The experience of feeling like something is holding you down while you’re asleep is commonly referred to as sleep paralysis. It can be an alarming and confusing phenomenon, especially for those experiencing it for the first time. However, there are a few key things to understand about what exactly is happening during episodes of sleep paralysis and what it might signify about your sleep patterns or health.
What is Sleep Paralysis?
Sleep paralysis refers to a temporary inability to move or speak while falling asleep or waking up. It is due to muscle atonia, which causes your body to become immobile during certain stages of the sleep cycle.
During sleep paralysis, you may feel awake and aware of your surroundings, but unable to move your body for anywhere from a few seconds to a few minutes. Many people also report disturbing sensory hallucinations like a sense of a threatening presence in the room with them, hearing voices or noises, feeling physical sensations like something pressing on their chest, or seeing shapes and shadows.
Causes
Sleep paralysis has a few potential causes:
Disrupted Sleep Cycles
Sleep paralysis tends to happen when there is a disruption in your normal sleep cycles. It can occur when:
– You don’t get enough sleep overall.
– You have an irregular sleep schedule with different bed and wake up times.
– You are sleep deprived or fatigued.
– You have jet lag.
– You take frequent naps during the day.
This causes you to spend more time in lighter stages of sleep and have more awakenings during rapid eye movement (REM) sleep, which is when your muscles naturally become immobile. If you wake up during REM sleep before your muscles have regained full mobility, you may find yourself unable to move or speak.
Sleep Disorders
People with certain sleep disorders may be more prone to episodes of sleep paralysis:
– Narcolepsy – a disorder that causes excessive daytime sleepiness and abnormal REM sleep patterns.
– Sleep apnea – when breathing is repeatedly disrupted during sleep.
– Restless leg syndrome – unpleasant sensations in the legs that leads to difficulty falling asleep.
Mental Health Conditions
Those with underlying mental health issues may also be at higher risk, including people with:
– Bipolar disorder
– Anxiety disorders
– Post-traumatic stress disorder (PTSD)
– Panic attacks
High stress levels and sleep loss related to mental health problems can contribute to sleep paralysis.
Substance Use
Both prescription and recreational drugs, as well as alcohol use, have been linked to a higher incidence of sleep paralysis:
– Antidepressants
– Opioids
– Antihistamines
– Stimulants
– Alcohol
– Withdrawal from alcohol or sedatives
These substances can alter sleep cycles and REM sleep. Withdrawal, especially from alcohol and tranquilizers or sleeping pills, can also trigger episodes.
Genetics
There may also be a genetic component, as sleep paralysis tends to run in families. Having a close relative with sleep paralysis increases your risk.
Prevalence
Sleep paralysis is quite common, though prevalence rates vary widely. Some key statistics on how many people experience it include:
– Around 8% of the general population will have at least one episode of sleep paralysis in their lifetime.
– Up to 28% of students may experience it.
– Up to 32% of psychiatric patients report sleep paralysis.
– Lower rates around 3-6% are reported in Asia. Higher rates around 20-50% are reported in Egypt.
– Episodes typically begin in the late teens or early 20s.
– Both men and women can experience sleep paralysis, but some research suggests episodes may be more common in men.
So while a disturbing event, sleep paralysis is not at all uncommon. Many people will brush off occasional episodes as strange but harmless occurrences. However, if it happens frequently and causes you distress, then it becomes worth investigating potential underlying causes.
Hallucinations and Sensations
The immobility experienced during sleep paralysis is often accompanied by vivid sensory experiences that can feel quite real in the moment. Common hallucinations and sensations include:
Sense of a Presence
The most widely reported hallucination is a sense that something hostile or malevolent is in the room with them. While no visual apparition is seen, there is a strong feeling that someone or something is lurking just out of view.
This presence is often described as ominous, evil, or crushing. People perceive the entity as a threat, sometimes believing it intends to harm or suffocate them. Many cultures interpret this presence as demons, ghosts, or other supernatural beings.
Auditory Hallucinations
Hearing sounds is another unsettling symptom. Noises like loud bangs, hissing, buzzing, roaring, laughing, mumbling voices, or footsteps are commonly reported. These sounds may reinforce the feeling of an intruder in the room or evil presence.
Touch Hallucinations
Many people describe physical sensations of being pushed, sat on, or held down during sleep paralysis episodes. This can include feelings of pressure on the chest making it hard to breathe. Others may feel like they are being grabbed, choked, dragged out of bed, or stabbed.
Visual Hallucinations
While less common than a sensed presence, some do see shapes, shadows, human-like figures, demons, monsters under the influence of sleep paralysis. The images are described as looming and terrifying.
Fear and Distress
Being unable to move with these perceived threats understandably elicits panic, anxiety, and extreme fear in the moment. The combination of paralysis and vivid hallucinations makes for an immersive nightmare-like experience.
Other emotions commonly reported include:
– Helplessness
– Vulnerability
– Disorientation
– Dread
– Impending doom
– Suffocation
– Chest pain from pressure or tightness
– Embarrassment and confusion upon waking
This distress fades as muscle control returns. But the memory can leave a lingering unsettled feeling and reluctance to sleep.
Risks
While sleep paralysis itself is not dangerous, there are some risks associated with chronic or severe episodes to be aware of:
– Excessive daytime sleepiness from fear of recurring episodes at night.
– Heightened anxiety and symptoms of depression.
– Disruptions to sleep quality that compound issues.
– Rarely, some people self-medicate with alcohol or drugs to deal with episodes, risking addiction issues.
– Potential injuries from panicked movements upon waking like falling out of bed.
– Misperceiving episodes as serious health issues and seeking unnecessary medical testing.
So while not directly harmful in isolation, addressing the root causes is prudent if it becomes frequent or distressing.
Treatments
Some self-help tips can reduce episodes of sleep paralysis:
Improve Sleep Hygiene
Practicing good sleep hygiene can minimize disruptions that contribute to sleep paralysis:
– Maintain a consistent sleep schedule, even on weekends.
– Develop calming pre-sleep rituals like a warm bath.
– Make sure your sleep environment is cool, dark, and quiet.
– Avoid stimulants like caffeine late in the day.
– Limit daytime naps to 30 minutes.
– Keep screens out of the bedroom.
Sleep Position
Sleeping on your side rather than back can potentially decrease episodes in some people. The science is mixed on this, but it may help reduce REM disruptions.
Stress Management
Given the ties between stress and sleep paralysis, calming practices may help:
– Relaxation techniques before bed like meditation, deep breathing, progressive muscle relaxation.
– Reduce anxiety and racing thoughts by writing worries down earlier in the day.
– Consider cognitive behavioral therapy techniques to lower stress.
– Get regular exercise.
Reframe Fear
When paralyzed, reminding yourself it will pass and that you are safe may reduce anxiety in the moment. Some tips include:
– Avoid escalating fear by trying to move and making it worse.
– Close your eyes and wait patiently for control to return.
– Distract yourself by wiggling toes and fingers until you can move.
– Focus on trying to relax your body rather than breaking free.
Productive Actions Upon Waking
Shaking off the fear right after an episode can short-circuit anxiety. Try:
– Turning a light on to reassure yourself of your safety.
– Getting out of bed and moving around to re-orient yourself.
– Engaging in a calming activity like reading.
– Speaking with a partner about what occurred.
Avoid Severe Sleep Deprivation
Since deprivation can trigger episodes, don’t drastically undersleep. That said, some short-term mild sleep restriction may lessen episodes by deepening sleep drive.
If episodes become frequent or severe, speak with your doctor who may recommend:
– Overnight sleep testing to identify any underlying sleep disorders behind recurrent sleep paralysis.
– Mental health assessment for anxiety, depression, PTSD, or medications that could contribute.
– Temporary prescription sleep aids or muscle relaxants.
– Further cognitive behavioral therapy for coping strategies and lessening distress.
– Referral to a sleep specialist who may advise treatments to target an underlying disorder like narcolepsy or sleep apnea.
When to Seek Help
Occasional, brief episodes of sleep paralysis are not necessarily a cause for concern. However, speak to your doctor if:
– Episodes occur multiple times per week.
– They cause such fear that you resist sleep or are exhausted during the day.
– You have symptoms of a co-occurring physical or mental health condition.
– You experience vivid, distorted thoughts revolving around the episodes.
– Sleep paralysis persists after improving sleep habits and reducing stress.
While alarming, even chronic sleep paralysis is manageable with a combination of lifestyle changes, therapy techniques, and guidance from sleep medicine professionals when required.
Historical and Cultural Explanations
Sleep paralysis has played a role in folklore and been interpreted through a supernatural lens in many cultures:
European Nightmares
Throughout European history, sleep paralysis was sometimes attributed to nocturnal visits from demons or witches that would sit on the chests of sleepers. This is reflected in terms like the Old Hag in Britain and Canada, Hexendrücken (witch pressing) in Germany, and Kokmaar or nachtmerrie (nightmare) in the Netherlands.
Asian Ghosts
In Chinese culture, sleep paralysis is known as ghost pressing or gui ya meaning ghost oppression. Japanese legends speak of kanashibari, bound up by metal, inflicted by spirits. It is called cao tăng đè in Vietnamese, meaning ghost binds you down. Similar folk explanations exist in other Asian countries.
Middle Eastern Djinn
The term Jinn stems from Arabic and Islamic folklore of supernatural creatures. Among some Arab groups, sleep paralysis is referred to as ja-thoom meaning what sits heavily on the chest, and is attributed to evil jinns.
Sudden Unexplained Nocturnal Death Syndrome
In some groups in Southeast Asia, sleep paralysis is known as bangungut and xixik in the Philippines orpokkuri in Japan. The fear and belief that the experience causes imminent death has been linked to sudden unexplained nocturnal death syndrome among Hmong, Thai, Laotian, and Filipino communities.
Alien Abduction
Sleep paralysis is sometimes perceived as threatening alien visitations in western cultures as well, due to associations drawn between episodes and claims of abduction experiences. Around 20-50% of those reporting alien abductions describe episodes that resemble sleep paralysis.
Voodoo
In Newfoundland folklore, sleep paralysis was sometimes attributed to a crone-like night visitor called the ‘Old Hag’ who would haunt sleepers’ bedrooms at night. Similar to voodoo beliefs, people believed she could hex her victims, rendering them immobile during their sleep.
Minority Faith Persecution
In 1693, a special court was convened in Salem, Massachusetts to hear testimony on demonic possession related to witchcraft. This led to the famous Salem Witch Trials, during which time many women were persecuted, convicted, and executed for witchcraft. Some historians now link these supernatural experiences to episodes of sleep paralysis.
Hmong Sudden Death
Among the Hmong community, sleep paralysis episodes are interpreted as a literal assault by a jealous and vengeful spirit. This belief can instill such terror that individuals have been reported to die in their sleep, lending the phenomenon the name ‘sudden unexpected death syndrome.’
Examples from Religion and Mythology
Sleep paralysis frequently arises in religion and myth as the work of demons or the supernatural. These are some of the mythical creatures and concepts tied to sleep paralysis around the world:
| Creature | Culture | Description |
|---|---|---|
| Alp | German folklore | A goblin that torments sleepers by pressing on their chests |
| Jinn | Islamic mythology | A spirit capable of good or evil that can possess humans |
| Kanashibari | Japanese folklore | A spirit that immobilizes sleepers by binding their limbs or choking them |
| Mare | Slavic folklore | An evil goblin that sits on the chests of sleepers to induce nightmares |
| Incubus | Medieval European folklore | A male demon believed to sexually assault women in their sleep |
| Succubus | Medieval European folklore | A female demon that preys on men in their sleep |
These mythical explanations arose before rapid eye movement sleep and sleep disorders were medically identified. While terrifying in the moment, most episodes of sleep paralysis are now considered harmless neurological events.
Similar Phenomena
While sleep paralysis has some unique characteristics, other conditions share similarities worth differentiating:
Nightmares
Nightmares are disturbing dreams that can awaken someone from REM sleep. While vivid and scary, you can move and speak upon waking from a nightmare. Nightmares are also associated with visual dream imagery rather than sensations of an evil presence.
Nocturnal Panic Attacks
Nocturnal panic attacks involve abrupt feelings of fear, anxiety, racing heart, chest pain, or shortness of breath. But they allow movement and come fully awake quickly without hallucinations.
Hypnopompic Hallucinations
Waking up from sleep and experiencing hallucinations for up to a few minutes without paralysis is called hypnopompic hallucination. You can move and speak, though remain confused.
Narcolepsy
Like sleep paralysis, people with narcolepsy experience disrupted REM sleep and loss of muscle tone. But narcolepsy also causes severe daytime sleepiness not characteristic of isolated sleep paralysis.
SIDS
While some cultures may interpret sleep paralysis as fatal, there is no direct link between episodes and sudden infant death syndrome (SIDS). SIDS refers to unexplained death of an otherwise healthy infant, usually while sleeping.
Conclusion
Sleep paralysis can be a perplexing experience, both for those experiencing it firsthand and researchers trying to uncover all of its biological underpinnings. However, increased understanding of its ties to REM sleep, sleep disorders, mental health, and genetic factors provide explanations beyond supernatural causes.
While rarely dangerous on its own, chronic episodes should prompt discussions with your doctor to identify if any treatable conditions or habits are contributing to its occurrence. Episodes often fade or lessen in frequency with age and lifestyle changes to support quality sleep. Arm yourself with information on the realities of sleep paralysis so that fear and myths do not worsen distress.
