Sleep Paralysis

What is sleep paralysis?

Sleep paralysis is when you can’t move any part of your body right before falling asleep or as you wake up. It happens when your body is in between stages of sleep and wakefulness. An episode is temporary and only lasts for a few seconds to a couple of minutes. It’s a type of parasomnia.

You’ll likely feel scared or anxious during a sleep paralysis episode. When it ends, you may feel confused because you’ll regain movement of your body as if nothing happened.

Even one sleep paralysis episode can make you nervous about going to sleep. This can affect how you feel and function during the daytime.

There’s no treatment available to stop a sleep paralysis episode when you’re in the middle of one, but treatment is available to reduce how often episodes affect you.

Is sleep paralysis dangerous?

Sleep paralysis isn’t dangerous, but it can cause emotional distress during an episode. Some cases of sleep paralysis link to other sleep disorders, so let a healthcare provider know if you’re not sleeping well.

How common is sleep paralysis?

An estimated 30% of people around the world experience at least one sleep paralysis episode within their lifetimes.

What are the symptoms of sleep paralysis?

You may experience the following symptoms during a sleep paralysis episode either right before falling asleep or as you’re waking up:

• You can’t move your arms or legs.
• You can’t speak.
• Sensations of pressure against your chest (suffocation) or moving out of your own body.
• Hallucinations (like there’s a dangerous person in your room).
• Daytime sleepiness.

What does sleep paralysis feel like?

During a sleep paralysis episode, you’re aware of your surroundings but can’t move or speak. You can still move your eyes and breathe. You may feel:

• Fear.
• Panic.
• Helplessness.

How long does sleep paralysis last?

The length of time you’ll experience a sleep paralysis episode varies. It could only last for a few seconds or up to 20 minutes. It usually only lasts a couple of minutes.

What happens if you wake someone up during sleep paralysis?

You can safely wake someone up during a sleep paralysis episode. The person having an episode may wake up fully and regain movement when you touch or talk to them. Someone in a sleep paralysis episode won’t be able to tell you what they feel or indicate with movement that they’re having an episode until they’ve recovered from one.

What causes sleep paralysis?

The exact cause of sleep paralysis is unknown. Healthcare providers notice they could happen with the following:

• Narcolepsy.
• Not sleeping enough (sleep deprivation).
• An irregular sleep schedule (shift work sleep disorder).
• Obstructive sleep apnea.
• Mental health conditions like anxiety, bipolar disorder, post-traumatic stress disorder (PTSD) or panic disorder.
• Certain medications (like ones that treat ADHD).
• Substance use disorder (SUD).

Why does sleep paralysis happen?

Sleep paralysis happens when you regain awareness going into or coming out of rapid eye movement (REM) sleep. Your body hasn’t fully switched sleep phases or woken up during sleep paralysis.

When you’re sleeping, your brain sends signals that relax the muscles in your arms and legs. The result — muscle atonia — helps you remain still during REM sleep. As you’re in the REM sleep stage, you’ll likely have dreams. Your brain prevents the muscles in your limbs from moving to protect yourself from acting dreams out and causing injury.

What are the risk factors for sleep paralysis?

Sleep paralysis can happen to anyone at any age. It’s more common among people who have a varying sleep schedule (like with shift work). Symptoms may first appear in childhood or adolescence. Episodes are more frequent in your 20s and 30s.

How is sleep paralysis diagnosed?

Healthcare providers confirm or rule out sleep paralysis after a physical exam and a sleep evaluation. Your provider may ask you about:

• Your symptoms, such as how often you experience sleep paralysis, what it feels like and when it started.
• The quantity and quality of sleep you get, such as how many hours you sleep at night and whether you feel tired during the day.
• Your medical history, including what medications you currently take and whether you smoke, use alcohol or unprescribed drugs.
• Your mental health, like if you experience stress or have an underlying mental health condition like anxiety or depression.
• Your family history and if you’re aware of any biological family members who experience sleep paralysis.

What tests diagnose sleep paralysis?

Your healthcare provider may recommend testing if they suspect a sleep disorder that causes sleep paralysis like narcolepsy. You may need:

• An overnight sleep study (polysomnogram): The test monitors your breathing, heartbeat and brain activity while sleeping. It may enable healthcare providers to observe an episode of sleep paralysis or detect issues like sleep apnea.
• Multiple sleep latency test (MSLT): This test measures how quickly you fall asleep and what kind of sleep you experience during a nap. The test helps uncover issues such as narcolepsy.

How is sleep paralysis treated?

Your treatment will depend on the reason why you have sleep paralysis. Your provider may recommend the following:

• Taking medications that prevent you from reaching the REM stage of sleep.
• Taking medications to treat an underlying mental health condition or sleep disorder (like antidepressants, for example).
• Improving your sleep hygiene (habits that help you sleep better).
• Talking to a mental health provider if you experience frequent stress.

How to stop sleep paralysis in the moment?

There’s no way to stop a sleep paralysis episode as it happens. You may notice that you come out of an episode sooner if you focus on making small body movements, like moving one finger, followed by moving two fingers, etc.

Can sleep paralysis be prevented?

There isn’t much you can do to prevent sleep paralysis from happening. But there are steps you can take to lower your risk.

One of the best ways to avoid sleep paralysis is to improve the quality of your sleep. You can do this by:

• Having a set sleep schedule with specific times for going to bed and waking up.
• Creating a comfortable sleep environment that’s dark and quiet.
• Putting phones, tablets, e-readers and computers away before bedtime.
• Relaxing before bed by taking a bath, reading or listening to soothing music.

If I’ve only had one sleep paralysis episode, will it happen again?

You may experience only one episode in your lifetime. But this varies from person to person. You’re more likely to have an episode during periods of high stress or when you’re not sleeping well.

How can I take care of myself after a sleep paralysis episode?

It’s natural to feel tired, confused and scared after a sleep paralysis episode. Sleep paralysis is a frightening experience. Be kind to yourself, including getting extra rest if you need it. Talk to a loved one for comfort or see your healthcare provider if you have concerns.

When should I see a healthcare provider?

If you have frequent sleep paralysis episodes, you should discuss them with your healthcare provider. There may be an underlying cause that they can treat.

What questions should I ask my healthcare provider?

Questions you may want to ask your provider include:

• What’s causing sleep paralysis?
• How can I come out of a sleep paralysis episode sooner?
• Should I talk to a mental health provider?
• Do you recommend treatment?
• Are there side effects of treatment?