Do you ever feel that while you are still asleep you are conscious and can listen to everything around you? This is Sleep Paralysis.
Sleep Paralysis is simply a sign that your body is not able to move through the stages of sleep. However, you are conscious and can listen to everything.
During it, your sense and awareness are intact but may feel pressure on your sense as if they are choking.
Moreover, it may be accompanied by Hypnagogic hallucinations and intense fear.
It is not life-threatening, however, it can cause anxiety in a lot of people. Moreover, it can happen along with other sleeping disorders like narcolepsy.
In most cases, it often starts during adolescence and can become more frequent during your 20s.
What is Sleep Paralysis?
Sleep paralysis is like Parasomnia or an undesirable event that is associated with sleep. It happens mostly while you are falling asleep or upon waking up in the morning.
Or it can also happen in the time between waking and sleep. During this, you are unable to move.
In most cases, it is an episode is accompanied by auditory, visual, and sensory hallucinations.
These happen during the transition between sleeping and waking and they constantly fall into the following 3 categories:
Intruder: You can hear different sounds like doorknobs opening, shuffling footsteps, a shadow of a person, or a sense of threat in the room.
Incubus: Feeling of pressure on your chest, difficulty breathing, stranded or assaulted. Moreover, an individual believes that they are going to die.
Vestibular Motor: A sense of spinning, falling, floating, or hovering over one’s body or another type of experience like out-of-body.
Sleep paralysis has been documented for centuries and people from different cultures have the same experiences.
The episodes may last for a few seconds to a couple of minutes however, it may occur as a single episode or be recurrent.
Causes of Sleep Paralysis
One of the most common causes of sleep paralysis is sleep deprivation, stress, and anxiety.
While you are asleep, the body relaxes and the voluntary muscles do not move. This prevents them from injury due to abrupt action while dreaming.
It involves disruption of the rapid eye movement REM sleep cycle. During this, your body alternates between rapid eye movement (REM) and non-rapid eye movement (NREM).
One REM-NREM cycle lasts for almost 90 minutes and in most cases, a person spends time in an NREM sleep cycle.
During NREM, your body relaxed, however, during REM your eyes move quickly. however, during REM your body is relaxed however, dreams occur during this time.
During sleep paralysis, the transition of REM sleep is not in sync with the brain, your consciousness is awake however, your body stays in a paralyzed sleep state.
The area or part of your brain that detects threat is at a high alert state and overly sensitive.
Certain factors are linked to Sleep Paralysis. These are Narcolepsy, irregular sleep patterns, sleeping on your back, and family history.
Moreover, it can be a symptom of medical problems like clinical depression, migraines, Sleep Apnea, hypertension, and anxiety disorders.
Signs and Symptoms of Sleep Paralysis
Sleep Paralysis is not life-threatening, however, knowing the signs and symptoms can provide peace of mind.
The most common sign you will experience is your inability to move or speak during the episode.
An episode may last for a few seconds to 2 minutes at least. You may also experience:
- A feeling that someone is pushing you down
- Like someone or something is in the room you are in
- Sense of fear
- Hypnagogic and hypnopompic experiences which doctors describe as hallucinations during, right before, or after you fall asleep.
Some other signs and symptoms may include difficulty breathing, feeling as if you are about to die, sweating, muscle ache, and paranoia.
In most cases, the episode typically ends on its own, however, it may also end when someone touches you or moves you.
During Sleep Paralysis, you may be aware of what is happening but you are unable to move or speak during this episode.
You may also be able to recall things after temporary paralysis disappears,
However, in some cases, people have hallucinations which are dream-like situations that may cause fear or anxiety, but they are harmless.
Diagnosis of Sleep Paralysis
No particular medical tests are done to diagnose Sleep Paralysis. However, your doctor will ask you about your sleeping patterns and medical history.
Moreover, they will ask you to keep a sleep diary, to document your experiences during the episode of Sleep Paralysis.
It is important to note that sleep paralysis can also occur in the contest of other medical conditions like hypokalemia, narcolepsy.
When you experience an episode independent of these conditions it is termed as isolated sleep paralysis, however, if they occur frequently and cause significant distress then it is termed as recurrent isolated sleep paralysis.
The best way to differentiate it from narcolepsy is to note when the attacks occur most often.
Narcolepsy attacks are more common when you are falling asleep, however, sleep paralysis is common upon waking up.
Conditions that are similar to Sleep paralysis are as follows:
Exploding Head Syndrome: This is a kind of potentially frightening parasomnia.
Nightmare Disorder: It is a REM-based parasomnia.
Sleep Terrors: It is not REM based and there is also a lack of awareness of the surroundings
Nocturnal Panic Attacks: It involves fear, and acute distress but does not cause paralysis
Treatment For Sleep Paralysis
The signs and symptoms of Sleep Paralysis often resolve within a matter of minutes and do not cause any lasting physical effects of trauma.
However, the experience can be quite upsetting and frightening for an individual.
Most often, that occurs in isolation does not require any treatment, however, those who show signs of Narcolepsy should consult the doctor.
It is important if the signs and symptoms are interfering with working conditions and personal life.
In some cases, your doctor might treat the underlying cause. They will treat Hypnagogic hallucinations.
Hypnagogic hallucinations are perceiving that there is an object or an event in your surrounding. The defining symptom is imaging realistic objects or events right before falling asleep.
Moreover, your doctor will prescribe certain medications that are stimulants and selective serotonin reuptake inhibitors (SSRIs).
In some cases, they might prescribe sleep medicine.
Stimulants help you stay awake. Your doctor may also study your sleep pattern, polysomnography.
This study will help your doctor to make a diagnosis and will help them differentiate whether you are experiencing sleep paralysis or signs or symptoms of Narcolepsy.
During this study, your health care provider will place electrodes on your chin, scalp, and the other edge of your eyelids.
These electrodes measure electrical activity in your muscles and brain waves. They will also monitor your breathing and heart rate.
Some doctors believe that the key to mitigating sleep paralysis is improving the sleep hygiene of a person.
This is done by sticking to a good bedtime routine which includes avoiding blue light before sleeping and keeping the room temperature low.
In some cases, your doctor might refer to Cognitive-behavioral Therapy.
In this therapy, your doctor will treat the signs and symptoms of anxiety and clinal depression which are causing Sleep Paralysis.
The basis of this therapy is that your thoughts, feelings, and physical sensations are all interconnected and that negative thoughts and feelings can entrap you into a vicious cycle.
The aim of Cognitive-behavioral Therapy is to deal with an individual’s overwhelming problems in a more positive way by breaking them into smaller parts.
Moreover, your therapist will show you how to change your negative patterns to improve the way you feel about certain things.
Unlike other treatments, CBT deals with your current problems and then focusing on issues from the past.
It looks for different ways to improve your state of mind on a daily basis.
Difference between Sleep Paralysis and Narcolepsy
Narcolepsy is a disorder of sleep and causes severe daytime drowsiness and unexpected attacks of sleep in an individual.
Most individuals can have difficulty staying awake for longer periods of time regardless of situations or circumstances.
Signs and symptoms of Narcolepsy can be sleep paralysis, however, not everyone will have this symptom.
A study in 2013 shows that a way to differentiate between Sleep Paralysis and Narcolepsy is that Sleep Paralysis patterns are common upon waking up however, of Narcolepsy, they are common while falling asleep.
Many signs and symptoms can be managed with certain lifestyle changes although there is no cure for this chronic condition.
How can You Prevent It?
With a few lifestyle changes, you can prevent the signs and symptoms of this disorder. These include:
- Reducing stress
- Sufficient rest
- Regular sleep schedules and painting them
- Keep a track of your medications and knowing the side effects
Moreover, doctors recommend therapy, trauma counseling, yoga, and breathing exercises to prevent Sleep Paralysis.
In case, a person has certain medical conditions like clinical depression or anxiety disorder, you might want to take antidepressants to diminish episodes of sleep paralysis.
These medications can help reduce the number of dreams and lessen sleep paralysis.
What can You Do?
There is nothing frightening about sleep paralysis. You can take certain steps at home to control this disorder.
Start by making sure you get enough sleep and take certain measures to reduce stress in your life especially before bedtime.
Try different sleeping positions. However, be sure to visit your doctor if it prevents you from a good sleeping pattern and routine regularly.
Even though when you wake up with an inability to move or speak can be frightening, however, sleep paralysis does not continue for a long period of time and is also not life-threatening.
If you find yourself having this disorder on regular basis, you might want to schedule an appointment with the doctor as it may be because of an underlying medical condition.
Moreover, inform them about any sleep disorders you had in the past and medications you supplements you are taking.