Sleep Paralysis – Types, Causes, Signs & Symptoms, Treatments and more 

When you are sleeping, you suddenly get a feeling of someone strangling you and you cannot breathe. You cannot move your hands and legs. You get vexed and might imagine some paranormal experience.

The fact is your body is playing with your senses. When you are in a deep sleep, only your brain is awake, and other organs are at rest. And so, the message from the brain to your legs and hands takes time to reach. So, you will not be able to move your hands and legs at that moment.

As a result, you will think that you had some paranormal activity. But the truth is it was due to some physiological changes in your body when you sleep.

Sleep paralysis is a stage where you are conscious, yet you will be unable to move. It occurs when you complete one full sleep cycle and then proceed to another. An in-between stage of sleepiness and wakefulness.

There will be a transition of sleepiness and wakefulness after you complete one cycle and move to the other and most sleep paralysis happen at this stage.

Sleep paralysis can affect anyone and there can be hallucinations. Sleep paralysis may happen during the REM (rapid eye movement) sleep. Sounds like humming, hissing, buzzing and static noise are reported during the sleep paralysis accompanied by fear and panic.

One common theory suggests that when the neural functions that regulate sleep are out of balance, it causes different sleep states to overlap. This may also cause sleep paralysis. Sleep paralysis may pass on within families when there is a defective gene.

About 7.6% of the overall population is estimated to have sleep paralysis, according to a paper published in the National Library of Medicine titled “Sleep paralysis”.

Types of sleep paralysis

Sleep paralysis is a condition of temporary loss of muscle control called muscle atonia. There are two types of sleep paralysis.

Isolated sleep paralysis

During the isolated sleep paralysis condition, you will be aware of the things that are happening around you, but you will not be able to respond.

If you don’t have any medical condition like narcolepsy and experience sleep paralysis, it is called isolated sleep paralysis.

According to a paper published in the journal National Library of Medicine titled “Isolated Sleep Paralysis and Fearful Isolated Sleep Paralysis in Outpatients with Panic Attacks”, about 2.2 to 39.6% of non-clinical samples and 7.4-50.0% of clinical samples have a lifetime prevalence rate of isolated sleep paralysis.

Isolated sleep paralysis is always accompanied by hallucinations that can be vivid and disturbing. Isolated sleep paralysis is reported to onset during the adolescent stage and the paralysis is likely to occur when the person sleeps in the supine position. The average length of the episode is reported to be 6 minutes in length.

Recurrent sleep paralysis

When there are multiple episodes of isolated sleep paralysis, it is called recurrent sleep paralysis. Recurrent sleep paralysis is described as benign parasomnia.

The lifetime prevalence of recurrent sleep paralysis is 7% in students and 28% in females, as reported by a paper published in the journal National Library of Medicine titled “Recurrent sleep paralysis – Fear of sleeping”.

The recurrent sleep paralysis onsets during the adolescent stage and is more prevalent in girls. In recurrent sleep paralysis hallucinations are considered mostly disturbing. Other symptoms like pressure on the chest and the feeling of being strangled are also reported.

How does sleep paralysis feel?

When you have sleep paralysis episodes, you will be able to see and breathe, but you cannot respond for a brief period of time. The episode is accompanied by scary sounds and hallucinations. Can you imagine the chilling fear a person goes through?

The types of hallucinations a person experiences are listed below.

Intruder hallucinations

Intruder hallucination is often associated with the feeling of an evil presence. This will manifest into a hyper-realistic multisensory hallucination of a real intruder.

Sleep paralysis is linked with intruders, fear and auditory and visual hallucinations. The hallucination is assumed to initiate from the midbrain in a hypervigilant state.

The parental lobe is reported to play an important role in intruder hallucination, especially the superior parental lobule.

Chest pressure hallucinations

Chest pressure hallucination is also called incubus hallucination. Sleep paralysis is associated with a feeling of pressure on your chest, difficulty in breathing and chest pain.

There will be a reduction in respiratory muscle activity during the REM sleep. There will be inhibition of motor neurons as a result of which the activity decreases. This is attributed to respiratory-related effects in incubus hallucination.

Vestibular-motor (V-M) hallucinations

The vestibular motor hallucination is different from both the above hallucination. In vestibular motor hallucination, there can be a feeling of unusual out-of-body experience. The experience is related to flying and floating.

How Common Is Sleep Paralysis?

Sleep paralysis is common throughout the world and approximately affects 7.6% of people throughout the world. Sleep paralysis can occur in anyone and it starts mostly in the teen.

The sleep paralysis episode is said to start during the onset of sleep or the offset. The body paralysis during sleep paralysis is triggered by the pons and ventromedial medulla that inhibit the motor neurons during REM sleep with alpha-aminobutyric acid and glycine.

Sleep paralysis is accompanied by a somatic sensation like chest pain, shortness of breath, feeling of choking, heart palpitation, trembling, sweating and nausea. Auditory hallucination is also common in sleep paralysis.

Causes

The major cause of sleep paralysis is lack of sleep. When your sleep schedule changes continuously, your sleep cycle will be affected and may lead to sleep paralysis. Stress is also another reason for sleep paralysis.

Narcolepsy

Narcolepsy is a chronic disorder when you have difficulty sleeping and waking up. It is a neurological disorder with the rapid onset of rapid eye movement (REM) sleep. People with narcolepsy will have an uncontrolled sleep disorder. They will fall asleep at any part of the day during any activity.

Rapid eye movement (REM) sleep is characterised by excessive daytime sleepiness (EDS). People also experience episodes of frequent uncontrolled sleep attacks, cataplexy (a sudden muscle weakness when the person is awake), sleep paralysis and hallucinations.

Narcolepsy is of two types. Narcolepsy type 1 and Narcolepsy type 2. In type 1, there will be narcolepsy with cataplexy and in type 2, the narcolepsy without cataplexy.

According to a paper published in the journal National library of medicine, titled “Narcolepsy”, close to 50% of people develop symptoms during their teenage and the disorder has enormous morbidity that causes impairment in social and academic performance.

The cause of narcolepsy is the loss of neurons that contains orexin. Narcolepsy is considered an autoimmune disorder and is triggered by an infection. The cause of type 2 narcolepsy is still unknown.

Narcolepsy requires clinical and non-clinical treatments. Usually, people with narcolepsy will have to reduce social interaction and may fall prey to depression.

Non-clinical treatments like

• Emotional support,
• Mental health counselling,
• Make them take medication on time and
• Education about alcohol and drug use.

Shift work sleep disorder

When you have a disrupted sleep cycle, sleep paralysis is common. About 12% of nurses claimed that they have suffered from sleep paralysis, according to data published in Pubmed.

The sleep paralysis caused by shift work is called shift work sleep disorder. The shift work sleep disorder condition affects people who work in rotational shifts like early morning, night and afternoon shifts. This disorder is common in people who work rotational shifts.

Shift work sleep disorder affects people‘s circadian clock which leads to sleep paralysis and insomnia. The common symptom of shift work sleep disorder is excessive sleepiness and difficulty in sleeping.

People who work in shifts sleep only minimal hours, like 3-4 hours. The required sleeping time for a healthy person is 7-9 hours.

People with shift work sleep disorder can follow simple steps to decrease the effects.

• Always maintain a regular sleep cycle even during your day-offs. This will help you to sleep well and avoid sleepiness during the daytime.
• People who work night shifts can sleep during the day with minimal lights or make their room dark and cosy for you to sleep.
• Limit your working days to 5 or less. Do not work four shifts together. Take a break and then work.
• When you are working in shifts, avoid prolonged working hours and overtime.
• Do not consume too much caffeine. Too much consumption may make you stay awake for a long time.

Sleep deprivation

Sleep deprivation is not getting adequate sleep that includes voluntary sleep deprivation and circadian clock disorders.

Sleep is important for the human body to rest and wake up fresh for the next day to carry out our daily routine. Like food and water, sleep is also important for humans.

A sleep-deprived person is prone to accidents while driving, impaired judgement and more like to make bad decisions. When you are sleep-deprived, there is less or no hand-eye coordination.

Sleep deprivation can lead to consequences like the disruption of circadian rhythm, sleep fatigued and extreme sleepiness during the day.

Symptoms of sleep deprivation include

• Tendency to doze off when not active for a short while
• Grogginess during the morning
• Poor concentration and
• Mood changes.

Obstructive sleep apnea

Unlike the other conditions that are described above, obstructive sleep apnea is a sleep-related breathing disorder. The disorder is caused when your throat muscle relaxes and blocks the airways during sleep. A common sign of obstructive sleep apnea is snoring.

Sleep apnea will cause short episodes of pause in breathing and again you start to breathe. As a result, there will be disruption in your sleep cycle. There are devices available to blow air into your lungs to keep the airways open while you are sleeping. A positive pressure is applied with the help of a machine to keep the airways open.

In rare cases, surgery may be recommended for obstructive sleep apnea. Symptoms of obstructive sleep apnea include

• Loud snoring
• Daytime sleepiness
• Episodes of stopped breathing during sleep
• Awakening accompanied by gasping
• Headache
• Difficulty in concentrating during the day
• Mood changes and irritability and
• High blood pressure

Signs and symptoms

The signs and symptoms of sleep paralysis are discussed below. These symptoms are common and if you have them, it doesn’t mean that you have sleep paralysis.

Paralysis in your limbs

During sleep paralysis attacks, you will not be able to move your limbs for a brief period of time. This is because when you are sleeping, only your brain will be active and all other organs will be at rest.

The limbs will receive the message from the brain after some time. You will be awake and conscious but will not be able to respond.

Inability to speak

Like the paralysis of limbs, you will not be able to speak. The same mechanism as in the paralysis of limbs happens here and you will not be able to speak.

Sense of suffocation

When you are sleeping, you tend to wake up suddenly. You cannot speak or move your limbs immediately and you have a feeling of suffocation.

Hallucinations

People with sleep paralysis hallucinate. The hallucination may be related to some paranormal things or intruder hallucination.

Fear

When people have sleep paralysis, it is accompanied by fear. They tend to wake up at night and have a feeling of fear.

Panic

Sleep paralysis attacks are accompanied by fear and panic.

Helplessness

People wake up gasping during sleep paralysis and feel helpless.

Tightening around your throat

People who have sleep paralysis attacks will experience tightened throat and will not be able to speak for a short span.

Daytime sleepiness, which may be a sign of narcolepsy

Sleep paralysis cause sleep deprivation and people may not get enough sleep. This might cause narcolepsy.

Diagnosis

Like the other diseases, there is no blood test for sleep paralysis. When you visit the doctor, your doctor might ask you a few questions regarding your sleeping pattern and medical history.

They will also ask for a note of sleep paralysis episodes. To track your episodes of sleep paralysis, your doctor might ask you to participate in a sleep study.

Treatment and prevention

Sleep paralysis lasts for a few minutes but may have lasting effects that can be quite frightening. They do not cause any major trauma. Still, people facing these episodes know the real pain behind it.

Medications and therapy

Medication and therapy may help with the episodes of sleep therapy. Your doctor may prescribe drugs that can treat narcolepsy.

For people who experience excessive sleeplessness, your doctor might recommend a sleep study called polysomnography.

An electrode will be placed on your chin, scalp and eyelids. The electrode will help to measure the electrical activity of the brain and muscle waves.

The study will also monitor your heart rate and breathing.

How can I prevent sleep paralysis?

Sleep paralysis can be prevented with medical care and also personal care. A few lifestyle changes may help you to cope with the condition.

• Always stick to your sleep cycle.
• Physical activity with less impact may help you sleep better.
• Do not take stimulants that might keep you awake for long.
• Avoid stress and get sufficient rest.

Conclusion

Sleep paralysis is common, and it can occur to anyone. Do not stress about the condition. Instead, take precautionary action and follow medications.  

When there is extreme sleeplessness, consult your doctor immediately. Do not take drugs and stimulants on your own. This may aggravate your condition.

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