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Have you ever woken up feeling paralysed? Not able to move any part of your body? If you have experienced this phenomenon just after falling asleep or waking, you could be experiencing sleep paralysis. This is a form of parasomnia, which means an undesirable experience that can occur during different stages of sleep.

Sleep paralysis is a strange and often frightening experience that occurs when the body is unable to move, and for some, it can feel like there is pressure on your chest, or that you are falling, or perhaps worst of all, that there is someone else in the room with you.

Sleep paralysis

Sleep paralysis is characterised by a temporary loss of muscle function, termed atonia, which occurs upon falling asleep or waking. Alongside atonia, individuals frequently experience hallucinations during episodes of sleep paralysis without even taking any mushrooms!

This phenomenon occurs during REM (rapid eye movement) sleep, during which we experience vivid, emotionally laden dreams and rapid eye movements, as the name suggests.

What is REM sleep?

During the REM (rapid eye movement) sleep phase, our brains become active again, treating us to various emotionally charged dreams. To prevent us from physically acting out these nocturnal reveries, our brain induces temporary paralysis, known as postural atonia. This paralysis is orchestrated by inhibiting skeletal muscle tone, controlled by neurotransmitters like ?-Aminobutyric acid (GABA) and glycine, under the regulation of the brainstem’s pons and the ventromedial medulla.Since REM sleep hosts our most intense dreams, this paralysis mechanism kicks in to safeguard us. However, in sleep paralysis, consciousness returns while still in the REM stage, rendering us unable to move any part of our body.

Sleep paralysis and REM

Sleep paralysis is when individuals begin to regain mental awareness while still experiencing REM paralysis. This leaves the person feeling “trapped,” unable to move or communicate upon falling asleep or waking up. However, they can still breathe and remain fully conscious of their surroundings.

Sleep paralysis occurs when the brain fails to smoothly transition through the usual stages of sleep, leaving it in a state of limbo between wakefulness and slumber. Researchers suggest that sleep paralysis entails a hybrid state of consciousness, blending wakefulness and REM sleep elements. Consequently, characteristics such as atonia and vivid mental imagery typical of REM sleep persist even when conscious and awake.

Why does sleep paralysis occur?

During sleep, your brainstem blocks the signals that prompt movement in your body, preventing you from acting out your dreams and risking injury. However, in the case of sleep paralysis, the brain glitches and fails to transition smoothly through the typical sleep stages, leaving it somewhere between wakefulness and sleep. Recent research indicates that the mild hallucinations experienced during sleep paralysis, such as the sensation of someone opening your bedroom door, may stem from a dream state occurring outside of regular sleep cycles. This phenomenon occurs because our frontal cortex (the front part of the brain) remains more alert than usual during sleep paralysis. At the same time, our emotional centre (limbic system) and visual centres send messages to the parietal lobe, inducing dream-like hallucinations in response to perceived threats.

The two types of sleep paralysis

Medical professionals typically classify cases of sleep paralysis into two main categories:

  • Isolated sleep paralysis: These singular episodes of sleep paralysis occur independently and are not linked to an underlying diagnosis of narcolepsy.
  • Recurrent sleep paralysis: This condition involves experiencing multiple episodes of sleep paralysis over time. It may be associated with narcolepsy. Narcolepsy is a neurological disorder that disrupts the brain’s ability to regulate wakefulness, often resulting in episodes of sleep paralysis.

In some instances, these two characteristics are combined to describe a condition known as recurrent isolated sleep paralysis (RISP). RISP entails ongoing occurrences of sleep paralysis in individuals who do not have narcolepsy.

What does sleep paralysis feel like?

We mentioned earlier that sleep paralysis can be associated with hallucinations, which occur without taking any mushrooms! There are three different types of hallucinations associated with sleep paralysis.

First, we’ve got the “Intruder Hallucinations.” Imagine lying in bed and suddenly feeling like there’s someone creepy lurking around, and it’s not your significant other or maybe even standing right next to you. Well, I hope it’s not your partner; otherwise, that’s definitely something you need to talk about!

Next, we’ve got the “Chest Pressure Hallucinations,” aka the infamous “Incubus Hallucinations.” Imagine feeling like a weight is pressing down on your chest, making breathing hard. Some folks even swear they feel like someone’s literally sitting on them!

Last but not least, we’ve got the “Vestibular-Motor Hallucinations.” Have you ever had the sensation that you’re floating, flying, or even zooming around the room? That’s what we mean here, but scientists give it this fancy terminology to show off. So, while your body is paralysed in bed, your brain takes your mind on a trippy rollercoaster ride.

About 75% of the time, these hallucinations aren’t your run-of-the-mill dreams. Nope, they’re special. They can pop up as you’re drifting off to dreamland (hypnagogic hallucinations) or when you’re just waking up (hypnopompic hallucinations). *

*My apologies for including these scientific terms, but they just sounded so cool, ahh hypnogogic

So, there you go. Sleep paralysis involves more than simply not being able to move; it also involves a weird psychedelic trip that can either feel like an elephant sitting on your chest or have you soaring to the heavens. Just remember that all this occurs because there is a small glitch in the way the brain moves through the stages of sleep.

Is there any deeper meaning to sleep paralysis?

How people respond to sleep paralysis pretty much depends on their cultural background. But whatever background you are from when you’re stuck in that paralysed state, it’s pretty distressing. When you add in some freaky hallucinations into the mix, you’re left with a recipe for pure, unadulterated fear. That’s why 90% of people going through sleep paralysis feel fear coursing through their veins. Only a few lucky individuals get to experience the trippy nature of the hallucinations associated with sleep paralysis… luck devils!

How long do episodes of sleep paralysis last?

These episodes can last anywhere from just a few seconds to a whopping 20 minutes! Imagine being in an atonic or paralysed state for that length of time. However, fortunately, when we look at the overall average, we find that the average length of time spent in this state is about six nail-biting minutes.

But don’t worry; most of the time, these episodes wrap up on their own. However, every now and then, they might be cut short by a gentle touch, someone’s reassuring voice, or a burst of Herculean effort to move again.

How common is sleep paralysis?

Researchers estimate that roughly 20% of us will come face-to-face with sleep paralysis at some point in our lives. That’s about one in five people! Unfortunately, we don’t have much data on how often these episodes of sleep paralysis return for an encore.

Sleep paralysis demographics

Sleep paralysis is not ageist, so it doesn’t play favourites when it comes to age. It can strike at any time. However, the first signs of this spine-tingling phenomenon often pop-up during childhood, adolescence, or those wild, free, and uninhibited early adult years. After appearing during those halcyon years, it can resurface more frequently when you reach your 20s and 30s.

What causes sleep paralysis?

Scientists have been puzzled by the cause of sleep paralysis. But here’s what they do know: it’s like a perfect storm of different factors swirling together.

For starters, sleep disorders are significant players in this game. People who experience obstructive sleep apnoea (OSA), where breathing is obstructed and stops during the night, report sleep paralysis episodes at a whopping 38% rate. Other sleep conditions, such as chronic insomnia, disrupted circadian rhythms from jet lag, and nighttime leg cramps, have all been linked to sleep paralysis.

People who have narcolepsy have a disruption in their brain’s neurotransmitter levels, which messes with their brain’s ability to regulate sleep-wake cycles. So, instead of sleeping normally at night and staying awake during the day, your brain gets a little confused. It might decide to knock you out for a quick nap in the middle of a conversation or even while you’re driving. Along with these unexpected naps, narcolepsy can also throw in some other unexpected treats. Have you ever heard of cataplexy? It’s when your muscles suddenly go weak, almost like they’ve turned to jelly, usually triggered by strong emotions like laughter or surprise. As if this wasn’t enough, scientists are looking into research to suggest that people with narcolepsy are more prone to experience sleep paralysis.

Mental health disorders also have a hand in sleep paralysis. PTSD, anxiety disorders, and even hitting pause on alcohol or antidepressants – they can all trigger REM rebound and set the stage for some seriously spooky sleep paralysis episodes. Common antidepressants interfere with or reduce REM sleep, and so when you stop taking them, REM returns with a vengeance, making “Everybody Hurts” when it is accompanied by sleep paralysis. *

*I hope you got this pop culture reference!

Scientists have also turned the spotlight of sleep paralysis on those creative types you love to hate. It turns out that if you’re the creative type, prone to wandering off into daydreams or experiencing vivid nightmares, you might be more likely to experience sleep paralysis. That’s the price that is paid when your imagination is on overdrive, blurring the lines between dreams and reality.

Is sleep paralysis dangerous?

For most people, sleep paralysis is more of an annoyance than a real danger, albeit a pretty terrifying annoyance. Despite the fear factor, sleep paralysis is considered pretty harmless. Most of the time, it doesn’t happen often enough to really mess with your health.

However, about 10% of people who have to put up with frequent episodes of sleep paralysis can experience detrimental effects on their overall health. If you are a child of the 80s, you will remember Freddy Kruger from the Nightmare on Elm Street franchise. Now, imagine going to sleep each night and meeting Freddy—not a pleasant thought. So, inevitably, you will put off sleeping, causing severe sleep deprivation issues that can significantly impact your overall health.

So, while sleep paralysis might not be viewed as serious if they are one-off episodes, however, if they tend to recur, then it’s time to contact your doctor or book an appointment with Dr Zak Taylor at sleephelp.co.uk.

What are the treatments for sleep paralysis?

The first step in the treatment process involves reaching out to a healthcare professional. You can talk to your GP or book a private consultation with Dr Zak Taylor at sleephelp.co.uk. This allows for the identification and management of any underlying issues that might ramp up the frequency or intensity of your sleep paralysis episodes. For instance, if narcolepsy or sleep apnoea is in the mix, then these issues can be addressed, which in turn should see an improvement in the episodes of sleep paralysis. They can also help determine if CBT, cognitive behavioural therapy or medications are suitable options.

However, if you know your sleeping habits are poor, they could be a contributing factor, so start with the low-hanging fruit. Here are some handy tips to improve your sleep hygiene:

  • Establish a consistent sleep schedule, even on weekends. A relaxing pre-bed routine can help you wind down and prep your body for some serious snooze time.
  • Create a sleep sanctuary for sleep and sex only. Make sure you invest in thick curtains to keep out the light and a good mattress. Regarding mattresses, remember that more expensive is not always better. Look out for our upcoming blogs on choosing the right mattress for your sleep and wallet hygiene.
  • Reduce your caffeine and alcohol intake, especially in the evening, to ensure a smoother transition into dreamland.
  • Banish electronic devices—yes, even your beloved smartphone—from the bedroom at least an hour before bedtime. The blue light from your phone can disrupt the release of your Dracula hormone, melatonin, from your brain, which helps you to enter the land of nod.

References:

  1. McNally RJ, Clancy SA, Barrett HM, Parker HA, Ristuccia CS, Perlman CA. Autobiographical memory specificity in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse Cogn Emot. 2006;20:527–35Brooks, P. L., & Peever, J. H. (2008). Unraveling the mechanisms of REM sleep atonia. Nature and Science of Sleep, 10, 355-367.
  2. Brooks PL, Peever JH. Identification of the transmitter and receptor mechanisms responsible for REM sleep paralysis J Neurosci. 2012;32:9785–95
  3. Denis, D., French, C. C., Schneider, M. N., & Gregory, A. M. (2018). Subjective sleep-related variables in those who have and have not experienced sleep paralysis. Journal of Sleep Research, 27(5), e12650
  4. Olunu, E., Kimo, R., Onigbinde, E.O., Akpanobong, M.A.U., Enang, I.E., Osanakpo, M., Monday, I.T., Otohinoyi, D.A. and Fakoya, A.O.J., 2018. Sleep paralysis is a medical condition with a diverse cultural interpretation. International Journal of Applied and Basic Medical Research, 8(3), pp.137-142.
  5. Denis, D., French, C. C., & Gregory, A. M. (2018). A systematic review of variables associated with sleep paralysis. Sleep Medicine Reviews, 38, 141–157.
  6. Olunu, E., Kimo, R., Onigbinde, E.O., Akpanobong, M.A.U., Enang, I.E., Osanakpo, M., Monday, I.T., Otohinoyi, D.A., & Fakoya A.O. (2018). Sleep paralysis is a medical condition with a diverse cultural interpretation. International Journal of Applied & Basic Medical Research, 8(3), 137–142.
  7. Sharpless, B. A. (2016). A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatric Disease and Treatment, 12, 1761–1767.
  8. Scammell, T. E. (2022, July 12). Clinical features and diagnosis of narcolepsy in adults. In A. F. Eichler (Ed.).
  9. Denis, D., & Poerio, G. L. (2017). Terror and bliss? Commonalities and distinctions between sleep paralysis, lucid dreaming, and their associations with waking life experiences. Journal of Sleep Research, 26(1), 38–47

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