What is Sleep Paralysis?

Sleep paralysis is extremely common in the UK, with 30% of the population reporting that they have experienced it. Sleep disturbance is predominant in young women, up to the age of 24. Though not dangerous, research around sleep paralysis is limited.

What is sleep paralysis?

Sleep paralysis refers to a phenomenon when for a short period of time just after falling asleep, or waking up, an individual cannot move. This is not due to any physical impairment, as usually, the individual has no existing mobility issue. For the duration of the paralysis, the individual is partially or completely aware. Individuals who have experienced sleep paralysis report disturbing hallucinations and visualisations, alongside a feeling of not being able to breathe. Some report feeling as though they are being pushed down towards the mattress, and others note an out-of-body experience.

In some cases of sleep paralysis, the individual can be in between sleep and being awake, which can be a frightening, but non-harmful experience.

Other signs of sleep paralysis include:

• Being unable to speak.
• Panic.
• Tight chest and throat.
• Daytime fatigue.

When does sleep paralysis happen?

As mentioned, sleep paralysis occurs shortly after falling asleep, or just after waking up. Sleep paralysis occurs at the beginning or at the end of the REM stage of sleep (Rapid Eye Movement). This refers to a phase of sleep where the eyes move around in many directions, but as your eyes are closed, they do not create visual images.

The REM stage of sleep follows the non-REM stage of sleep. The non-REM stage of sleep refers to the period of sleep as you instantly start to fall asleep. Though your body is preparing for deep sleep, it is easy to be woken up. REM sleep typically begins around 90 minutes after falling asleep and is the stage of sleep where vivid dreaming occurs, as your brain is more stimulated.

Young people are in the REM stage of sleep the most, with older people experiencing REM sleep less and less, with much older people remaining mostly in a light sleep. Young people also report sleep paralysis much more frequently than older people.

What causes sleep paralysis?

When a person is dreaming during the REM stage of their sleep, they are in a state of atonia, meaning that they have temporarily lost active control of their muscles. This is the brain’s innate defence mechanism, as a way of preventing people from acting upon the events of their dreams without consciousness.

When an individual wakes from the REM stage of sleep, they usually regain muscle control instantly. However, a person with sleep paralysis experiences being in the non-REM and REM stages of sleep simultaneously. They appear to have the visualisations and dreams of REM sleep, but awareness and even wakefulness. This can be a very scary experience, as the body is unable to move, whilst the individual may be experiencing visualisations that make them instinctively want to move.

Whilst this explains how sleep paralysis occurs, it is unknown why it occurs, and why it occurs to some and not others. However, people who suffer from mental health issues such as anxiety and PTSD are more likely to be affected by sleep paralysis at some point in their lives. Equally, people who have been subject to physical, sexual and emotional abuse are more likely to experience sleep paralysis. It is thought that long-standing or suppressed anxiety can cause an individual to wake in the REM phase of sleep.

People with other sleep disorders also report higher rates of sleep paralysis. People who suffer from sleep apnoea, a condition which affects breathing during sleep, report more instances of sleep paralysis, as well as people who generally have more frequent wakefulness due to insomniatic sleep disorders.

People who have daytime sleepiness and sleeping routines that are out of sync with the day’s natural patterns of light and dark are more susceptible to sleep paralysis. It is also thought that people who have a tendency to daydream are more prone to instances of sleep paralysis.

Additionally, sleep paralysis may be triggered by discontinuing the use of substances such as alcohol, drugs and antidepressant medications.

What happens during sleep paralysis?

During sleep paralysis, as the body is unable to move, the individual feels aware of their surroundings but unable to engage with them. The majority of people experience hallucinations during a sleep paralysis episode, which do not correlate with their dreams. An instance of sleep paralysis lasts on average for 7 minutes but can last up to three times longer.

There are three types of hallucination that can occur:

• Vestibular-motor hallucinations – These types of hallucinations can mimic sensations of movement, e.g. running, walking, or flying.
• Chest pressure hallucinations – These types of hallucinations mimic a sensation of suffocating/difficulty breathing, as if someone or something is sitting heavily on your chest.
• Intruder hallucinations – These can occur with chest pressure hallucinations, and mimic the sensation that something or someone else is in the room.

Sleep paralysis alongside hallucinations can be extremely disturbing, with many sufferers fearing going to sleep. Most instances of sleep paralysis come to an end without any assistance, but sometimes someone needs to intervene by speaking or touching the individual.

Who develops sleep paralysis?

Sleep paralysis is common in young people. Sleep paralysis can happen at any age, but tends to be noticed first during childhood and up to the age of 25. It is also more likely to occur in people who are sleep deprived, or people who have a very disruptive sleep schedule. These may be people who work in jobs with night shifts, or even new parents who are in and out of sleep at unusual times.

Myths about sleep paralysis

Sleep paralysis has a long history in folklore, with many different tales being passed down through generations about the reason for its occurrence. The first time sleep paralysis was officially recorded was in 1664, in the Journal of Sleep Research. The woman who was subject to the episode of sleep paralysis described it as the ‘devil’ being on top of her and holding her down.

Sleep paralysis is often depicted in imagery as a dark, fantastical figure holding the subject down on a bed. Other common myths surrounding sleep paralysis include that it is the result of alien abduction, or enemies plotting against you.

There are other myths about sleep paralysis, which on the surface may appear to hold more weight, but are in fact, untrue.

Sleep paralysis only has one standard form

There are actually two kinds of sleep paralysis, which relate to how frequently you experience them:

Isolated sleep paralysis

Isolated sleep paralysis refers to individual instances of sleep disturbances related to paralysis which are not linked to a disorder. A common disorder which stops the brain from being able to control when you wake up is Narcolepsy.

A symptom of narcolepsy is sleep paralysis, but in order to be diagnosed with narcolepsy, it must be more frequent. You can read more about narcolepsy by visiting our knowledge base.

Recurrent sleep paralysis

Recurrent sleep paralysis is when the paralysis occurs more than a few times, and could be indicative of a parasomnia condition like narcolepsy.

Sleep paralysis is dangerous

As your body is in a state of atonia, sleep paralysis doesn’t actually present any danger, as you are unable to act on your hallucinations or nightmares. Whilst it can feel as though your breath is being restricted, this is not the case.

Frequently disturbed sleep can have negative effects on your overall health; however, sleep paralysis itself is not threatening. The paralysis experienced is not physical, though it can feel very real for those few minutes.

How is sleep paralysis diagnosed?

Sleep paralysis is simply diagnosed by a series of questions posed by a doctor or sleep specialist. It is best when visiting a doctor to take a record of your sleeping patterns and episodes of sleep paralysis.

• The specialist will ask about the frequency of the episodes, and what happens each time.
• You will need to give information about your sleep schedule, including your job, the amount of time you spend in bed and whether your sleep feels restful.
• It would be useful to know if there is a history of sleep paralysis in your family.
• You will need to report whether you are using any substances that could interfere with sleep, e.g. alcohol, drugs, or antidepressants.
• Any mental health conditions that involve stress such as PTSD, anxiety and depression will be taken into consideration.

Sometimes, this information isn’t enough to diagnose sleep paralysis. A specialist might refer you for sleep tests which can help to determine if there is a sleeping disorder.

The two tests used are:

MSLT (Multiple Sleep Latency Test)

This test monitors the speed at which you fall asleep, and what phase of sleep you experience when you fall asleep during the daytime. MSLT is used to detect the presence of sleep disorders such as narcolepsy and idiopathic hypersomnia, two conditions which involve sleepiness in the daytime, where rest and sleep is unrefreshing. This can lead to sleep paralysis.

Polysomnogram

A polysomnogram is an overnight test which is done to monitor breathing, brain signals, oxygen levels and heart rate as you sleep. It also monitors eye and leg movements. The results of this test give specialists a good indication of sleep disorders such as sleep apnoea, where breathing during sleep is restricted. This too can lead to episodes of sleep paralysis.

How is sleep paralysis treated?

There is no known way of preventing sleep paralysis from happening, and it usually goes away on its own. Some people have managed to break themselves out of an episode when it occurs by moving body parts such as fingers and toes, which can arouse them from atonia. Many specialists advise to avoid sleeping on your back, as this can increase the chance of sleep paralysis.

Your doctor may refer you to a sleep specialist or for sleep therapy. Whilst this cannot cure any sleeping disorder, it can help to address some of the issues around sleep disorders such as creating a sleep schedule, which can help to create a routine for going to sleep and waking up. It is optimal for teenagers to get between 8 and 9 hours of sleep per day, and for adults between 6 and 8 hours. It is also advised to go to sleep and wake up at the same time each day so that your brain can learn to differentiate between sleep and wakefulness.

Sleep therapists can also help you with sleep hygiene. Practising good sleep hygiene means creating the right environment for restful sleep to occur. This could be not using your phone past a certain time, avoiding screens, taking baths, taking supplements, dimming lights or using a light bulb without blue light, and so on. Whilst this may not stop sleep paralysis, it can help make the other parts of your sleep restful.

You may also be referred for Cognitive Behavioural Therapy (CBT), which can help to uncover behaviours that may trigger sleep paralysis, and move forward with new behaviours that can help to overcome episodes of sleep paralysis more quickly. You can read more about Cognitive Behavioural Therapy by visiting our knowledge base.

Who can help with sleep disorders?

• The Sleep Charity offers support to people who suffer from sleep disorders, including workshops and courses that can help to overcome different sleep disorders.
• Anxiety UK is a charity that helps people who are suffering from anxiety disorders. This can be useful to get support with anxieties that may be playing a role in sleep disturbance, and the anxiety around going to sleep that sleep paralysis can instil.

Many people who suffer from sleep disorders use apps such as Calm, which has been reported by many users to play a role in improving their sleep and reducing anxiety. Calm has a library of stories, sounds and CBT programmes available on the app which can be used at bedtime and throughout the day.

Some people find that conventional approaches are not useful, so they look into hypnotherapy. Hypnotherapy is not proven to help sleep paralysis. The Hypnotherapy Directory can connect you with qualified specialists who can help you to decide if hypnotherapy is the right approach.