Sleep paralysis

What is sleep paralysis?

Sleep paralysis is when you cannot move or speak for a short time after waking up or while falling asleep. It may last a few seconds or a few minutes.

About 8 in every 100 people will experience sleep paralysis at some stage. It might happen only once, or reoccur often. It usually starts in adolescence and happens most often between ages 20 and 40 years.

It does not cause any physical harm, but it can be scary.

During a stage of sleep called ‘rapid eye movement (REM)’ sleep, your body becomes temporarily paralysed. This means you can’t move your muscles. It may be your body’s way of preventing you from acting out your dreams. Being paralysed during sleep is normal, but you are usually unaware of it because you are asleep at the time.

If this effect on your muscles from REM sleep continues after you wake up, you will be fully aware of being paralysed.

What are the symptoms of sleep paralysis?

During an episode of sleep paralysis, you are awake and aware of what is going on. Episodes can involve:

• not being able to move any part of your body, except your eyes
• not being able to talk
• feeling scared
• hallucinations — for example, feeling there is an intruder in your room or that something is pressing on your chest or choking you

What causes sleep paralysis?

Sleep paralysis is not usually a sign of a problem. Sleep paralysis may occur on its own or it may be related to other health conditions, including:

• high blood pressure
• mental health problems —in particular anxiety and post-traumatic stress disorder (PTSD)
• obstructive sleep apnoea
• narcolepsy — this is a brain problem involving extreme daytime drowsiness even when you’ve had enough sleep at night
• alcohol or substance abuse

Sleep paralysis is also linked to:

• not getting enough sleep — for example, because of work hours or insomnia
• irregular sleeping patterns, for example those experienced by shift workers or students, or because of jet lag
• family history of sleep paralysis
• sleeping on your back

When should I see my doctor?

Talk to your doctor if you feel anxious or tired because of repeated episodes of sleep paralysis. Sleep paralysis is not usually harmful.

How is sleep paralysis diagnosed?

Your doctor will ask you about your symptoms. They may ask you to keep a sleep diary to record your sleeping patterns.

Tests are not needed to diagnose sleep paralysis. You might do a sleep study to check if you have any other sleep problems.

If your doctor thinks you may have narcolepsy, they will ask you to do a special sleep study called a ‘multiple sleep latency test’. In this test you will be given several opportunities to go to sleep during the day. The test will measure how long it takes you to fall asleep and what kind of sleep you experience.

How is sleep paralysis treated?

Sleep paralysis doesn’t cause significant problems for most people, and no treatment is needed. It’s often helpful to learn about sleep paralysis and be reassured that it is not a cause for concern.

If treatment is needed, measures that may help include:

• some types of antidepressant medicines
• relaxation techniques and meditation
• cognitive behavioural therapy

Your doctor may refer you to a specialist sleep physician.

It’s also important to treat any health conditions that may be causing your sleep paralysis.

Can sleep paralysis be prevented?

Getting enough sleep may reduce your chances of experiencing sleep paralysis. Most adults need between 7 and 9 hours of sleep a night. It may also help to keep to a regular sleeping pattern, by going to bed around the same time each night and getting up at the same time each morning.

Other ways to improve your sleeping habits include the following:

• Cut down on coffee and other drinks containing caffeine — and avoiding them completely in the evening.
• Get regular exercise, but not too close to bedtime.
• Do not drink alcohol, smokeor eat big meals before bedtime.
• Reduce your stress and create a relaxing environment, and especially before bedtime.
• Avoid screens for 1 to 2 hours before bedtime.

Complications of sleep paralysis

Sleep paralysis won’t cause any complications. It generally doesn’t stop you getting enough sleep.