As a person falls asleep or wakes up, his brain sends signals to the muscles in his arms and legs to relax. In sleep paralysis, consciousness is regained, but not the person’s ability to move. According to researchers, in most cases, sleep paralysis is a sign that the stages of restful sleep are not being completed properly due to causes such as sleep apnea, insomnia or stress, rarely finding a connection between paralysis and various psychological or psychiatric problems.
Over the centuries, the symptoms of sleep paralysis have been described in many ways and often attributed to an “evil” presence. Almost every culture throughout history has created stories of evil creatures or shadows that terrorize people at night when they are helpless. However, there are scientific explanations for this phenomenon, as well as methods to avoid episodes of sleep paralysis.
What is sleep paralysis?
Sleep is divided into three stages (called non-REM), followed by a REM (rapid eye movement) stage, characterized by rapid eye movement. Passing through these stages, lasting between 90 and 110 minutes in adults, forms a sleep cycle, which is repeated several times throughout the night.
If during non-REM sleep tissues regenerate and bones and muscles strengthen, REM sleep is the stage when the brain becomes more active, processing what we learned or thought during the day and forming memories. The REM stage is when we dream, and in order not to reproduce in real life what happens in the dream, risking injury, the brain prevents the muscles of the limbs from moving. Sleep paralysis occurs when we enter or exit REM sleep, accidentally becoming conscious.
During sleep paralysis, people are aware of where they are, and can breathe and move their gaze, but cannot move their body. A person’s inability to move and speak can last for seconds or even minutes.
If sleep paralysis occurs when a person is about to fall asleep, then it is called hypnagogic or presleep paralysis, and if it occurs when a person is waking up, it is called hypnopompic or post-sleep paralysis.
“… just then, death had approached him and rested its head at the foot of the bed (…) He could not speak to tell him to drive it away, and now it was crouching, heavier and heavier, on his chest, no longer he was able to breathe.” (Ernest Hemingway – The Snows of Kilimanjaro).
Symptoms of sleep paralysis include:
- Impossibility of limb movement
- Inability to speak
- Intense fear or panic (including fear of death)
- Chest pressure or feeling of suffocation
- Hallucinations (either visual or related to the feeling that someone else is in the room).
- These intense states, as well as the possibility that a person may wake up crying or having palpitations, can be explained by the state of anxiety and confusion that accompanies the inability of the conscious person to move
Causes of sleep paralysis
Up to 4 out of 10 people may suffer from sleep paralysis. This common condition is often first noticed in the teenage years, but men and women of any age can experience it. It is not clear what causes this condition, but the following factors appear to be related to this phenomenon:
- Obstructive sleep apnea. Sleep problems and disturbances show the strongest correlations with sleep paralysis. Obstructive sleep apnea is one of the most common causes, causing breathing to stop repeatedly during sleep, even over a hundred times. This condition causes heavy snoring and fatigue throughout the day, even after many hours of sleep. Left untreated, it can lead to serious health problems such as high blood pressure and heart problems. Sleep apnea can affect anyone, but it most often affects older men who are overweight.
- Insomnia or lack of sleep. Insomnia is a sleep disorder that affects up to 35% of adults. It is characterized by difficulty falling asleep or staying asleep all night, until the desired wake-up time. This can have serious effects on physical and mental health, leading to excessive daytime sleepiness, lack of concentration, irritability, a higher risk of car accidents, etc.
Common causes of insomnia include stress, an irregular sleep schedule, poor sleep habits, mental health disorders such as anxiety and depression, physical illness and pain, medications, neurological problems, and specific sleep disorders. For many people, a combination of these factors can initiate and exacerbate insomnia.
Sleeping on the back. Research shows that sleeping on your back may be associated with an increased risk of sleep paralysis. It is recommended to place a pillow in the back area to prevent the body from turning during sleep.
A constantly changing sleep schedule or time zone change.
Nocturnal muscle cramps. These are sudden and intense sensations of pain in the sole or leg. Pain occurs when a muscle contract and is relieved by moving the leg, massaging the affected area, or using a warm compress placed on the muscle.
Various mental conditions. People with post-traumatic stress disorder (PTSD) or anxiety disorders, including panic disorder, seem to experience episodes of sleep paralysis more often.
Narcolepsy. This is a rare condition that causes a person to fall asleep suddenly at inopportune times. It is often caused by a lack of the brain chemical hypocretin (also known as orexin), which regulates wakefulness. If the brain is not able to regulate sleep and wake patterns properly, this can lead to excessive daytime sleepiness, difficulty concentrating and staying awake, falling asleep suddenly, cataplexy (temporary loss of muscle control leading to weakness and possible collapse), prolonged REM sleep resulting in more dreams but less restful sleep, waking during the night, and sleep paralysis. Narcolepsy does not cause serious or long-term physical health problems, but it can have a significant impact on daily life and can be difficult to cope with emotionally.
Substance abuse and withdrawal are caused by giving up various substances such as drugs or alcohol.
Use of certain medications, such as those for ADHD.
In some cases, sleep paralysis affects members of several generations of the same family. However, this is rare and there is no clear scientific evidence that the condition is hereditary.
Some studies have also found that people who dissociate frequently (daydreaming but without necessarily having problems) are more likely to experience sleep paralysis. There may also be a link between sleep paralysis and nightmares and/or lucid dreams.
Diagnosing sleep paralysis
If a person occasionally has episodes of being unable to move or speak for a few seconds or minutes before falling asleep or when waking up, these are probably isolated cases of sleep paralysis that do not require treatment.
However, the doctor should be consulted if:
- Excessive worry about symptoms occurs
- The symptoms cause states of fatigue during the day
- Sleep is interrupted or avoided due to fear of a new episode
The doctor may want to gather more information about a person’s sleep health by asking for the following:
- Describing symptoms and keeping a journal with observations about sleep quality for several weeks
- Medical history including any known sleep disorders or any family history of sleep disorders
- The additional evaluation carried out by a specialist doctor
- Carrying out overnight and even daytime sleep studies to rule out the existence of a sleep disorder
Treating sleep paralysis
“She was between sleep and consciousness, without one of them predominating… and harassed by the desire to get rid of a weight that pressed on her chest. He felt that if he could have cried out, the weight would have disappeared; he closed his eyelids, forcing himself to swallow the lump in his throat…” (F. Scott Fitzgerald – The Beautiful and the Damned).
Most people do not need treatment for sleep paralysis, but treating any underlying conditions, such as panic disorder or anxiety, can help improve sleep quality and make this frightening phenomenon disappear.
There is currently no cure for narcolepsy, but some changes in your sleep schedule and medication administration can help minimize the impact this condition has on your daily life. Taking short naps throughout the day is one of the best ways to manage excessive daytime sleepiness.
Other suggestions to avoid sleep paralysis are:
- A regular sleep schedule, which involves going to bed and waking up at roughly the same time throughout the week
- Avoiding sleeping on the back
- Removing distractions from the bedroom to get restful sleep (TV, phone, etc.)
- Reducing or giving up caffeine or alcohol consumption close to bedtime
- Developing a sleep routine that leads to relaxation (this may include reading, meditation, a warm bath or breathing exercises)
- Use of antidepressant medications if prescribed to help regulate sleep cycles
Conclusions
There is no need to fear demons or aliens that will kidnap you at night. If you suffer from occasional sleep paralysis, you can take action, starting by making sure you’re getting enough sleep and that you’re not suffering from a sleep disorder like sleep apnea. Do everything you can to get rid of stress in your life by avoiding negative thoughts, especially before bed. If you’ve tried reading about the effect of stress and obsessive thought patterns on the mind, but can’t seem to apply the relaxation techniques you’ve learned, consider seeing a professional.
Although sleep paralysis is not a serious problem, research suggests that those who experience recurrent episodes may develop negative thoughts about sleep, associating the distress they feel during an episode with bedtime. Consequently, this can reduce their sleep quality and cause insomnia, leading to daytime sleepiness and other unwanted effects on overall health.
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