Sleep Paralysis.

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It’s possible you’ve heard about it before, perhaps from a friend or an acquaintance. Perhaps you’ve even experienced sleep paralysis yourself. 

‘Paralysis’ is a scary word in itself, and when put together with the word ‘sleep’, it conjures up a whole lot of unwanted images. Just like this sleep condition’s name suggests, ‘paralysis’ means the inability to move. So, with this definition in mind, what is sleep paralysis? 

Sleep paralysis means that you’re unable to move your body during two phases of the sleep process – when falling asleep (predormital or hypnagogic form) and when waking up (postdormital or hypnopompic form).

Over the years, medical professionals and researchers have had problems pinpointing the causes of sleep paralysis. Another unknown was how many people have actually experienced sleep paralysis – in many ways it is still a baffling subject. 

To add to the confusion, a variety of studies that have been carried out show a staggering difference in the amount of people suffering from sleep paralysis. The range was massive to say the least – from 5 to 65%. 

But in 2011, Sharpless and Barber were able to shed a bit of light with their research paper: Prevalence of Sleep Paralysis.

They concluded that around 8% of people experiences sleep paralysis at some stage of their lives. This rises to 28% for those deemed ‘high risk’, in other words those who already have disrupted sleep patterns. This number then jumped again with them suggesting that a staggering 34% of people that have some sort of psychiatric disorder like depression or anxiety will also experience sleep paralysis. With these stats in mind, sleep paralysis occurs more than we probably even realise.  And because sleep paralysis alone is not dangerous, there are probably many cases that go unreported. 

The idea of sleep paralysis alone is enough to freak a person out, so imagine when you’re actually unable to move but conscious of your surroundings. It’s more than likely that whoever’s having a sleep paralysis episode will feel anxious and afraid. In some cases, they may even have hallucinations. And this seeing and hearing things only leads to more panic. 

Why does Sleep Paralysis Happen?

Under normal circumstances your brain sends messages to your muscles to relax and remain still during your sleep; this state is known as ‘atonia’. Sleep paralysis is when this ‘atonia’ happens while you’re awake. 

Obviously, sleep paralysis leaves you being unable to move your limbs, body and head. In some cases, you may not even be able to speak, but despite the lack of speech, breathing is normal and you’ll be completely aware of what’s going on. 

An episode can range in time. Usually it’ll just end by itself and sometimes it’ll end when another person touches or speaks to you, bringing you out of that ‘trance-like’ state.

A sleep paralysis episode may be a one-off or it may be a regular occurrence. It all depends on the person and their mental wellbeing and sleep history.  

So far there’s no research to state that a person is born with sleep paralysis. It’s typically developed when a person’s in their 20s or 30s, and although it may continue into a person’s later years, it isn’t considered to be a serious medical condition. 

What Causes Sleep Paralysis? 

You’re probably thinking ‘Why me?’ ‘Why not him/her?’ The truth is sometimes it is just potluck. 

Sleep paralysis takes place when some parts of your rapid eye movement sleep (REM) happens while you’re still awake instead of being fast asleep. 

The REM stage of sleep is when the brain goes into overdrive – it’s really active, which is why it makes sense that it’s also the stage that people often have dreams. 

During the normal REM stage, when you’re sleeping, your body doesn’t move, although you’re still able to breathe. A possible explanation of not being able to move during the sleeping REM phase is to keep a person safe – in other words there’s no chance that you can act out your dreams.

Despite all the research and studies that have been carried out, medical experts still aren’t 100% as to why some people experience REM while awake and others don’t. The most likely explanations are: 

  • Sleep deprivation
  • Insomnia
  • Irregular sleep patterns
  • Jet lag
  • Narcolepsy
  • A family history
  • Sleeping on the back



Sleep Paralysis and Narcolepsy – The Link

You’ve probably heard of that condition where a person can just fall asleep out of the blue. This condition is called narcolepsy. Some people with narcolepsy don’t even realize that they’ve got it until later on in life because they don’t display all the more known signs of narcolepsy (which debunks the notion of always falling asleep at random times and random places). 

There are a number of symptoms of narcolepsy, with unexplained sleepiness during the day being one of them. Another one is sleep paralysis. So, if a person experiences frequent sleep paralysis episodes and he or she hasn’t been formally diagnosed with narcolepsy as yet, the doctor will run more tests to try and rule it out and get to the root of the recurrent sleep paralysis attacks.

Sleep Paralysis Symptoms – How to know if you’re having an Episode 

When you suffer from a sleep paralysis episode you’re fully aware of your surroundings and what’s going on. But during this moment, you’re also unable to move or speak which can be extremely frightening.

Although you’ll be able to breathe, panic often sets in. People will often try to take deep breaths, but may have difficulty doing so. Some people have even gone as far as describing it as if your chest is being either ‘crushed’ or ‘restricted’. 

You’ll also find that moving your eyes during this period is near impossible. Some might not be able to open their eyes despite being conscious while others find something as normal as blinking unmanageable.

Then there are the hallucinations. A few have described it as a ‘bad trip’. This symptom of sleep paralysis, although rare, can be eerie. You may have an awful sensation that you’re not alone, like there’s someone else or something together in the room with you. 

No matter how scary it is you’ll be 100% fine after experiencing sleep paralysis. Once the moment has passed, everything will go back to normal. It’s not dangerous, and you’ll be able to speak and move as normal afterwards. Feeling unsettled afterwards is however inevitable.

To briefly sum up, symptoms of sleep paralysis include:

  • Inability to move while falling asleep or waking up
  • Being conscious
  • Inability to speak or move the mouth
  • Feeling chest pressure
  • Hallucinations
  • Having difficulty taking heavy breaths
  • Having trouble deciphering what was real and what wasn’t after a sleep paralysis event
  • Sweating
  • Feeling paranoia
  • Headaches



When to Consult a Doctor 

You might feel inclined to go to the doctor in the first instance if you suffer from sleep paralysis for the first time, but you need to remember that the majority of sleep paralysis cases are just a one time thing – once it happens, the chances are that it’s going to happen again are very low. 

You do need to remember that sleep paralysis isn’t harmful. Usually consulting a doctor isn’t necessary, however, in instances when you experience it on a regular basis, it’s advisable to get booked in to see your family doctor, who will likely refer you to a specialist, such as a neurologist.  

You should also consult a doctor if you feel more anxious than usual when going to sleep, as this could affect your sleeping habits. And more importantly, if you suffer from insomnia and you’re having trouble sleeping often, you should also pop into your doctor’s clinic for some advice.

The same goes for if you constantly feel unusually sleepy throughout the day, or if you have moments when you just suddenly fall asleep of lose control of your muscles. These could be more serious signs of an underlying sleep disorder like narcolepsy. 

Visiting your doctor shouldn’t be a scary thing. It’s best to get everything under control so you can rest easy at night. In most cases, if your doctor doesn’t think there’s a cause for concern, he or she will suggest a number of ways in which you can improve your sleeping habits and your overall quality of sleep. 

When your doctor feels that you need to undergo further checks, they’ll refer you to a medical practitioner that specializes in sleep and sleep disorders, such as a neurologist. 


Sleep Paralysis – The Risk Factor 

Let’s get one thing straight. As scary as sleep paralysis is, it can’t harm or kill you. However, like with every kind of health condition there are a few typical risk factors that have been identified. 

The most common risk factor associated with sleep paralysis is sleep disruption. Researchers have found that those people who already have disrupted sleep patterns, such as people that work shifts or those who’re insomniacs are more at risk of having a sleep paralysis episode. 

Some other risk factors could include stress, anxiety, depression, and a distressing life event. All of the above mentioned impact a person’s life, especially their sleep. 


1. Disrupted Sleep 

Studies show that if a person has a disrupted sleep cycle, there is an increased risk of sleep paralysis. The researchers deprived volunteers of their REM sleep by waking them up frequently before they reached this stage. Eventually, this brought about a sudden onset of REM while some of the volunteers were still asleep. Out of 184 volunteers, there were eight recorded episodes of sleep paralysis.


2. Distressing Life Event

Other research shows that people who are prone to panic attacks or have had post-traumatic stress disorder (PTSD) are more at risk of having a sleep paralysis episode due to the higher levels of physiological arousal.  

An example of the above is a study that was carried out on 100 refugees. In a period of a year, 49 out of the 100 had experienced at least one sleep paralysis episode. A number of those refugees were clinically diagnosed with PTSD, 65% of which had at least one sleep paralysis attack each month.

In 2008, similar research was carried out in the US. This showed something quite startling – sleep paralysis was more common among African Americans compared to the white American population. The researchers suggested that there were a number of factors that contributed to that higher percentage, with social hardship and racism playing major roles. 


3. Stress, Anxiety and Depression 

Today, the world is a crazy place. There’s so much pressure and more and more people are becoming affected by stress, anxiety and depression. Eventually, such negative feelings do take its toll on you, so it’s no surprise that they also adversely affect our sleep. 

Studies show that patients that have been clinically diagnosed with some sort of stress or anxiety disorder are more prone to sleep paralysis due to disrupted sleep and irregular sleeping patterns. The same research also discovered that drugs that are commonly used to treat such mental illnesses don’t significantly reduce the rates of sleep paralysis. 

It’s also been found that young students are most affected by the anxiety and sleep paralysis connection. Young people are not as aware of their emotions, and often do not know how to deal with stress of study and other stressors effectively.

Extreme anxiety, such as fearing death or having the fear of being constantly watched also causes a great deal of social anxiety. Studies in this area found that such distress often triggers a variety of sleep disorders, with the most common one being sleep paralysis. 

What’s more, when a person seriously has social anxiety while they’re awake, it’s more likely they’ll experience threatening hallucinations or sense an ‘evil presence’ as they dream in their REM sleep, which of course adds to the likelihood of them having a sleep paralysis episode. 


Sleep Paralysis – Fast Facts

  • There are higher chances of sleep paralysis occurring during adolescence.
  • The majority of sleep paralysis cases occur when people are sleeping on their backs. 
  • Sleep paralysis episodes last from just a few seconds to a few minutes.
  • There is a link between having recurrent sleep paralysis episodes and narcolepsy.
  • Stress and predisposed disorders can bring on sleep paralysis.
  • Sleep paralysis is often accompanied by hallucinations.
  • During sleep paralysis a person has the inability to move.
  • Sleep paralysis can’t harm you physically. 
  • It is preventable. 



Reduce the Risk of Sleep Paralysis 

Thankfully, sleep paralysis doesn’t have to feature heavily in your life. By improving your overall lifestyle, health and sleep patterns, you’ll be able to drastically cut your chances of experiencing sleep paralysis. 

A lot of this is common sense. Most of it boils down to focusing on the basics of having a healthy sleep. 

The number one thing you need to do is to get into a good sleeping routine. Some people struggle with this, especially if they’re used to having disrupted sleep. Simple tweaks to your lifestyle and daily routine can significantly help you. 

Go to bed and wake up at around the same time on a daily basis. Aim to get around 8 hours of sleep on a daily basis. Too little and too much sleep can have a negative effect on your sleep patterns. 

Steer clear of anything that’s going to keep you awake. This is especially true for alcohol, caffeine and nicotine. Add some regular exercise to the mix, maintain a healthy weight, eat well, and avoid eating too late at night will also help. 

Since there are proven links between stress, anxiety, and depression and sleep paralysis, taking care of your mental health is also imperative. Because of today’s hectic world and the amount of everyday stressors we face, anxiety and depression are common. You should never feel like you can’t seek medical advice or help, and once you have these feelings under control, it’s likely it’ll affect other areas of your life, namely your sleep. 


Tips for Getting a Better Night’s Sleep

  • Be consistent with betimes
  • Improve your sleeping environment
  • Maintain a clean bedroom
  • Have limited light exposure in the night while sleeping
  • Have a good amount of daylight exposure 
  • Do not nap after 3pm
  • Limit any napes to less than 90 minutes
  • Avoid heavy evening meals
  • Do not eat 2 hours before bedtime
  • Do not have any lights or the TV on while sleeping
  • Avoid caffeine and alcohol in the evenings
  • Take regular exercise
  • Avoid viewing any kind of electronic device at least 1 hour prior to going to bed
  • Practice calming rituals
  • Avoid sleeping on your back


Remember

This is probably easier said than done, but if you do happen to experience sleep paralysis or something similar, don’t panic. You will be fully aware of your surroundings and what’s going on with your body, so try and calmly remind yourself that despite the situation being terrifying and disturbing, it is only temporary. It’s also important to remember that sleep paralysis is harmless and it will soon pass. Having a better understanding of sleep paralysis may also help you avoid it by reducing its triggers.