Sleep paralysis 

Experiencing moments when you can't move or speak while falling asleep or waking up can be quite unsettling. This condition, known as sleep paralysis, often occurs during the transitions between REM sleep and waking up. Despite its frightening nature, sleep paralysis is usually harmless and short-lived.

Understanding why it happens, its causes, and how to manage it can help alleviate some of the fear associated with these episodes. Advocate Health Care’s Sleep Centers in Chicago are here to help you.

Our team of sleep specialists will help you understand why sleep paralysis occurs and give you tips on how to get better sleep so you can stop it from happening.

Contact us to schedule a consultation near you.

What is sleep paralysis?

Sleep paralysis is a temporary condition where you are unable to move or speak while falling asleep or waking up. Sleep paralysis can be categorized into two primary types based on when they occur during the sleep cycle:

• Hypnagogic (predormital) sleep paralysis: Hypnagogic sleep paralysis happens as you are falling asleep. As your body begins to relax and transition into sleep, you normally lose awareness of your surroundings. However, if you remain conscious while your body enters REM sleep, you may experience hypnagogic sleep paralysis. This state can cause a sense of being awake yet unable to move.
• Hypnopompic (postdormital) sleep paralysis: Hypnopompic sleep paralysis occurs as you are waking up. During REM sleep, your brain is highly active, and your body remains in a state of temporary paralysis to prevent you from physically acting out dreams. If you regain consciousness before a REM cycle is complete, you may experience hypnopompic sleep paralysis, waking up but being unable to move or speak.

Both types of sleep paralysis can be accompanied by vivid hallucinations and a feeling of pressure on the chest, often resulting in intense fear and anxiety during the episode.

Why does sleep paralysis happen?

Sleep paralysis occurs when your brain and body are out of sync during the sleep cycle. During REM sleep, your brain is active, and you may experience vivid dreams.

To prevent you from acting out these dreams, your brain sends signals to inhibit muscle activity, causing temporary paralysis. If you wake up before the REM cycle is complete, you may become conscious while still unable to move or speak, leading to a sleep paralysis episode.

Causes of sleep paralysis

The exact causes of sleep paralysis are not understood, but several factors may contribute to its occurrence:

• Sleep deprivation: Lack of sleep or an irregular sleep schedule can increase the likelihood of experiencing sleep paralysis.
• Sleep disorders: Conditions such as narcolepsy and insomnia can increase the risk of sleep paralysis.
• Sleep position: Sleeping on your back is often associated with a higher number of sleep paralysis episodes.
• Stress and anxiety: High levels of stress and anxiety can disrupt your sleep patterns and contribute to sleep paralysis.
• Substance use: The use of alcohol or certain medications can affect your sleep cycle and potentially trigger sleep paralysis.

Symptoms of sleep paralysis

The primary symptom of sleep paralysis is being awake but unable to move or speak. This can happen at any stage of sleep. Other sleep paralysis symptoms to look for include:

• Feeling of pressure: A sensation of pressure on the chest or a feeling of being choked is common during an episode.
• Hallucinations: Many people report experiencing hallucinations during sleep paralysis, which can be visual, auditory, or tactile.
• Intense fear: The inability to move combined with hallucinations often leads to intense feelings of fear and panic.

How to get out of sleep paralysis

While sleep paralysis episodes can be alarming, there are ways that may help you get out of them:

• Stay calm: Remaining calm can help reduce the duration and intensity of the episode. Focus on breathing slowly and deeply.
• Move small muscles: Try to wiggle your fingers or toes. Small movements can help you regain full control of your body.
• Seek help from a partner: If you share a bed with someone, let them know about your condition. They can help wake you if they notice you are experiencing sleep paralysis.

Sleep paralysis diagnosis

Your doctor or sleep specialist will discuss your medical history and your symptoms to rule out any underlying conditions or sleep disorders. If you frequently experience sleep paralysis, your sleep specialist may have you do a sleep study and keep a sleep diary.

Undergoing a sleep study can help identify any underlying sleep disorders contributing to sleep paralysis, while keeping a sleep diary can provide insights into your sleep patterns and help you and your doctor identify potential triggers.

If your doctor suspects sleep apnea may be an underlying cause, you may be able to do an at-home sleep apnea test.

Treatment for sleep paralysis

Treating sleep paralysis often involves addressing the underlying causes and improving your overall sleep health. Some tips to improve your sleep include:

• Establish a regular sleep schedule: Aim for a consistent sleep schedule with sufficient rest each night.
• Reduce stress: Practice stress-reducing techniques such as meditation, yoga, or deep breathing exercises.
• Exercise: Keeping a regular exercise schedule can improve your overall health, including your sleep health.
• Establish a bedtime routine: Avoid caffeine for several hours before bedtime, turn off electronics before bed and ensure your sleep environment is comfortable and relaxing.
• Medication: In some cases, medications may be prescribed to manage underlying conditions such as narcolepsy or anxiety.

While sleep paralysis can be a scary experience, understanding its causes and symptoms can help you manage future episodes. If you continue to have concerns, speak with an Advocate sleep specialist for further evaluation and treatment options.