Sleep Paralysis

Overview

What is sleep paralysis?

While falling asleep or waking up, your brain sends signals that relax muscles in your arms and legs. The result — muscle atonia — helps you remain still during rapid eye movement (REM) sleep. With sleep paralysis, you regain awareness but can’t move.

What does sleep paralysis feel like?

During a sleep paralysis episode, you're aware of your surroundings but cannot move or speak. But you can still move your eyes and breathe. Many people hear or see things that aren’t there (hallucinations), making episodes even more frightening.

How long do sleep paralysis episodes last?

They last anywhere between a few seconds and a few minutes.

Who gets sleep paralysis?

Rare or isolated sleep paralysis can occur in people of all ages. And it’s more common in the setting of sleep deprivation in association with a changing sleep schedule, which may happen if you are a college student or do shift work. Recurrent sleep paralysis is a symptom of narcolepsy, a disorder of unstable sleep-wake boundaries.

Symptoms and Causes

Why does sleep paralysis happen?

During the rapid eye movement (REM) sleep stage, you’re likely to have dreams. The brain prevents muscles in your limbs from moving to protect yourself from acting dreams out and hurting yourself. Sleep paralysis happens when you regain awareness going into or coming out of REM. Because narcolepsy is characterized by unstable wakefulness and unstable sleep, people with narcolepsy have frequent night awakenings that can be associated with sleep paralysis.

Are there specific causes?

The condition has many causes, including:

  • Narcolepsy.
  • Shift work.
  • Sleep deprivation.
  • Obstructive sleep apnea.

What are the symptoms of sleep paralysis?

The symptoms include:

  • Paralysis in your limbs.
  • Inability to speak.
  • Sense of suffocation
  • Hallucinations.
  • Fear.
  • Panic.
  • Helplessness.
  • Tightening around your throat.
  • Daytime sleepiness, which may be a sign of narcolepsy.

Diagnosis and Tests

When should I see a healthcare provider?

Even one sleep paralysis episode can leave you feeling anxious about going to sleep. If it bothers you, discuss your concerns with your healthcare provider. You should also consider seeking care if you feel excessively sleepy during the day.

How is sleep paralysis diagnosed?

Healthcare providers confirm or rule out sleep paralysis after an evaluation. They may ask you about:

  • Symptoms, such as how often you experience sleep paralysis, what it feels like and when it started.
  • Sleep, such as how many hours you sleep at night and whether you feel tired during the day.
  • Medical history, including medications you are taking and whether you smoke, use alcohol or illegal drugs.
  • Mental health disorders, which may include anxiety, post-traumatic stress or depression.
  • Family history of sleep paralysis.

Will I need tests to confirm my diagnosis?

Your healthcare provider may recommend testing if they suspect a sleep disorder. You may need:

  • 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 (unusual daytime sleepiness), which is the most common cause of sleep paralysis.

Management and Treatment

How can I stop sleep paralysis?

There are no proven therapies that can stop a sleep paralysis episode, but most people who experience it routinely report that focusing on making small body movements (such as moving one finger, then another) helps them to recover more quickly. Your healthcare provider can recommend treatments that lower the risk of future episodes.

It may also help to consolidate your sleep, try to prevent sleep deprivation and avoid the use of alcohol and recreational drugs.

Prevention

How can I prevent future episodes of sleep paralysis?

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 in advance of bedtime.
  • Relaxing before bed by taking a bath, reading or listening to soothing music.

Outlook / Prognosis

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

You may experience only one episode in your lifetime. But it may also come and go. You're more likely to have an episode during periods of high stress when you’re experiencing sleep deprivation. If you have sleep deprivation that goes away and comes back, you should discuss it with your healthcare provider.

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

It’s natural to feel tired, emotional and scared after recovering from sleep paralysis, and with good reason. 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.

A note from Cleveland Clinic

Sleep paralysis is uncommon. But many people feel scared after an episode. The experience may have felt so strange that you may wonder whether anyone will believe what happened.

Don’t let these feelings hold you back from getting medical attention and the support you need. A healthcare provider can pinpoint the causes, provide treatments or offer self-care recommendations to lower your risk of future episodes.

Last reviewed by a Cleveland Clinic medical professional on 10/18/2021.

References

  • American Sleep Association. Sleep Paralysis: Causes, Symptoms and Treatments. (https://www.sleepassociation.org/sleep-disorders/more-sleep-disorders/sleep-paralysis/) Accessed 11/2/2021.
  • National Center for Biotechnology Information (NCBI). Sleep Paralysis. (https://www.ncbi.nlm.nih.gov/books/NBK562322/) Accessed 11/2/2021.
  • NOVA (A Science Series from the Public Broadcasting System [PBS]). The Nightmare of Sleep Paralysis. (https://www.pbs.org/wgbh/nova/article/the-nightmare-of-sleep-paralysis/) Accessed 11/2/2021.
  • American Academy of Sleep Medicine. Sleep Paralysis – Overview and Facts. (https://sleepeducation.org/sleep-disorders/sleep-paralysis/) Accessed 11/2/2021.

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