What Causes Sleep Paralysis and How to Deal With It?

Sleep paralysis has been reported over the centuries as primarily an “evil” presence that haunted some people. In most cases, as modern understanding suggests, sleep paralysis is a sign that the body has difficulty keeping up with the different sleep cycles. In rare cases, it indicates a deep underlying psychiatric problem. If you ever wake up at night to find yourself unable to move, or still worse, feel the presence of someone standing close to you while you cannot move, it could be sleep paralysis. Read through all you need to know about sleep paralysis and how and why it happens.

What Is Sleep Paralysis and When Does It Occur?

Several adults experience sleep paralysis at some point in their lives. Sleep paralysis leaves you with a paralyzed feeling where you cannot move when you suddenly wake up from sleep. Some people also report seeing people or entities next to them as they are wide awake but paralyzed, unable to move their limbs or even shout. Primarily, sleep paralysis occurs when one is about to fall asleep or wake up.

When people are asleep, they enter a ‘rapid eye movement’ or REM sleep phase. This is a phase when one has dreams while asleep that they can remember soon after waking up. The REM dreams are often intense, involving running, jumping, or escaping from a predator. The dreams are realistic enough to cause people to jump out of bed and start acting it out; the brain puts the body in a state of paralysis during the REM cycle. When people wake up during the REM sleep mode, and the brain still keeps the body paralyzed for unknown reasons, they experience a few moments of sleep paralysis.

Most people experience their first episode of sleep paralysis as children or young adults. While it is uncomfortable, it is not a serious or life-threatening condition for most.

Types of Sleep Paralysis

Sleep paralysis is generally classified into the following types:

1. Isolated sleep paralysis

When narcolepsy, a neurological disorder that affects the brain’s ability to control sleep and wakefulness, is not connected to sleep paralysis episodes, it is classified as isolated sleep paralysis.

2. Recurrent sleep paralysis

Multiple episodes characterize recurrent sleep paralysis over some time.

3. Recurrent isolated sleep paralysis

Recurrent isolated sleep paralysis (RISP) has the defining characteristics of the above two points. It is a diagnosis of recurrent sleep paralysis in a person who doesn’t have narcolepsy.

Causes of Sleep Paralysis

Here are some of the reasons that are known to cause sleep paralysis:

• Lack of sleep
• An erratic sleep schedule
• Sleeping on the back
• Certain types of medications
• Stress and anxiety
• Alcohol and drug abuse
• Leg cramps related to sleep
• Certain mental conditions such as bipolar disorder
• Other types of medical conditions
• Family history of sleep paralysis

Signs and Symptoms of Sleep Paralysis

The symptoms of sleep paralysis include:

• Atonia is the inability to move the body that occurs shortly after falling asleep or waking up. In this state, the person is aware he is awake and unable to move the muscles.
• Sleep paralysis hallucinations of an intruder involve seeing or feeling a dangerous person or entity in the room.
• The feeling of flying or having an out-of-the-body experience

Does Sleep Paralysis Cause Health Problems?

For most people, sleep paralysis is a one-time event or an experience that is rare and harmless. The episodes can be pretty distressing for those with recurring sleep paralysis, especially with hallucinations of a menacing presence in the room. The condition is also colloquially called “old hag syndrome,” as people from different cultures report being strangled by a ‘creature’ that bears down on the person’s chest and covers the body so they cannot move or scream. Such episodes can cause significant anxiety that can be eased with counseling. Those who feel excessively sleepy during the day need to have themselves checked for narcolepsy.

Risk Factors of Sleep Paralysis

Several risk factors contribute to sleep paralysis, such as:

1. Narcolepsy

Narcolepsy is a condition in which the person has difficulty with their sleep and wake cycles. It is often associated with sleep paralysis.

2. Sleep apnea

Sleep apnea is a condition where people stop breathing partially or fully in their sleep. The state can increase the risk of sleep paralysis.

3. Irregular sleep schedules

This frequently occurs in shift workers who will have rotating shifts every few weeks that hinders their ability to have a steady sleep schedule.

4. Post-traumatic stress disorder (PTSD)

PTSD combined with high levels of stress and anxiety can trigger episodes of sleep paralysis.

5. Genetic predisposition

People who have family members with sleep paralysis are more likely to experience it as well.

Diagnosis and Treatment

The diagnosis is made by the symptoms experienced by the individual, such as the experience while falling asleep or waking up, reviewing the history and the answers to some specific questions used as a diagnostic criterion.

The treatment for sleep paralysis involves maintaining a sleep diary to record episodes and patterns for weeks or months. Recommendations to food, physical activity, and sleep habits are also made to normalize the sleep and wake schedules. In severe cases, antidepressants may be used to regulate sleep cycles and treat any underlying mental conditions that could contribute to sleep paralysis.

How Can You Prevent Sleep Paralysis?

Since the condition’s exact cause is not known, there is no precise way to prevent the condition. However, specific changes can reduce the frequency or intensity of the episodes:

• Get regular exercise during the day.
• Avoid sleeping on the back.
• Get treated for insomnia or other conditions such as narcolepsy or bipolar disorder.
• Get enough sleep every day and practice going to bed at the same time each day.
• Look into the side effects of any medications that you might be taking. If it seems to trigger sleep paralysis, inform your doctor and have it replaced.
• Practice a bedtime routine such as taking a warm shower and keeping the room lit dimly in the night. Avoid using electronic devices before bed or looking at intense sources of light.
• Practice stress relief techniques such as yoga, meditation, and mindfulness to gather more awareness of yourself.

When to See a Doctor?

To most people, sleep paralysis might be a one-time event. However, do see a doctor if you:

• Experience frequent episodes of sleep paralysis over the months.
• Find it difficult to fall asleep or wake or have unusual sleep patterns.
• Find it difficult to stay awake during the day.
• Experience insomnia.
• Experience terrifying hallucinations that cause significant anxiety and sleep disturbances.
• Have other identified mental health conditions or suspect of having one.

Sleep paralysis can have a range of causes, from stress to narcolepsy and underlying mental health conditions. Although most people might experience it rarely or once in a lifetime, some can have frequent episodes. If the sleep paralysis episodes are distressing or occurring frequently, it is ideal to consult medical advice.

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