolescence, with episodes lasting from a few seconds to a few minutes. It can be bought on by stress, jet lag, sleep deprivation and panic disorders.

  • An inability to move or speak is a key feature, and there might also be hallucinations present, though it is not physically harmful and it can be prevented.

  • Hallucinations and a feeling of terror may accompany sleep paralysis.

Sleep paralysis is a parasomnia, an undesired event that is associated with sleep. These events are often accompanied by hypnagogic events, which are visual, auditory, and sensory hallucinations. These events occur during the transition between sleeping and awakening, and they usually fall into one of three categories:

  • Intruder: Perceived sounds like doorknobs opening, shuffling footsteps, objects being manipulated, shadows moving across the room, or just a strong sense of an evil or threatening presence nearby.

  • Incubus: Feelings of pressure on the chest, difficulty breathing with the sense of being smothered, strangled or sexually assaulted by a malevolent being. The individual believes they are about to die.

  • Vestibular-motor: An overwhelming sense of spinning, falling, floating, and hovering over your own body, as if it were disconnected.

The experience of sleep paralysis has been described for centuries. Sleep paralysis is brief and not life threatening, but the person may remember it as haunting and horrifying. Descriptions vary from culture to culture.

How REM Sleep Contributes To Sleep Paralysis

As we mentioned earlier, while sleeping, the body relaxes, and voluntary muscles do not move. This prevents people from injuring themselves due flailing body movements in our lucid dreaming during sleep. Sleep paralysis involves a disruption or fragmentation of the rapid eye movement (REM) sleep cycle. Typically, sleep paralysis is observed more frequently when a person is under stress.

During sleep, the body cycles between rapid eye movement (REM) and non-rapid eye movement (NREM). A typical REM-NREM cycle lasts an average of 90 minutes, most of them being spent in NREM. During NREM, the body relaxes. During REM, the eyes rapidly move as the brain is engaged in dreaming, however the body is relaxed. 

In a sleep paralysis event, the body’s ability to transition to or from REM sleep is not in sync with the brain. The individual is conscious and wake while their body remains in a paralyzed sleep state.

Sleep paralysis can be a symptom of medical problems such as clinical depression, migraines, obstructive sleep apnea, hypertension, and anxiety disorders. Also, everyday non-threatening sounds, sensations, or other stimuli that typically blends into the background suddenly is perceived as threatening.

When Medical Attention Is Necessary

Sleep paralysis is not generally considered a medical diagnosis, but if severe anxiety and distress are part of the experience, it may be a good idea to see a doctor. 

Medical attention may be warranted when:

  • Sleep paralysis events are frequent

  • Anxiety is present and interferes with falling sleep and sleep induction.

  • An individual falls asleep suddenly or experience narcoleptic symptoms during the day. Narcolepsy is a brain disorder that causes a person to fall asleep or lose muscle control at unexpected or inappropriate times. 

While there is no specific treatment for sleep paralysis, although stress management, designing a regular sleep schedule, a really comfortable and supportive mattress, and practicing good sleep hygiene, such as turning off blue light emitting devices can reduce the likelihood of sleep paralysis.

Here are some effective practices for improving sleep hygiene: 

  • Providing a comfortable sleep environment, with cotton sheets, weighted blankets, and other top of the bed softgoods.

  • Appropriate sleep wear that keeps you from being overheated, along with a clean, dark and cool bedroom

  • Minimizing blue light exposure in the evening and using night-lights only for trips to the bathroom.

  • Getting outside during waking hours keeps our diurnal sleep cycles on track

  • Avoid working or studying in the bedroom and use the space for sleeping and sex only

  • Eliminate naps after 3PM, and keep micro sleeps and naps under 30 minutes

  • Avoid eating a heavy meal, and avoid eating anything at all within 2 hours of going to bed

  • Eliminate leaving TV or lights on while sleeping or falling asleep.
  • Avoid evening alcohol or caffeine products up to 5 hours before bedtime.

  • Exercise vigorously daily, but not within 2 hours of bedtime

  • Integrate a calming activity in your sleep hygiene ritual, such as reading or listening to relaxing music

  • Dock your phones and other devices outside the bedroom

  • Set down blue light emitting electronics and other EMF emitting devices aside at least 45 min. before going to bed

Understanding the physiology of sleep and the mechanism for sleep paralysis is an important step to overcoming sleep paralysis. Long term stress and disruption in the sleep cycle can have serious health consequences. Healthy sleep habits are necessary for sleep paralysis management, as well as overall health and wellness.