Understanding sleep paralysis

What is sleep paralysis?

Dreaming during sleep is common, but some people go through vivid perceptions of being attacked or throttled while they lie helpless. This phenomenon is called sleep paralysis. It is the sudden loss of ability to talk or move while waking up in the middle of sleep. This may sometimes be accompanied by hallucinations.

Sleep paralysis is not the same as having nightmares. Nightmares are bad dreams that occur when the person is fast asleep. A person experiencing nightmares may feel anxious but they won’t experience any limb paralysis.

The experience of sleep paralysis is unsettling for the person experiencing it and can often be misunderstood for a mental illness or being ‘possessed’. It is not a sleep disorder and does not pose any serious risk to a person's health, it’s a sleep phenomenon that usually lasts a few minutes.

What does it look like?

A person needs six to eight hours of sleep – this includes rapid eye movement (REM) sleep which lasts for two hours and non-rapid eye movement (NREM) sleep. During REM sleep, the brain paralyzes the voluntary muscles (while the involuntary muscles of the body continue to work) so that the person doesn’t act out their dreams. This is also the time when the body relaxes and restores itself.

During sleep paralysis, the brain is awake but the body is asleep. This means the voluntary muscles are paralyzed even when the person’s eyes are open. A person might forget a nightmare they had but they will remember the state they were in even after having woken up. Other symptoms of sleep paralysis include having hallucinations. These can occur either when the person is falling asleep or before they wake up.

While it is happening, the person experiencing it may feel helpless, scared and anxious for as long as the attack lasts. They may try and move their limbs, which in turn can cause muscle pain and headaches.

What causes sleep paralysis?

Sleep issues brought on by erratic sleep cycles, pre-existing mental illnesses such as depression or anxiety, narcolepsy, and excessive smoking and drinking. A study shows that persons with anxiety and panic attack disorder can be at risk for sleep paralysis.

Treatment

If a person with depression, anxiety or other mental illness experiences sporadic episodes of sleep paralysis, it is recommended that they discuss it with their treating psychiatrist. If sleep paralysis is persistent and causing you distress, seek the help of a sleep expert. Treatment for it involves working on a person’s sleep cycle by way of introducing lifestyle changes.

With inputs from Dr Satish Ramaiah, consultant neuropsychiatrist and sleep disorder specialist based in Bangalore.

Reference: 

‘Rates of isolated sleep paralysis in outpatients with anxiety’, by Michael W. Otto, Naomi M. Simon, Mark Powers, Devon Hinton, Alyson K. Zalta, Mark H. https://www.ncbi.nlm.nih.gov/pubmed/16099138, last accessed on 10th May 2019.