Sleep paralysis is a disorder that can occur while falling asleep or upon waking up. The subject can neither move nor speak, he is truly paralyzed. There are then two possibilities: to let it go or to fight. Advice from our neurologist.
The sleep paralysis (related to parasomnia) is a disorder that can occur while falling asleep or upon waking. The subject can neither move nor speak, he is truly paralyzed. This state, which can last from a few seconds to a few minutes, is often accompanied by hallucinations. Between 20% and 30% of the population have been victims of sleep paralysis, especially during adolescence. Lack of sleep, fatigue, stress and anxiety are the main culprits of this sleep disorder
Usually the body is paralyzed only during REM sleep (sleep phase with many dreams): a neurotransmitter, glycine, prevents the muscles from moving during this phase. Abnormal sleep paralysis occurs when the motor functions of the body remain inhibited upon awakening, or when the mechanism is triggered prematurely. The feeling of fear and possible hallucinations are caused by the intermediate state of consciousness of the brain which can include frightening associated “waking dreams”. Sleep paralysis is mainly facilitated by lack of sleep and lying on your back, but sometimes stress, anxiety, overwork, a sudden change in lifestyle (mourning, moving, new job), or irregular sleep schedules. It can also exist in the family, or in anxious people, or who have experienced sexual abuse. It is also one of the symptoms of narcolepsy.
During a sleep paralysis experience, the person wakes up unable to move or speak. The only active muscles are the eye muscles and the respiratory muscles. The sensation is similar to that of a daydream. Seizures are most often short and do not exceed a few minutes. They can occur when falling asleep or waking up. This paralysis is usually associated with hallucinations, which varies in nature depending on the case. The most common hallucinations result in the impression of feeling a hostile presence in the room or pressure on the body (most often on the chest, sometimes a person sitting on the sleeper’s chest). It can also be auditory hallucinations (creaks, footsteps), visual (perception of objects or light) or kinesthetic (feeling of falling, floating, vibrations, getting out of the body and levitating). Those hallucinations can be a source of anxiety, even insomnia: the person is afraid to go back to sleep to undergo a new experience.
“Fighting paralysis is difficult and anxiety-provoking”
“In very many cases, there is no need to see a doctor. It is already important to name what happens: it is a sleep paralysis, a brief disturbance of the exit from REM sleep, and not a paranormal event or a diabolical possession, as we thought in the past, nor a nightmare in Classes“, explains Professor Isabelle Arnulf, neurologist and somnologist (Pitié Salpêtrière Hospital – Paris). It is then important to properly realize that we are not going to die of it and that it will stop in a few seconds: the diaphragm works well and allows breathing, even if it can be more difficult (because the muscles of the rib cage are paralyzed). This alone helps reduce the fear associated with the phenomenon. “Once paralyzed, there are two possibilities: give in or fight. Fighting against paralysis is difficult and anxiety-provoking, because the person will feel even more that he is paralyzed and will hardly be able to generate more than a few guttural sounds or brief jerks.“, describes Professor Isabelle Arnulf. Before adding: “if his partner in bed realizes this thanks to these sounds or jolts, he can pinch or shake/seat the paralyzed person (who is all soft) to get him out of his paralysisBut letting go is by far the best strategy: by trying to project oneself into a pleasant mental universe (imagining oneself lying on a beach in the sun, for example) and to relax mentally but also to relax one’s muscles (precisely, the body will return the idea that one is relaxed and it will be positive). The person will then go either to sleep or to wakefulness, but will no longer remain “in between”. To prevent the paralysis from coming back, people prone to this problem avoid sleeping on their backsand especially from lack of sleep : sleep well and enough, on a regular schedule and learn to relax well in the face of stress.
“it is necessary to consult when the episodes of sleep paralysis become very frequent despite the precautions and techniques indicated above, when they occur not when waking up but when falling asleep, and when one is also abnormally drowsy during the day“, advises Professor Isabelle Arnulf. In these specific cases, we look for a cause and the doctor can offer drug treatments that restore muscle strength in REM sleep.
Thanks to Pr Isabelle Arnulf, neurologist and somnologist, Pitié Salpêtrière Hospital, for her clarifications and her validation.