Inside Sleep Paralysis: Symptoms and Causes of Sleep Paralysis

Sleep paralysis refers to the temporary inability to move or speak while either falling asleep or waking up. The body naturally experiences sleep paralysis during rapid eye movement sleep (REM sleep)—also known as atonia—to prevent our unconscious selves from moving around or acting out our dreams. However, certain occasions where a person may still be conscious when they experience sleep paralysis can cause anxiety or hallucinations.

There are two main types of sleep paralysis:

• Hypnagogic: Also known as predormital sleep paralysis, this sleep paralysis occurs as you fall asleep. Although the muscles in your body become relaxed and immobile, your brain retains awareness.
• Hypnopompic: Also called postdormital sleep paralysis, this sleep paralysis occurs after moving through the stages of sleep. As you reach the end of your sleep cycle, your body shifts from non-rapid eye movement sleep (NREM sleep) to REM sleep for the final time. However, sometimes the brain gains awareness before the REM phase is over, leading the sleeper to experience sleep paralysis.

A few symptoms of sleep paralysis include:

1. 1. Temporary paralysis: During sleep paralysis, your limbs may be unable to move, and you may be unable to speak while you’re awake, ranging from a few seconds to a few minutes.
2. 2. Chest pressure: Some people who have experienced sleep paralysis report a feeling of something pressing or sitting on their chest.
3. 3. Hallucinations: Since sleep paralysis can occur while the “dream” section of your brain is still active, those who gain consciousness may hallucinate images or sounds while their eyes are open, which can cause fear, anxiety, and paranoia. When the hallucinations occur as you’re falling asleep, they’re considered hypnagogic hallucinations. When they emerge as you approach wakefulness, they’re known as hypnopompic hallucinations.

Nearly eight percent of the population will experience at least one or two isolated episodes of sleep paralysis in their lifetime. There are a few reasons why sleep paralysis may occur, such as:

1. 1. Genetics: A family history of sleep paralysis is a potential risk factor. Multiple studies have linked sleep paralysis to genetics, though research is still underway to determine the exact role it plays.
2. 2. Sleep deprivation: Poor sleep hygiene and sleep disorders, such as narcolepsy and sleep apnea, can cause irregular sleep patterns, contributing to the likelihood of sleep paralysis. Learn more about sleep deprivation and tips to avoid it.
3. 3. Sleep position: People report experiencing sleep paralysis while sleeping on their back more than any other sleeping position.
4. 4. Medical conditions: Narcolepsy, bipolar disorder, post-traumatic stress disorder (PTSD), or medications used to treat these and other conditions (like antidepressants) can increase risk factors for sleep paralysis. Type 1 narcolepsy, defined by cataplexy (sudden loss of muscle tone), excessive daytime sleepiness, and sleep attacks, is closely tied to sleep paralysis. However, when sleep paralysis occurs frequently and is separate from narcoleptic conditions, it is considered recurrent isolated sleep paralysis (RISP).

Adequate, restful sleep is essential to a person’s overall health. Consult a doctor or licensed sleep medicine specialist to discuss treatments and medical advice if you experience sleep-related issues. Here are some tips that promote healthy sleep hygiene:

1. 1. Start a daily exercise routine. According to research from Johns Hopkins, exercise can help you fall asleep quicker and improve sleep quality. Exercise increases deep sleep—the sleep stage where the body begins to recover and repair itself. Adding 30 minutes of stretching, light jogging, or low-impact weight-lifting to your morning routine can help you get adequate sleep.
2. 2. Schedule naps. Combat excessive daytime sleepiness by scheduling a brief nap (or two) during the day to recharge your energy. Neuroscience studies have suggested that a 20-minute nap may be just as regenerative as a longer nap. During this time, you may enter REM sleep (which is why many nappers experience dreams). You will not enter slow-wave deep sleep, which is usually best saved for nighttime. Learn more about the benefits of napping.
3. 3. Avoid midday caffeine and late-night alcohol. A late-afternoon coffee boost may help get you through the end of your workday, but any caffeine consumed within six hours of your bedtime has the potential to keep you lying wide awake in bed. While alcohol will make you feel sleepy initially, just one alcoholic beverage close to your bedtime can obstruct your sleep cycle, preventing you from getting enough REM sleep and deep sleep.
4. 4. Adhere to a sleep schedule. Some sleep disorders are caused or exacerbated by inconsistent sleep schedules—for instance, going to sleep in the early evening one night and past midnight on the next. To help your body adhere to a healthy sleep-wake cycle, set a specific bedtime, and commit to waking at the same time each day. If you have a bed partner, work with them to create a schedule that aligns with each party’s sleep patterns to keep light and other distractions to a minimum.
5. 5. Eliminate environmental noise. If you live in a noisy location or sleep during more boisterous daytime hours because you work a night shift, try sleeping with earplugs to prevent outside noise from disturbing you. White noise machines can also help drown out environmental sounds.
6. 6. Establish a relaxing bedtime routine. Partaking in a relaxing activity within the hour before you plan to fall asleep will ease your transition into sleep. Some examples of relaxing pre-bedtime activities include reading a book, taking a warm bath, listening to soothing music, and meditating.
7. 7. Turn off your phone, laptop, and TV. The blue light that radiates from electronic screens prevents your body from releasing the sleep hormone melatonin, which throws off the timing of your circadian rhythm. In addition, electronic devices tend to keep your mind racing and make it more difficult to wind down into sleep mode.

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