Sleep paralysis is a condition in which a person is mentally conscious but physically unable to move. It is sometimes accompanied by hallucinations. The result is a scary, almost nightmarish experience of sensing an intruder but being unable to respond. Thankfully, this is nothing more than the product of a half-awake brain. We sat down with our very own Dr Priyanka to get a more thorough understanding of sleep paralysis and why it happens.
Sleep paralysis is a temporary loss of muscle function while you’re sleeping which typically occurs:
- as a person is falling asleep
- shortly after they have fallen asleep
- while they’re waking up
According to the American Academy of Sleep Medicine, people with sleep paralysis usually experience this condition for the first time between the ages of 14 and 17 years old.
It’s a fairly common sleep condition. Researchers estimate that between 5 and 40 percent of people experience this condition.
Episodes of sleep paralysis may occur along with another sleep disorder known as narcolepsy.
Narcolepsy is a chronic sleep disorder that causes overwhelming drowsiness and sudden “sleep attacks” throughout the day. However, many people who don’t have narcolepsy can still experience sleep paralysis.
This condition isn’t dangerous. Though it can feel alarming to some, no medical intervention is usually necessary.
What are the symptoms of sleep paralysis?
Sleep paralysis isn’t a medical emergency. Being familiar with the symptoms can provide peace of mind.
The most common characteristic of an episode of sleep paralysis is the inability to move or speak. An episode may last for a few seconds to about 2 minutes.
You may also experience:
- feeling as if something is pushing you down
- feeling like someone or something is in the room
- feeling fear
- hypnagogic and hypnopompic experiences (HHEs), which are described as hallucinations during, right before, or after sleep
Our GP Dr. Priyanka Vaidya, notes that other symptoms may include:
- difficulty breathing
- feeling as if you’re going to die
- muscle aches
Episodes typically end on their own, or when another person touches or moves you.
You may be aware of what’s happening but are still unable to move or speak during an episode. You may also be able to recall the details of the episode after temporary paralysis disappears.
In rare cases, some people experience dreamlike hallucinations that may cause fear or anxiety, but these hallucinations are harmless.
What are the causes and risk factors of sleep paralysis?
Children and adults of all ages can experience sleep paralysis. However, certain groups are at a higher risk than others.
Groups that are at an increased risk include people with the following conditions:
- anxiety disorders
- major depression
- bipolar disorder
- post-traumatic stress disorder (PTSD)
Sleep paralysis is also usually caused by a disconnect between mind and body, which happens during sleep, says Dr Priyanka.
She also notes that the usual causes include:
- poor sleep hygiene, or not having proper sleep habits that are necessary for good quality sleep
- sleep disorders like sleep apnea
- Having a disrupted sleep schedule has also been linked to sleep paralysis. Examples where your sleep schedule can be disrupted include working night shifts or being jet lagged
In some cases, sleep paralysis seems to run in families. However, this is rare. There’s no clear scientific evidence that the condition is hereditary.
Sleeping on your back may increase your chances of an episode. Lack of sleep may also increase the risk of sleep paralysis.
How is sleep paralysis diagnosed?
No medical tests are needed to diagnose sleep paralysis.
Your doctor will ask you about your sleeping patterns and medical history. They may also ask you to keep a sleep diary, documenting your experience during sleep paralysis episodes.
In some cases, your doctor may recommend you participate in an overnight sleep study to track your brain waves and breathing during sleep. This is usually only recommended if sleep paralysis is causing you to lose sleep.
What are the treatment options for sleep paralysis?
Symptoms of sleep paralysis typically resolve within a matter of minutes and don’t cause any lasting physical effects or trauma. However, the experience can be quite unsettling and frightening.
Sleep paralysis that occurs in isolation doesn’t typically require treatment. But those who also have signs of narcolepsy should consult a doctor. This is especially important if symptoms interfere with work and home life.
Your doctor may prescribe certain drugs to help manage your sleep paralysis if narcolepsy is the underlying cause.
The most commonly prescribed medications are stimulants and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac). Stimulants help you stay awake.
Your doctor may order a sleep study called a polysomnography.
The study results will help your doctor make a diagnosis, if you’re experiencing sleep paralysis and other symptoms of narcolepsy. This type of study requires an overnight stay at a hospital or sleep centre.
In this study, a healthcare provider will place electrodes on your chin, scalp, and at the outer edge of your eyelids. The electrodes measure electrical activity in your muscles and brain waves.
They’ll also monitor your breathing and heart rate. In some cases, a camera will record your movements during sleep.
Dr Priyanka believes that the key to mitigating sleep paralysis is improving sleep hygiene by sticking to a good bedtime routine, which includes:
- avoiding blue light prior to sleep
- ensuring the room temperature is kept low
- These bedtime routines can help ensure that you get a better night’s rest.
- How can I prevent sleep paralysis?
You can minimise symptoms or the frequency of episodes with a few simple lifestyle changes, such as:
- Reduce stress in your life
- Exercise regularly but not close to bedtime
- Get sufficient rest
- Maintain a regular sleep schedule
- Keep track of medications you take for any conditions
Know the side effects and interactions of your different medications so you can avoid potential side effects, including sleep paralysis.
Dr Priyanka notes that following these tips can also help prevent sleep paralysis:
- trauma counselling
- yoga and breathing exercises to reclaim this sense of agency over your body
If you have a mental health condition, such as anxiety or depression, taking an antidepressant may diminish episodes of sleep paralysis.
Antidepressants can help reduce the number of dreams you have, which lessens sleep paralysis.
How do I tackle sleep paralysis?
“The key to mitigating sleep paralysis is improving sleep hygiene by sticking to a good bedtime routine. This includes avoiding blue light prior to sleep and ensuring the room temperature is kept low so that you get a better night’s rest.”
If you are struggling to get an appointment with your NHS GP, At Pall Mall Medical, we offer private appointments with GPs and Consultants via telephone and video call.