Health Tips

Imagine, you tuck yourself nicely into bed, just about to fall asleep but suddenly, you feel a pressure in your chest and sense a presence in your room. You cannot move your body but you can see your surroundings. Feeling helpless with your mind racing, you attempt to shout for help but you are unable to speak. In olden days, people often link this phenomenon to supernatural beings such as having a demon in the bedroom and the symptoms are simply due to its “evil” presence. However, is this folklore really true? Thankfully, sleep researches have ruled out this factor and concluded that this condition is no less than a sleep disorder called sleep paralysis. Now, let’s dive into the science behind this!

HOW DOES SLEEP PARALYSIS OCCUR?

Sleep paralysis can be classified into 2 groups namely: hypnagogic sleep paralysis and hypnopompic sleep paralysis. Hypnagogic sleep paralysis, also known as predormital sleep paralysis occurs as we are falling asleep, whilst hypnopompic sleep paralysis (postdormital sleep paralysis) occurs when we are waking up. In general, sleep paralysis is a mixed state of consciousness, an overlap where the person is in a sleep state but the mind is still awake.

Hypnagogic sleep paralysis (predormital)

As we fall asleep, our muscles slowly relax, body temperature decreases and our heartbeat becomes slower. Normally we become less aware of our surroundings so we do not notice this change. However, if we become aware while falling asleep, we may notice ourselves not being able to move nor speak as a result of our body being in its relaxed state.

Hypnopompic sleep paralysis (postdormital)

During sleep, our body experiences 4 stages: wake, light sleep, deep sleep, and REM sleep. We cycle through all stages over 3-5 times during a typical night, and each cycle usually lasts around 90 minutes. The first 3 stages can be categorised as non-REM (non-rapid eye movement). During the non-REM phase, our body muscles relax and restore itself. At the end of non-REM, our sleep transitions into REM phase. As the name suggests, this is the phase where our eyes move rapidly behind closed eyelids. Most dreaming occurs during REM sleep whilst our body muscles remain in its relaxed state, which prevents us from acting out our dreams. Sleep paralysis occur when we become aware before the REM cycle has finished, hence why we can’t move or speak for a few seconds to about 2 minutes.

Image credit: https://ouraring.com/blog/sleep-stages/#:~:text=Sleep%20has%20been%20traditionally%20divided,for%20the%20phases%20of%20sleep.

WHAT CAUSES SLEEP PARALYSIS?

Although unclear, there are several factors that researchers have linked this condition with such as:

• Poor sleep hygiene
• Disrupted sleep schedule (eg: working night shifts or being jet lagged)
• Lack of sleep
• Sleeping on your back
• Use of certain medications, such as those for ADHD
• Mental conditions such as general anxiety disorder, post-traumatic stress disorder (PTSD), stress, panic disorder 
• Narcolepsy 
• Family history of sleep paralysis

SYMPTOMS OF SLEEP PARALYSIS

• Inability to move or speak
• Feeling of fear
• Feeling as if something is pushing you down
• Feeling of a presence in the room
• Difficulty breathing
• Sweating
• Paranoia
• Muscle aches

According to American Academy of Sleep Medicine, first events of sleep paralysis commonly occur in teenagers aged between 14-17 years old and it is a common sleep condition amongst people – around 4 out of 10 people experience it. This condition is not dangerous nor it is life-threatening, so no medical intervention is usually necessary. However, there are certainly ways you can help prevent sleep paralysis!

DO:

1. Practice good sleep hygiene (eg: avoid blue light prior to sleep) 
2. Try to regularly get 6-8 hours of sleep a day
3. Go to bed at roughly the same time each night and get up at the same time each morning
4. Get regular exercise, but not in the 4 hours before going to bed
5. Ensure your room's temperature is kept low

DON'T:

1. Do not sleep on your back - this can make sleep paralysis more likely to happen
2. Do not eat a heavy meal shortly before going to bed
3. Do not drink alcohol or caffeine shortly before going to bed
4. Do not smoke shortly before going to bed 

WHEN SHOULD I SEEK HELP?

Although symptoms of sleep paralysis usually resolve within a short amount of time and don’t cause any major trauma, the experience can be quite unsettling and frightening. It is advisable to seek help from a doctor if you frequently experience sleep paralysis and if it affects the quality of your sleep to check for any underlying conditions that may be triggering it such as insomnia or narcolepsy.

If visiting a doctor does not help and you have tried all the methods above, you can consider visiting a sleep specialist to help manage your condition. You may be given a low dose antidepressant to help regulate sleep cycles.

TAKEAWAY:

In general, sleep paralysis is common and not life-threatening. In fact, there are ways to overcome them by making minor changes in our lifestyle such as maintaining good sleep hygiene. With that said, don’t be afraid to seek help if it is affecting your sleep health and wellbeing.

A WORD FROM DOC2US

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References:

1. NHS - https://www.nhs.uk/conditions/sleep-paralysis/

2. WebMD - https://www.webmd.com/sleep-disorders/sleep-paralysis

3. Healthline - https://www.healthline.com/health/sleep/isolated-sleep-paralysis

4. Oura - https://ouraring.com/blog/sleep-stages/#:~:text=Sleep%20has%20been%20traditionally%20divided,for%20the%20phases%20of%20sleep

Thumbnail image source: https://www.medicalnewstoday.com/articles/321569 

Written by

Ms Shin Yen Ter