Sleep paralysis is a frightening condition where someone temporarily experiences an inability to move or speak when waking up or falling asleep. It can often be accompanied by seeing, hearing, or feeling things that aren’t there. Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest. But is there actually a link between sleep paralysis and depression?
What is sleep paralysis?
Sleep paralysis occurs when someone wakes up during REM (rapid eye movement) sleep, but their body remains in a state of muscle atonia or paralysis. This paralysis is a normal part of REM sleep – it prevents us from acting out our dreams while we sleep. But sometimes the brain wakes up before the paralysis wears off, leading to brief episodes of being awake but unable to move.
Sleep paralysis episodes typically last anywhere from a few seconds to a couple of minutes. Though temporary and harmless, being paralyzed can feel alarming. Around 75% of people who experience sleep paralysis also hallucinate during episodes, sensing an evil presence in the room or feeling pressure on their chests. Understandably, this leads many to feel fear, panic, and confusion.
Common characteristics of sleep paralysis
- Inability to move or speak when waking up or falling asleep
- Episodes last seconds to minutes
- Awareness of surroundings
- Hallucinations in around 75% of cases
- Chest pressure or breathing difficulties
- Feeling an evil presence
- Fear, panic, confusion
Who gets sleep paralysis?
Around 20-40% of people will experience isolated episodes of sleep paralysis at some point. It seems to be more common in students and psychiatric patients. Recurrent sleep paralysis, happening at least once per month, affects around 8% of the general population but up to 28% of students. Sleep paralysis appears to run in families to some degree.
What causes sleep paralysis?
The exact causes of sleep paralysis aren’t fully understood. However, these factors are thought to contribute:
Disrupted REM sleep
Anything that disrupts normal REM sleep cycles can make sleep paralysis more likely. This includes:
- Lack of sleep
- Irregular sleep schedules
- Jet lag
- Sleep disorders like narcolepsy
- Medications that alter sleep cycles
- Drugs and alcohol
- Sleeping on the back
Genetics
Sleep paralysis seems to run in families, indicating there may be a genetic component. Having a close relative with sleep paralysis increases your risk.
Anxiety and mental health conditions
Anxiety disorders, depression, PTSD, and bipolar disorder are associated with higher rates of sleep paralysis. It’s unclear whether these conditions directly cause sleep paralysis or if sleep paralysis worsens symptoms.
Other factors
Various social and demographic factors also appear linked to sleep paralysis risk, including:
- Age – sleep paralysis peaks in late adolescence and early adulthood.
- Gender – slightly more common in women.
- Ethnicity – higher rates reported in African Americans, Asians, and Mexican Americans compared to Caucasians.
Is there a link between sleep paralysis and depression?
There does appear to be an association between sleep paralysis and depression. Studies have found recurrent sleep paralysis occurs more often in those with depressive disorders compared to the general public. But what explains this relationship?
Depression disrupts sleep
One reason for the link may be that the symptoms of depression make sleep paralysis more likely. Depression often impairs people’s ability to get regular, good quality sleep. Common effects of depression on sleep include:
- Difficulty falling asleep at night
- Waking up frequently during the night
- Waking up very early in the morning
- Feeling unrested despite adequate sleep time
- Excessive daytime sleepiness
- Alterations in REM sleep
All of these sleep disturbances associated with depression can increase the chances of waking up during REM atonia before it has passed, triggering sleep paralysis episodes.
Sleep paralysis may worsen depression
On the flip side, dealing with recurrent sleep paralysis could potentially exacerbate depression symptoms. Being awake but paralyzed, sensing evil presences, having difficulty breathing – these are profoundly frightening experiences. Understandably, being plagued by repeated episodes of sleep paralysis can spark anxiety and take a psychological toll over time. The chronic stress and exhaustion resulting from sleep paralysis may worsen underlying depression.
Shared risk factors
There are also a number of shared risk factors between sleep paralysis and depression, including:
- Genetics – family history of depression increases sleep paralysis risk.
- Trauma and PTSD – past trauma raises risk of both conditions.
- Social/economic stressors – linked to higher rates of both.
- Anxiety – often co-occurs with depression and sleep paralysis.
- Substance use – associated with more sleep paralysis and depression.
These overlapping risk factors likely contribute to the frequent co-occurrence of sleep paralysis and depressive disorders.
Treatments
Since the underlying causes are unclear, there are no definitive treatments to prevent sleep paralysis episodes. But the following strategies may help reduce frequency and manage symptoms:
Improve sleep habits
Developing better sleep hygiene by sticking to consistent bedtime routines, limiting blue light exposure before bed, avoiding caffeine/alcohol close to bedtime, and making the sleep environment comfortable and relaxing.
Manage underlying conditions
Treating any underlying physical or mental health conditions like sleep apnea, narcolepsy, anxiety, PTSD, or depression that may be disrupting sleep.
Medications
Certain antidepressants like SSRIs or tricyclics may decrease sleep paralysis episodes, possibly by improving mood and sleep quality.
Lifestyle changes
Avoiding trigger factors like sleep deprivation, irregular sleep schedules, sleeping supine, and recreational drug use.
Psychotherapy
Cognitive behavioral therapy (CBT) can help by addressing fear/anxiety reactions to sleep paralysis and developing coping strategies.
Stress management
Relaxation techniques and stress management skills may help lower anxiety around falling asleep and reduce sleep paralysis episodes.
| Treatment | Methods |
|---|---|
| Improve sleep habits | Consistent sleep routines, limit blue light at night, avoid caffeine/alcohol before bed, relax bedroom environment |
| Manage underlying conditions | Treat sleep disorders, mental illnesses like anxiety, PTSD and depression |
| Medications | Certain antidepressants like SSRIs or tricyclics |
| Lifestyle changes | Avoid sleep deprivation, irregular sleep, sleeping on back, recreational drugs |
| Psychotherapy | Cognitive behavioral therapy (CBT) to manage fear reactions and develop coping skills |
| Stress management | Relaxation techniques, mindfulness, stress reduction |
Conclusion
In summary, depression and sleep paralysis do seem to be linked. Depression can disrupt normal REM sleep cycles and worsen sleep paralysis. And dealing with recurrent sleep paralysis episodes may potentially exacerbate depression in some individuals due to the stress and anxiety it causes. There are also overlapping risk factors between the two conditions that could explain their frequent co-occurrence.
While more research is still needed, treating underlying depression and anxiety appears beneficial for reducing sleep paralysis episodes. Improving sleep hygiene, managing mental health conditions, making lifestyle adjustments, psychotherapy, stress reduction, and certain medications may also help alleviate symptoms. But more clinical studies are required to determine the ideal treatment approaches.