Sleep Paralysis: Symptoms, Causes, Risks, Treatment and Prevention

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A man during his sleep who suffer from sleep paralysis

1Overview

Have you tried being unable to move upon sleeping or in the middle of the night?
You might think that you’re just dreaming. However, this could be a sign of sleep paralysis.

Sleep paralysis is the inability to speak or move immediately after waking up, whether in the morning or the middle of the night. This can be an extremely frightening experience, which is sometimes, linked to certain beliefs like supernatural beings or a bad nightmare.

The condition is not harmful and should resolve in a few seconds or minutes.
It’s frightening but people may have it at least once or twice in their lifetime and some may experience more bouts.

People of all ages could experience this condition. When the sleep paralysis occurs more often, it is parasomnia, wherein there are undesired events during sleep. Sleep paralysis causes the person to become unable to move the body at either the following occasions – when falling asleep (predormital form or hypnagogic) and when waking up from sleep (postdormital form or hypnopompic).

The sleep paralysis episodes are often experienced with hypnagogic experiences wherein there are sensory, auditory and visual hallucinations. Sleep paralysis comes in three categories:

  • Intruder – The person with sleep paralysis will hear sounds like footsteps, a shadow man, doorknobs opening and the sense of a terrifying presence inside the room.
  • Vestibular-motor – The person will experience the sense of falling, floating, spinning, flying and hovering over the body. He may also feel like he’s having an out-of-body experience.
  • Incubus – The person will have the feeling of shortness of breath, difficulty breathing, pressure on the chest and the sense of being strangled or sexually assaulted by an invisible or supernatural being.

2Symptoms

The major symptom of sleep paralysis is aware of the surroundings or environment but being unable to move or talk. The symptoms usually appear or happen when waking up, but it can also occur when falling asleep.

During sleep paralysis, the patient may find it hard to breathe and there is a feeling that the chest is being crushed. There is a pressure felt on the chest as in someone is putting his weight on it.

Some people won’t be able to move their eyes, while others cannot open them. In some cases, however, they will feel a sensation that something or someone is inside the room, which is a sign of hallucination. They will feel very frightened and these sensations will last for about a few seconds to several minutes.

When to see a doctor:

Many cases of sleep paralysis do not happen again after about one or two bouts in their lifetime. This condition is not harmful and does not signal an underlying health problem. However, you need to visit your doctor when these symptoms happen:

  • The patient experience sleep paralysis frequently
  • The patient felt anxious and scared to go to sleep or they struggle to get enough sleep. The lack of sleep has taken a toll on their daily activities.
  • Daytime sleepiness and feeling extremely tired
  • Falling asleep suddenly during the day

It is important to know that if an underlying condition is causing the sleep problems, these may include:

3Causes

Sleep paralysis occurs when the parts of rapid eye movement (REM) sleep take place while you’re awake. This is the stage of sleep wherein the brain becomes very active that dreams develop. During this time, the body is unable to move, because the brain is stopping you from acting out your dreams and possibly hurting yourself.

In sleep paralysis, the transition of the body form and to REM sleep is out of sync with the brain, causing disruptions in normal sleep. This means that the consciousness of the person is awake but the body remains in a paralyzed state just like during sleep.

The exact reason for this phenomenon is unclear but it could be linked to:

  • Sleep deprivation or lack of sleep
  • Narcolepsy
  • Family history of sleep paralysis
  • Sleeping on your back
  • Irregular sleep patterns (working in shifts or jet lag)
  • Sleep apnea
  • Some medications

4Risk factors

Sleep paralysis can affect both males and females of any age group. Usually, the average age when the symptoms of sleep paralysis appear is between 14 and 17 years old. Worldwide, about 5 to 40 of people experience sleep paralysis and it’s considered a common sleep problem.

If you have a family member or relative with sleep paralysis, you are at a higher risk of developing it, too. Lack of sleep and other sleep problems may increase the risk of sleep paralysis.

Another risk factor is mental stress and sleep paralysis tend to occur when you’re sleeping on your back. You are more likely to experience sleep paralysis if you have the following conditions:

5Treatment

The treatment of sleep paralysis will need a valid diagnosis first. The doctor will most likely conduct a medical history interview to determine the risk factors present. For most individuals, there is no cure for sleep paralysis. The key is to prevent the condition and also treat the underlying causes.

You need to inform the doctor when the condition has started and how often it occurs. Moreover, the doctor will need to know the complete medical history of the patient including the medicines being consumed, the history of sleep problems in the family and the presence of other concurring sleeping problems.

Today, sleep paralysis is still not considered a medical diagnosis. However, if you have the symptoms, it’s always better to seek medical help and get the advice of a doctor. In some cases, medical help is needed if the sleep paralysis happens frequently, the person falls asleep suddenly during the day and he or she feels anxious when going to sleep. The sudden falling asleep during the day that can hinder normal daily activities is called narcolepsy.

Individuals with narcolepsy often experience sleep paralysis. These patients are usually on antidepressants to reduce dream sleep. These medicines may be helpful in easing the sleep paralysis. However, only licensed doctors can prescribe the medication.

If the sleep paralysis is serious and severe, it is important to see a specialist doctor and he can prescribe antidepressant pills. These drugs work by disrupting the REM sleep and are prescribed in lower doses than when used for depression.

Therapy

If changing the bad habits does not change or help the situation, the doctor might prescribe therapies.

Cognitive behavioral therapy (CBT) – This is the test for people with anemia. The therapy aims to change the bad habits and unhelpful thoughts and behaviors. CVT has many types including stimulus-control therapy, relaxation training, biofeedback and sleep restriction therapy.

6Prevention

Having a better sleep is the key to reducing the risk of sleep paralysis. The common preventive measures for sleep paralysis include:

  • Keep sleeping time and wake-up time consistent. Sleep and wake up at the same time each day, even during the weekends and holidays.
  • Reduce light exposure at night. You can use night lights if you’re going to the bathroom during the night. Limit blue light exposure by not using gadgets at night.
  • Ensure a comfortable, clean and suitable sleep environment.
  • Do not work or study in the bedroom.
  • Get daylight exposure especially upon waking up.
  • Get at least six to eight hours of sleep every night. Do not sleep too little and too much.
  • Do not nap after 3:00 p.m in the afternoon and do not nap more than 90 minutes.
  • Do not sleep with the lights or television switched on.
  • Engage in daily exercise.
  • Do not drink alcohol or caffeine.
  • Do not eat a heavy meal within two hours of sleeping or going to bed.
  • Leave all gadgets like tablets, laptops and cell phones outside the bedroom.
  • Manage depression, anxiety, and other mental health problems appropriately.
  • Listen to relaxing music before sleeping, as this will promote relaxation.
  • Put all electronic devices aside at least an hour before going to bed.
  • Do not sleep on your back.
  • Meditate to relax the mind and body.
  • Reduce the consumption of stimulants.
  • Stop drinking coffee or tea.
  • Avoid smoking and drinking alcoholic beverages.
  • Only go to bed when you’re feeling tired.
  • Create a relaxing bedtime routine.
  • Do not take OTC sleeping tablets because doctors should prescribe these medicines.
  • Use curtains or blinds to promote sleep. You can use an eye mask.
  • Make sure the room temperature is ideal for sleeping.
  • Avoid using the room for other activities other than sleeping.
  • Wear earplugs to reduce noise.
  • Make sure the mattress is comfortable.
  • Make sure you only have one pillow, too many pillows may strain your neck.
  • Do not sleep with anybody on the bed. Try sleeping on your own to observe your symptoms and if the sleep paralysis happens.
  • Eat a diet rich in vitamins and minerals. You can take supplements to boost the immune system and ward off germs.