Sleep Paralysis: What is it, what causes it and what can I do about it?

Sleep paralysis occurs when you are falling asleep (or waking up) and you find yourself unable to move or speak. An episode of sleep paralysis usually lasts only one or two minutes but, while it lasts, it can be quite frightening and may even result in the feeling that there is someone (or something) in the room that intends you harm.

Sleep paralysis can be a one-time occurrence or it may happen many times. It can occur in otherwise healthy people, and it is also associated with narcolepsy.  It often occurs more frequently if you are sleep deprived, or you are keeping a very inconsistent sleep schedule.  For example, teens often get up around 6am on school days but as late as noon on weekends and this can lead to sleep paralysis.

Sleep paralysis occurs when the wake state and the REM (dream) state overlap for a minute or so. Since you are essentially paralyzed during REM sleep (with the exception of your diaphragm and eye muscles), if you wake up and you are still in REM sleep, you will experience this paralysis.  Be reassured about the fact that this “overlap state” usually lasts only a short time and therefore, you will always be able to move again after a minute or two.

However, there are some ways that may help you to end an episode more quickly.

  1. You should always first try using the eye muscles to try to move out of the paralyzed state.  Try squinting your eyes or “making a face.”  You can also try using the diaphragm muscle to move out of the episode by taking a deep breath or trying to cough.
  2. You can try moving your toes or fingers.
  3. You can try not fighting the sleep paralysis.  For example, try relaxing your body INTO the mattress if you feel are you being pushed down.
  4. You can try sleeping in any position EXCEPT on your back.  It is less common to have sleep paralysis if you sleep on your side or stomach and even less common to have an episode if you sleep a bit elevated, so a wedge pillow that raises you up a bit may help.  The wedge pillow should be 10-12 inches high. If you do not like sleeping on a wedge pillow (after trying it for at least 3-4 nights), you can try any other method that will keep you from sleeping on your back.  For example, you can sew a pocket in the middle of the back of a tightly fitting t-shirt and put a tennis ball into this pocket (so that sleeping on your back would be uncomfortable).  This will help you to automatically move off of your back even when you are asleep. You might also try wearing a fanny pack with some tennis balls in it to bed after making sure the fanny pack rests in the small of your back. However, the pack can sometimes slide out of place at night, making it less helpful.
  5. If you have the sense that someone is in the room with you and intends to harm you during an episode, you can try imagining that this person is there to help you or guard you instead.

Once you are awake and able to move again after an episode, be sure to “change the scenery” to avoid dropping back into the same dream and to avoid associating your bed with anxiety. You can change the scenery by reading a book for a few minutes or by watching a video on your device with the brightness turned down. If you feel very anxious, get out of bed and sit in a comfortable place nearby until you feel drowsy and calm again. It’s usually better to use a distraction technique (such as reading or watching a video) rather than a self-focused technique (such as muscle relaxation or deep breathing) to reduce anxiety quickly.

More general tips include making sure that you are getting enough sleep each night because sleep paralysis (and nightmares as well) are more frequent when you are sleep deprived.

You should also try to go to sleep at night and get up each day at about the same time, within a two hour window.  “Catching up” on sleep by sleeping very late one day is not a good idea as it confuses the body clock and weakens the sleep/wake drive.  In addition, your body begins to make up for a poor night of sleep the very next night on its own by increasing the percentage of deep sleep and REM sleep and decreasing the percentage of light sleep until you are caught up.  In other words, you do not need to sleep late on the weekends because your body has probably already mostly made up for any lost sleep.

You should try to keep any daytime napping to an hour or less each day.

Try to avoid heavy meals or alcohol before bed (alcohol helps a person to fall asleep but fragments sleep in the second half of the night).  Try to avoid caffeine after 2pm.

It’s important to value and protect your sleep time. Many people see sleep as a waste of time but it is integral to good health.  Regular, sufficient sleep alone may prove to be one of the most helpful steps you will take in managing this issue. Finally, if you have sleep paralysis frequently, you should consult a sleep doctor to rule out narcolepsy or other sleep disorders.


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