We know about several sleeping conditions but a few of them triggers fear among people. One of the fearsome conditions out there is “sleep paralysis”, but why does it happen? You will find out about it here.

Sleep paralysis is when a person is aware, but is unable to move or speak. Whenever an episode occurs, most people experience hallucinations that tend to be related to seeing demons, weird creatures or such.

Sleep paralysis happens when falling asleep or waking up and people in the past, including some people until today, associate sleep paralysis with demonic signs or sayings.

During hallucinations, the person may see, hear or feel something that isn’t really there which also causes confusion for the person upon waking.

There are also times when the person would feel like they are unable to breathe and they will experience hallucinations that may cause them to want to scream, move, or run away but they simply can’t.

Sleep paralysis episodes usually last for less than a couple of minutes and it can happen once or become a recurrent problem. About 5% of people have regular episodes, any gender are equally affected.

Between 8% and 50% of people experience sleep paralysis at least once at some point in their life.

Studies revealed that sleep paralysis tend to occur in those who may have narcolepsy and there is also a chance that the problem runs in the family as a result of specific genetic changes.

People who are also perfectly healthy may also experience sleep paralysis, but not as common as those who are unhealthy.

Normally, sleep paralysis can be triggered by sleep deprivation, psychological stress and abnormal sleep routines.

It is believed that the underlying cause of this condition involves a dysfunction in REM sleep but diagnosis can be different depending on a patient’s description. (Related: REM Sleep Behavior Disorder)

Other conditions that can be associated with sleep paralysis is narcolepsy, atonic seizure, and hypokalemic periodic paralysis.

Apparently, there is not enough research done on the matter, making treatment for sleep paralysis poor and many people still suffer from it.

The reason why not many health experts are interested in this topic is because the condition is said to be common and not threatening at all.

Despite this, there are still people seeking for proper cure and so far, there’s a few methods that can work with sleep paralysis.

A better sleep hygiene, therapies on cognitive behaviors and antidepressants are said to be effective against stopping sleep paralysis episodes but this doesn’t work for everyone all the time.

Sleep paralysis has been described for a very long time, it’s a part of history. Due to its “mystic episodes” or mysterious events, some people believe it influenced early myths and creation of certain stories.

Stories such as alien abductions, demonic events and other paranormal events are believed to be inspired by sleep paralysis or potentially influenced it in some way.

Causes

In general, the brain causes our muscles to relax and be still whenever we sleep, this process is known as, “atonia”.

It is believed that sleep paralysis occurs when atonia starts to happen even while we are still awake, which is why it happens during falling asleep or when waking up because we are not in deep sleep yet.

When sleep paralysis happens without any signs of narcolepsy, it is referred to as “isolated sleep paralysis” because it doesn’t have any associated cause.

  • Possible causes of Sleep Paralysis
    1. Sleep deprivation
      • Lack of sleep can cause the heart and brain to become dysfunctional, leading to different problems when trying to fall asleep.
    2. Stress
      • Mental or physical stress can both possibly cause sleep paralysis. When the mind is overworked, atonia can occur during the wrong moment.
    3. Depression
      • Mental health issues can trigger abnormal sleep routines and affect the overall physical health of a person slowly as the condition eats the victim away.

        This can disrupt the brain functionality and potentially cause sleep paralysis.
    4. Anxiety
      • Similar to depression, being anxious can also lead to overthinking right before going to sleep. Those anxious thoughts can disrupt the brain’s functionality.
    5. Isolation
      • It is possible that social isolation can also lead to sleep paralysis when the person is continuously longing for physical contact or seeing other people.

        The hallucinations are easily triggered, due to the isolation they feel.
    6. Lack of physical activities
      • It is also possible that not exercising properly or simply not having the right kind of diet can disrupt the brain’s effectiveness.

        The less healthier a person is, the more they can be prone to sleep paralysis.
    7. Abnormal sleep pattern
      • An abnormal sleep routine can also trigger confusion for your body and your brain. Not following the normal clock our body has set for us can also make us easily sick.

        It is believed that the more a person keeps an unhealthy sleep hygiene, the higher the chance they can experience a sleep paralysis episode.
    8. Exhaustion or fatigue
      • Based on personal experience, I tend to have a sleep paralysis episode whenever I am sleep deprived plus physically exhausted due to work.

        However, when I get the right amount of sleep and rest that I need, the episodes will stop bothering me.

        Remember to relax and do not overwork yourself. If possible, sit down and do relaxing activities first before dropping yourself on the bed to fall asleep.
    9. Hereditary / Genetics
      • It is mentioned by researchers that genetic problems can occur and may be passed on to children, making sleep paralysis possibly inheritable.
    10. Narcolepsy
      • Patients with narcolepsy tend to experience dream-like hallucinations and fall into a state of paralysis whenever they are falling asleep or waking up.

        The disease is often associated with sleep paralysis or sleep paralysis is a common symptom of it.

It is also possible that sleep paralysis can occur when under the influence of drugs and alcohol.

For some cases, going to sleep with a heavy full stomach can potentially trigger sleep paralysis.

Previously, I thought that sleep paralysis occurs when the brain is trying to force us to wake up due to several reasons such as difficult breathing.

Visualizing a horrible image in a form of hallucination created by the brain, it can force us to wake up and help us breathe again. There are many reasons why a person may be unable to breathe during sleep.

Diagnosis

  • 3 Ways to Diagnose Sleep Paralysis
    1. Polysomnography
      • A harmless test that observes a person’s sleeping behavior as well as keep track of how their body functions during sleep. If necessary, a DNA test may follow after this.
    2. Genetic test (DNA test)
      • A genetic test is important in order to determine if sleep paralysis is caused by a disease known as “narcolepsy” or not
    3. Munich Parasomnia Screening
      • Parasomnia screening is for those experiencing recurrent isolated sleep paralysis episodes

Sleep paralysis is mainly diagnosed via clinical interview and ruling out other potential sleep disorders that could account for the feelings of paralysis.

For isolated sleep paralysis because it only shows the main symptoms without being associated to another disease unlike a different type of sleep paralysis that appears as a symptom of another disease.

Still, for those who are concerned about their health and want to get diagnosed to understand what’s happening, the first step is visiting their doctor to schedule an appointment for a sleep study.

A sleep study, or formally known as ” polysomnography ” allows technicians to monitor your body’s overall activities during sleep to see what may be causing you to have sleep paralysis episodes.

(Related: “How to Do a Sleep Study?”)

However, if sleep paralysis appears to be a sign or symptom of another condition such as narcolepsy, then that is the time the problem must be taken a lot more seriously than isolated sleep paralysis.

Sleep paralysis is one of the strongest symptoms checked to see if people may have narcolepsy due to the high prevalence of narcolepsy in conjunction with sleep paralysis.

A genetic test is available for narcolepsy, making it an easy disorder to rule out when finding out whether sleep paralysis is isolated or not.

For those who have isolated sleep paralysis that is recurrent, a Munich Parasomnia Screening is a way to properly diagnose the condition and to get the right prescription of medicine to potentially stop it.

Types of Isolated Sleep Paralysis

  • Isolated Sleep Paralysis (ISP)
    • Occurs once in a while, not frequent and not caused by other medical conditions
  • Recurrent Isolated Sleep Paralysis (RISP)
    • Multiple episodes in one night and can occur almost daily

Sleep paralysis can have several classifications.

The episodes of sleep paralysis may occur due to several medical conditions like narcolepsy or hypokalemia.

Hypokalemia is when a person has a deficiency in vitamin K or have low levels of potassium inside their blood serum.

It usually does not cause sleep paralysis, but severe deficiency can possibly do so.

Whenever episodes occur without being caused by other medical conditions or under influence of drugs and alcohol, it is referred to as “isolated sleep paralysis” (ISP).

Episodes of isolated sleep paralysis are short and lasts for one to six minutes at most, but longer cases can happen at times.

For recurrent isolated sleep paralysis, the patient can suffer from episodes every night and multiple episodes can happen in one night.

Perhaps, it can be difficult to fully differentiate narcolepsy from isolated sleep paralysis, but the DNA testing can easily rule it out.

Another way to differentiate between the two is to note when the attacks occur most often.

Narcolepsy attacks are more common when the person is falling asleep with isolated sleep paralysis and recurrent isolated sleep paralysis attacks are more common upon awakening.

Differential diagnosis

There are other conditions that may be confused with or should be differentiated from sleep paralysis.

Other sleep disorders may also display strange or fearsome hallucinations but it is not the same disease.

Here are some common conditions that are often mistaken for sleep paralysis.

  • Exploding head syndrome (EHS)
    • Exploding head syndrome is a type of sleep disorder classified under parasomnias wherein people “hear” loud noises like explosions for a short period of time when falling asleep or when waking up.

      Click on the link if you want to learn more about EHS.
  • Nightmare disorder (ND)
    • Nightmare disorder is a REM-based parasomnia and is also known as dream anxiety disorder. It is characterized by frequent nightmares but is different with sleep paralysis.
  • Sleep terrors (STs)
    • Night terrors is a sleep disorder causing feelings of terror or dread typically occurring during the first hours of stage 3 to 4 non-rapid eye movement (NREM) sleep.
  • Nocturnal panic attacks (NPA)
    • Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen.
  • Post-traumatic Stress Disorder (PTSD)
    • PTSD is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person’s life.

The conditions on this list may show similar symptoms of sleep paralysis, but they are all different conditions that have separate forms of treatment and causes.

Symptoms

The main symptoms of isolated sleep paralysis are being unable to move or speak during an episode and experiencing weird to terrifying hallucinations that often triggers fear.

Episodes should normally last for 1 to 6 minutes and only occur once a night, but may come back a week or a month later. The frequency can be uncertain.

The same goes for recurrent isolated sleep paralysis, but the only difference is that it can happen almost every night and the multiple episodes can occur in one night.

Sleep paralysis can be a sign of another disease such as narcolepsy, so similar symptoms of narcolepsy can be associated with sleep paralysis symptoms.

Treatment

Medical treatment for sleep paralysis, regardless of the type, starts with learning about the sleep stages and the inability to move muscles during rapid eye movement (REM) sleep.

First, patients should rule out if there are other diseases that may be causing sleep paralysis such as narcolepsy before determining the proper method of treatment.

Though no large trials have taken place which focus on the treatment of sleep paralysis, several drugs have promise in case studies.

Two trials of GHB for people with narcolepsy demonstrated reductions in sleep paralysis episodes.

  • Medications for Sleep Paralysis
    • Tricyclic Antidepressants
    • Selective Serotonin Reuptake Inhibitors

Despite the fact that these treatments are prescribed there is currently no drug that has been found to completely interrupt episodes of sleep paralysis a majority of the time.

  • 10 Tips for avoiding sleep paralysis
    1. Follow a proper, healthy sleep schedule
      • Sleep on time and avoid depriving yourself with sleep.
    2. Try to get plenty of exercises
      • Keeping your body awake and properly energized can improve your overall health. But remember not to exercise too much and exercise only in the morning.
    3. Eat a healthy, balanced diet
      • Your diet plays a role in improving the quality of your sleep.
    4. Avoid alcohol before sleep
      • Alcohol can cause your body to become dysfunctional.
    5. Stop unnecessary drug usage
      • When under the influence of drugs, a person’s body may become dysfunctional
    6. Treat other illnesses (mental illnesses)
      • Focusing on your anxiety, depression and other mental health issues can help stop sleep paralysis episodes.

        Your mental health is important and affects your overall physical wellness.
    7. Do some therapeutic activities
      • Relaxing before bed can also take your mind off your worries and help you sleep better.
    8. Manage your stress
      • Stress, regardless if it’s physical or mental, can cause your brain to become less effective and lead to other problems and sleep paralysis is one of them.
    9. Avoid sleeping with a heavy stomach
      • Going to bed with a heavy stomach can create difficulty in breathing, it may disrupt the system inside your body and also trigger sleep paralysis.
    10. Try to improve your surrounding environment
      • Your surroundings can affect you, mentally, or physically. Even your bedroom can boost your mental health.

        If possible, consider improving your lifestyle and surroundings.

Some of the earliest work in treating sleep paralysis was done using a culturally sensitive cognitive-behavior therapy called CA-CBT.

The work focuses on psycho-education and modifying catastrophic cognitions about the sleep paralysis attack.

This approach has previously been used to treat sleep paralysis in Egypt, although clinical trials are lacking.

Related Questions

Can sleep paralysis kill you?

No, sleep paralysis cannot kill you. According to research, it has been shown that there are no actual evidence that sleep paralysis can cause death.

It may, however, give a feeling of “suffocation” since the sufferers often cannot move due to their “paralyzed” state and may be confused with real life suffocation, making people think it can kill them.

What is the sleep paralysis demon?

Sleep paralysis patients tend to see similar hallucinations, they all appear to see a certain demon that researchers refer to as the “night hag”.

However, there are no real evidence that sleep paralysis patients are seeing the same, exact demons when they are hallucinating which is why there cannot be an actual “sleep paralysis demon”.

What is the name of the demon that sits on your chest?

The “night hag” or “old hag” is the name given to the demon that sits on your chest during sleep paralysis episodes.

Since the phenomenon used to be a mystery back then, people often looked for answers and the name “night hag” was chosen to refer to as the demon they see during sleep paralysis episodes.