Sleep paralysis is a short-term sleep anomaly when a person, being half asleep, realizes that he cannot move and make sounds, this in turn provokes an attack of panic. This phenomenon has been experienced by many at least once. If attacks occur regularly, a doctor’s examination and appropriate treatment are required.

Scientific rationale

Sleep stupor is of two types:

1. Hypnagogic – when falling asleep.
2. Hypnopompic – immediately upon awakening.

From a medical point of view, the rationale is as follows: at the time of the REM sleep phase, all body motility is turned off, only vital organs “work”. This is necessary for the safe rest of the brain and body. Turning on occurs when you enter the stage of slow sleep or when you wake up. Sometimes the mediators of the brain responsible for these processes fail, which is why the motor skills either turn on late or turn off earlier than expected. The result is sleep paralysis.

Is there a connection with genetics

To establish a predisposition to the state of sleep paralysis at the level of genetics, scientists have conducted studies with identical twins. It is these twins that “share” almost 100% of genes with each other ( fraternal – only 50%).

The experiment showed that there is actually a relationship at the genetic level. A predisposition to sleep stupor occurs in those people who have a mutation in a particular gene that is responsible for the cyclicity of sleep. Official confirmation of the relationship has not yet been presented, and geneticists have to do a lot of work in this direction.

When a state of immobility occurs

There are three stages of sleep:

1. Fast phase.
2. Slow phase.
3. Awakening.

In the fast phase, the brain is highly active, the heart muscle, the respiratory system and the organs of vision also work. You can observe how the sleeping person’s eyes move under the closed eyelids. This means that at this moment he sees vivid dreams. All other muscles of the body are completely relaxed during this phase. If a person wakes up at this moment, with the correct functioning of the brain, all the motor mechanisms of the body are simultaneously triggered, the muscles come to tone.

However, if there are sleep disorders, disruptions at the genetic level, paralysis does not go away even after waking up. In most cases, a minute is enough for a person to recover, but even during this short period, you can experience real horror and fear.

Sleep paralysis is a unique phenomenon of consciousness. Somnologists conducted tests and found that the activity of the brain in all participants in the experiment who experienced the anomaly occurs during the REM sleep phase, moreover, the results of the records are identical.

Most often, the phenomenon of stupor occurs at the moment of awakening. It has been found that if a person wakes up in REM sleep or immediately after it, stupor occurs. The brain still “sees” colorful dreams, while the body continues to “sleep” and remains motionless. Hence the effect – a person seems to be mystical phenomena, otherworldly shadows, there is a feeling of horror and detachment of the soul from the body. In a normal state, awakening occurs at the end of the slow-wave sleep phase, after complete rest of the body, prepared for wakefulness.

Sleep paralysis – causes

Sleep paralysis is sometimes one of the symptoms of neurological pathology:

• narcolepsy (spontaneous, unintentional falling asleep);
• somnambulism (walking while sleeping);
• bipolar disorder (psychosis in which manic activity alternates with major depression).

But most often the phenomenon is spontaneous and arises on its own due to short-term disorders of the nervous system, in which the stages of switching on consciousness after sleep and the work of the muscular system do not agree with each other.

What causes sleep paralysis? There are several provoking factors:

• violation of the daily routine (frequent lack of sleep, short-term, but frequent falling asleep during daytime activity);
• persistent sleeplessness at night;
• acute and chronic stress;
• long-term use of tablets that affect the nervous system (antidepressants);
• addictions in a chronic form (nicotine addiction, alcoholism, drug addiction, substance abuse);
• restless legs syndrome;
• the habit of sleeping on your back (it has been proven that sleep paralysis occurs less often when sleeping on your side);
• hereditary factors.

Scientists have been studying this phenomenon for a long time and have done a lot of research. The result is staggering: 40 out of 100 people have experienced post-sleep paralysis at least once.

Both men and women of all ages are predisposed to the syndrome, but it is more common in the age group from 13 to 25 years.

Psychological point of view

Sleep paralysis nightmares, according to psychiatrists, are not dangerous for the psyche of a healthy person. But if a person is emotionally unstable (this is especially true for women who are more susceptible to everything), there may be problems associated with the fear of death, the feeling of falling into a coma.

This is due to the fact that the hallucinations accompanying the phenomenon are very realistic, and the defenselessness of the paralyzed body is frightening. Sleep paralysis is quite often accompanied by auditory hallucinations, when the sounds of the outside world are distorted, amplified, supplemented by echoes of a dream that has not yet gone completely.

Signs and symptoms

Different types of this anomaly have their own symptoms.

Hypnagogic stupor (on falling asleep):

• unexpected abrupt awakening with an almost complete transition to sleep, when it seems to a person that he fell or someone pushed him;
• a feeling of numbness in the body due to fright;
• oppressive sensation, as if the end of life is approaching along with immersion in drowsiness, death may occur, or there is a feeling of falling into darkness;
• abrupt or complete understanding of what is happening around without the ability to influence it;
• a feeling of absolute awareness of one’s own body (when fingers, hair, bones are felt, something that a person does not pay attention to in everyday life and takes for granted);
• the realization that you can move your hand or roll over on your stomach, but the transition from thought to action takes an infinitely long time;
• the appearance of hallucinations of hearing – the noise in the ears grows, turns into ringing and a kind of monotonous squeak.

Hypnopompic stupor (upon awakening):

• complete immobility of the limbs, inability to open the mouth, utter words or shout;
• a feeling of heaviness in the body, as if someone, having piled on the whole body, does not give the opportunity to move;
• a sense of the presence of otherworldly mystical creatures, the appearance of which depends on a person’s worldview, his cultural, religious traditions (devils, dead, vampires – any subconscious fears);
• a feeling of animal horror at the level of primitive instincts (fear of death, suffocation, complete helplessness);
• dreams in reality – conscious hallucinations in which a person sees shadows, ghosts, silhouettes of people where they should not be;
• audible hallucinations accompanied by audible voices, footsteps, creaks, knocks;
• disorientation in the outside world (a person does not understand where he is);
• twitching of nerve endings in the fingers, limbs;
• a false sense of movement (a person imagines that he has turned over on his back, although in fact he did not move).

Any of the listed symptoms force a person to wake up. Due to the sudden emotional jump that has arisen, a person may jerk his hand or moan softly. This helps to finally get out of sleep paralysis and wake up.

There are several common symptoms for both types of stupor:

• difficulty breathing, a feeling of suffocation, lack of oxygen, it seems to a person that he has forgotten how to breathe;
• a false feeling as if the heart has stopped, after the heartbeat increases;
• sometimes blood pressure rises, cold sweat appears, an internal tremor appears, accompanied by a feeling of anxiety.

Symptoms are short-term and gradually subside after 1-2 minutes, but it feels like an eternity.

Diagnostics

Sleep paralysis does not belong to medical diagnoses; in the classification of sleep disorders, it is positioned as a type of parasomnia .

If post-sleep paralysis syndrome occurs only once, there is no need to seek medical attention. With frequent episodes, medical attention is necessary. The doctor will make a history based on the events and factors described by the person. After that, if necessary, he will prescribe a special examination that will help identify the causes of frequent sleep paralysis.

The phenomenon can be a symptom of a mental disorder. A deeper diagnosis is needed if:

• stupors are repeated and regular, and especially if they occur every night or several times during a night’s sleep;
• the symptoms of sleep paralysis are pronounced, with a clear effect on the psyche and nervous system;
• there is a factor of confusion, a constant feeling of fear;
• there are concomitant sleep disturbances (nightmares, sleepwalking, inclination to sleep during the day, but insomnia at night);
• sleep paralysis is accompanied by other symptoms of mental disorders: panic attacks in the daytime, unreasonable aggression, increased suspiciousness.

To make a correct diagnosis, psychiatrists practice the following methods:

• The patient should keep a constant diary in which he records each episode of sleep paralysis. The records should be very detailed, with a description of all sensations and experiences. Also, the doctor himself makes notes about the presence of other diseases of the nervous system and psyche, which are risk factors. The diary should be kept from 4 to 6 weeks, if necessary, and for a longer period.
• Polysomnography is a recording of a patient’s sleep using a computer program connected to special equipment. If sleep paralysis is not, in a particular case, a pathology of the patient’s psyche, polysomnography will show the sleep rate.

After the examination, when the pronounced signs of parasomnia disturbing the patient are established, he is sent to a specialist dealing with sleep behavior disorders – a somnologist.

Treatment

Doctors say that sleep paralysis does not need special treatment and that it is impossible to solve the problem just by taking sedative pills. However, specific prophylaxis is required under other aggravating circumstances – neuroses, stress, sleep disorders in depression, drug addiction, alcohol abuse. All of these factors have a causal relationship, and paralysis will bother a person until he eliminates them.  

Eliminating concomitant factors, it is possible to achieve normalization of sleep and get rid of recurrent sleep paralysis by following simple therapeutic recommendations:

1. Developing the habit of going to bed at the same time.
2. Exercise regularly, be active during the day, and be outdoors more often. A healthy lifestyle helps to improve the interaction of the brain with muscles, which allows them to achieve well-coordinated work during sleep.
3. Refusal of bad habits, exclusion of the use of tonic drinks before bedtime and in the evening, refusal to take pills that cause insomnia.
4. Airing the room before bed, taking relaxing baths and drinking relaxing herbal teas.
5. You need to learn how to fall asleep on your side, at first you can put objects under your back that prevent you from turning on your back, or fall asleep tightly against the wall.
6. The number of hours needed to sleep should be set. This indicator is individual – for someone six hours is enough, someone does not get enough sleep even for eight.

What to do if sleep paralysis occurs

Sleep paralysis cannot be prevented if it has already occurred. The half-asleep brain is unable to understand where is the dream and where is reality. However, any person can get rid of the syndrome as quickly as possible.

The main thing is to realize that shadows, monsters, witches and devils are hallucinations, they have no mystical background, they are harmless, easily removable. Some rules will help to stop the panic from sleep paralysis.

What not to do:

• There is no need to rush to get rid of muscle weakness, try to raise your arm or turn your head. It has been proven that until the brain itself “turns on” the muscles, stupor will only increase the panic fear of helplessness.
• You should not hold your breath, as most people do when they are afraid of something. Cessation of oxygen supply leads to the accumulation of carbon dioxide in the lungs, which further complicates the respiratory reflexes.
• But you also don’t need to breathe faster, hyperventilation (oversaturation of the lungs with oxygen) exacerbates the feeling of anxiety and fear.

What should be done:

• try to mentally relax;
• take one deep breath and then breathe evenly, as usual;
• since the muscles of the mouth are also constrained, you need to try to make at least some sound with your mouth closed – mumble, moan;
• close your eyes tightly even with closed eyes;
• at the first signs of muscle activity, start movements with the tongue, move them along the gums and palate;
• try to move, making small movements at first – move your index finger on your hand, puff out your cheeks, move your feet in different directions;
• intellectual warm-up of the brain helps: counting from 0 to 10 and back, enumeration of letters of the alphabet, memories of the past day.

The listed actions help to quickly regain control over your body and eliminate sleep paralysis.