Sleep Paralysis – What is it?

I get a lot of questions about sleep paralysis. Sleep paralysis is an inability to move the body when falling asleep or when waking up from sleep.  This happens when the mind and the brain/body are out of sync.  The mind and your consciousness is moving either faster or slower through normal sleep transitions.

This paralysis makes it hard to speak or move voluntarily,  but you can still breathe normally.  A person is usually fully aware of what is happening. This obviously generates great anxiety in people.

What is Sleep Paralysis?

Being ‘paralysed’ in sleep is normal.  We just usually aren’t aware of it. However, in sleep paralysis, this paralysis and low muscle tone happens while awake and during one of those transitional phases where this would be considered ‘normal’.  The only difference between when this normally happens and our perception of ‘paralysis’  is that our mind is awake when it’s normally sleeping during this process.

So, when you have this experience upon waking up – your mind is awake but your body has not yet come out of it’s ‘paralysis’ and transitioned back into wakefulness.

And when you experience it when falling asleep, your body has fallen into a normal sleep state where paralysis is expected, but your mind has not yet slowed down enough to join it in sleep.

Who gets sleep paralysis?

This parasomnia is most common in people suffering from narcolepsy, happening in approximately 30 to 50% of these cases. However, people without narcolepsy can also experience sleep paralysis, especially teenagers or young adults. It is also often related to sleep deprivation, abnormal sleep cycles, psychological stress, depression, post-traumatic stress disorder, panic disorder, or substance abuse.

Sleep paralysis is sometimes accompanied by hypnagogic experiences like visual, auditory, and sensory hallucinations:

• Sense of intrusion, hearing sounds similar to doorknobs opening and shuffling footsteps, seeing shadows, or thinking there is a threat in the room.
• Believing to be strangled, smothered, or sexually assaulted by someone, expressing as difficulty breathing or pressure.
• Movement experiences, presenting a sense of falling, floating, spinning, flying, or out-of-body feelings.

An episode can last from seconds to minutes,  and people can have one episode of paralysis or many. The episode usually ends on its own, but it can also finish when someone touches or speaks to the person.  Making an intense effort to move can also end it.

Is sleep paralysis dangerous?

Normally, this parasomnia is not considered a medical problem per se. It isn’t harmful in and of itself.

While most people need no treatment, episodes can be prevented by practising good sleeping habits which tend to be consistent with parts of CBTi.

• Using your bed only for sleep and sex.
• Limiting or eliminating daytime sleep,
• Going to bed only when you are sleepy.
• Limiting time in bed when awake.
• Sleeping in a quiet, comfortable, dark, and cool room.
• Limiting exposure to bright light and electronics before bedtime.

How can I stop it from happening?

Cognitive behavioural therapy for insomnia can be used as well. In many cases, this can be especially useful because sleep paralysis is often related to insomnia caused by stress and anxiety, resulting in a hyperaroused mind.

If you have episodes of sleep paralysis, it would be very normal to be concerned – but it isn’t dangerous in and of itself. Try to remember that it is not harmful at all and avoid fearing it or letting it interfere with positive feelings you have toward bed and sleep. Practising stimulus control can be helpful for those who are having this experience, in order to more strongly associate bed with being asleep and rested.

However, if you are too afraid of sleeping due to the possibility of having an episode of sleep paralysis, you should get help.  This could be additional sleep education, sleep consolidation training and relaxation training to promote a healthier relationship between emotions and sleep.

If you are in need of support, I offer sleep coaching services both in person and online. Just reach out.