Sleep paralysis is when, during waking up or falling asleep, a person is aware but unable to move or speak. During an episode, one may hallucinate (hear, feel, or see things that are not there), which often results in fear. Episodes generally last less than a couple of minutes. It may occur as a single episode or be recurrent.
When Does Sleep Paralysis Usually Occur? Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep, it’s called hypnagogic or predormital sleep paralysis. If it happens as you are waking up, it’s called hypnopompic or postdormital sleep paralysis.
What Happens With Hypnagogic Sleep Paralysis? As you fall asleep, your body slowly relaxes. Usually you become less aware, so you do not notice the change. However, if you remain or become aware while falling asleep, you may notice that you cannot move or speak.
What Happens With Hypnopompic Sleep Paralysis? During sleep, body alternates between REM (rapid eye movement) and NREM (non-rapid eye movement) sleep. One cycle of REM and NREM sleep lasts about 90 minutes. NREM sleep occurs first and takes up to 75% of your overall sleep time. During NREM sleep, your body relaxes and restores itself. At the end of NREM, your sleep shifts to REM. Your eyes move quickly and dreams occur, but the rest of your body remains very relaxed.
Signs and symptoms
Imagined sounds such as humming, hissing, static, zapping and buzzing noises are reported during sleep paralysis. Other sounds such like voices, whispers and roar are experienced. Symptoms accompanied by intense emotions such as fear and Panic. People also have sensations of being dragged out of bed or of flying, numbness and feelings of electric tingles or vibrations running through their body. Sleep paralysis may include hypnagogic hallucinations, such as a supernatural creature suffocating or terrifying the individual, accompanied by a feeling of pressure on one’s chest and breathing difficulty. Another example of a hallucination involves a menacing shadowy figure entering one’s room or lurking outside one’s window, while the subject is paralyzed.
Sleep paralysis is mainly diagnosed via clinical interview and ruling out other potential sleep disorders that could account for the feelings of paralysis. The main disorder that is checked for is narcolepsy due to the high prevalence of narcolepsy in conjunction with sleep paralysis. The availability of a genetic test for narcolepsy makes this an easy disorder to rule out. Several measures are available to reliably diagnose)
Medical treatment starts with education about sleep stages and the inability to move muscles during REM sleep. People should be evaluated for narcolepsy if symptoms persist. The safest treatment for sleep paralysis is for people to adopt healthier sleeping habits.
Tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) may be used. Despite the fact that these treatments are prescribed there is currently no drug that has been found to completely interrupt episodes of sleep paralysis.
The work focuses on psycho-education and modifying catastrophic cognitions about the sleep paralysis attack. It begins with self-monitoring of symptoms, cognitive restructuring of maladaptive thoughts relevant to ISP (e.g., “the paralysis will be permanent”), and psychoeducation about the nature of sleep paralysis. Prevention techniques include ISP-specific sleep hygiene and the preparatory use of various relaxation techniques (e.g. diaphragmatic breathing, mindfulness, progressive muscle relaxation, meditation).