Sleep Paralysis: Everything You Need to Know

Sleep paralysis is a condition that occurs when you are awake but unable to move or speak, usually during the transition between sleep and wakefulness. It can be a frightening experience, but it is not harmful or a sign of a serious problem. Here is everything you need to know about sleep paralysis, including its causes, symptoms, treatment and prevention.
What causes sleep paralysis?
Sleep paralysis happens when your brain and body are not in sync during the rapid eye movement (REM) stage of sleep, which is when you have vivid dreams. Normally, your brain sends signals to your muscles to relax and prevent you from acting out your dreams. This is called muscle atonia. However, sometimes you may regain consciousness before your muscles are fully active, resulting in temporary paralysis.
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There are many factors that can increase your risk of experiencing sleep paralysis, such as:
- Narcolepsy: A sleep disorder that causes excessive daytime sleepiness and sudden attacks of sleep.
- Shift work: Working irregular hours or changing your sleep schedule frequently.
- Sleep deprivation: Not getting enough or quality sleep on a regular basis.
- Obstructive sleep apnea: A breathing disorder that causes pauses in breathing during sleep.
- Mental health conditions: Such as stress, anxiety, depression, post-traumatic stress disorder (PTSD) or bipolar disorder.
- Substance use: Such as alcohol, caffeine, nicotine or drugs.
What are the symptoms of sleep paralysis?
The main symptom of sleep paralysis is being unable to move or speak while being aware of your surroundings. This can last from a few seconds to a few minutes. Some people may also experience:
- Hallucinations: Seeing, hearing or feeling things that are not there, such as shadows, voices, figures or sensations of pressure or choking.
- Fear: Feeling scared, panicked or helpless during the episode.
- Difficulty breathing: Feeling like you cannot breathe properly or suffocate.
- Tightness in the chest or throat: Feeling like something is squeezing or constricting your chest or throat.
How is sleep paralysis diagnosed?
Sleep paralysis is usually diagnosed based on your symptoms and medical history. Your doctor may ask you questions about your sleep habits, lifestyle, mental health and any medications you are taking. They may also perform a physical exam and order some tests to rule out other conditions that can cause similar symptoms, such as:
- Sleep studies: Such as polysomnography (PSG) or multiple sleep latency test (MSLT), which measure your brain activity, eye movements, muscle activity and other factors during sleep.
- Blood tests: To check for any hormonal imbalances, infections or other abnormalities that can affect your sleep quality.
- Imaging tests: Such as magnetic resonance imaging (MRI) or computed tomography (CT) scan, can show any structural problems in your brain or nervous system that can interfere with your sleep.
How is sleep paralysis treated?
Sleep paralysis does not require any specific treatment, as it usually goes away on its own after a few minutes. However, if you have frequent or severe episodes that affect your quality of life, you may benefit from some treatment options, such as:
Improving your sleep hygiene: Adopting healthy habits that promote good sleep quality and quantity, such as:
- Going to bed and waking up at the same time every day.
- Avoiding caffeine, alcohol, nicotine and heavy meals before bedtime.
- Creating a comfortable and quiet sleeping environment.
- Following a relaxing routine before bed, such as reading, listening to music or meditating.
- Getting enough exposure to natural light during the day and avoiding blue light from screens at night.
Treating any underlying conditions: Addressing any medical or psychological issues that may contribute to your sleep paralysis, such as:
- Narcolepsy: Taking medications such as citalopram (an antidepressant) or lithium (an antimanic agent) to help regulate your sleep cycle and prevent narcolepsy symptoms.
- Obstructive sleep apnea: Using a device such as a continuous positive airway pressure (CPAP) machine to keep your airway open during sleep and prevent breathing pauses.
- Mental health conditions: Seeking therapy such as cognitive behavioural therapy (CBT) to help you change your negative thoughts and behaviours that may cause stress, anxiety or depression.
Coping with anxiety and fear: Developing strategies to deal with the emotional distress that may accompany sleep paralysis episodes, such as:
- Reminding yourself that sleep paralysis is not dangerous and will pass soon.
- Trying to move your eyes or fingers to break the paralysis.
- Focusing on your breathing and relaxing your muscles.
- Seeking support from your family, friends or a professional if you feel overwhelmed or traumatized by your experience.
How can you prevent sleep paralysis?
There is no sure way to prevent sleep paralysis, but you can reduce your chances of having it by following these tips:
- Get enough sleep: Aim for at least seven to nine hours of sleep every night, and avoid napping during the day.
- Stick to a regular sleep schedule: Try to go to bed and wake up at the same time every day, even on weekends and holidays.
- Avoid sleeping on your back: Sleeping on your side or stomach may reduce the pressure on your chest and throat and prevent sleep paralysis.
- Practice good sleep hygiene: Follow the same recommendations as mentioned above for improving your sleep quality and quantity.
What is the outlook for people with sleep paralysis?
Sleep paralysis is not a life-threatening condition, and it does not cause any physical harm or complications. However, it can be a distressing and unpleasant experience that can affect your mood, energy and productivity. If you have frequent or severe episodes of sleep paralysis, you should seek medical help to find out the cause and get the appropriate treatment. With proper management, you can improve your sleep quality and reduce your risk of sleep paralysis.