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Exploring the Causes and Symptoms of Sleep Paralysis

Sleep paralysis is a sleep disorder that affects approximately 7.5% of the population at some point in their lives, with slightly more women than men experiencing episodes. Individuals with idiopathic hypersomnias, narcolepsy, insomnia, sleep apnea, anxiety disorders, and those undergoing stress or major life changes are more prone to experiencing sleep paralysis. Recent research also suggests a potential genetic predisposition, with a heightened likelihood of experiencing sleep paralysis if a close family member has also experienced it.

What causes sleep paralysis?

Sleep paralysis occurs when an individual wakes up during REM (Rapid Eye Movement) sleep, a stage characterized by muscle paralysis. This paralysis is normal and is meant to prevent the acting out of dreams. When a person wakes up during REM sleep, the body remains paralyzed for a brief time, until the brain comes out of REM. This mismatch between body paralysis and consciousness often triggers fear and distress.

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, a sense of falling, floating, spinning, flying, or out-of-body feelings.  These are not necessarily negative experiences.

These sensations are linked to the sudden awareness of the body’s paralyzed state during REM sleep and the residual and completely normal shallow and irregular breathing people experience during this stage of sleep.

Is sleep paralysis dangerous?

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.


Managing Sleep Paralysis

Research into interventions for sleep paralysis remains sketchy and sparse.  However, if we look at the things that make a person more likely to experience sleep paralysis, it makes sense to manage triggers for poor sleep quality as that is the common connection between the non-medical causes. Effective stress management, strategies for deepening sleep (such as those found in CBTI), and addressing the fear of sleep paralysis can all help.

Why address the fear itself? Fear of sleep paralysis may lead to insomnia or poor sleep quality, increasing the chance of further episodes of sleep paralysis.  This can create a vicious circle.

Cognitive behavioural therapy for insomnia (CBTI) and acceptance and commitment therapy (ACT) are recommended interventions for reducing the impact of these frightening experiences and for improving and deepening sleep. 

Coping Strategies for Sleep Paralysis Episodes

People who wake in the middle of a sleep paralysis episode can remind themselves that it is not a dangerous experience – this becomes easier if someone has more frequent episodes.  It doesn’t feel safe but it is. 

Learning how to use imagery rehearsal techniques and lucid dreaming could help influence the experience of hallucinations. By transforming the experience into a less threatening or even a positive one, people can reduce fear of the experience, which reduces their impact on sleep quality – and subsequently reduce the likelihood of experiencing future episodes.

Seeking professional guidance from a sleep therapist can be instrumental in both addressing sleep paralysis and enhancing overall sleep quality.

Unravelling and understanding sleep paralysis can help people in managing their episodes and improving their overall sleep health. By addressing triggers, managing responses, and reshaping their perceptions, people can gain be well on a journey toward better sleep and well-being.

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

This website contains information that is for informational purposes only. Nothing on this website should be construed as personal healthcare advice. Always seek the advice of your own healthcare professionals when working to improve your sleep.