Sleep paralysis is a sleep disorder during which the sufferer is completely unable to move their body for a short period of time. The disorder is not dangerous and usually occurs in isolation, but sometimes in conjunction with other sleep disorders such as narcolepsy.
What is sleep paralysis?
Sleep paralysis refers to a state of temporary inability to move that occurs during or just before falling asleep. Sleep paralysis sets in when the person transitions between periods of being awake and asleep. See biotionary for What does CLL stand for.
For seconds or even minutes, people are unable to move or speak. You often feel a state of shock or panic during this time. A sleep disorder, such as sleep paralysis, often coexists with other sleep disorders, such as narcolepsy. Physical and psychological symptoms combine during sleep paralysis to create a horrifying condition for those affected.
People often report physical rigidity in the twilight state, combined with the uneasy feeling that an intruder is entering the room. Sleep paralysis can occur in connection with psychological or physical disorders such as anxiety disorders or migraines.
Causes
It is estimated that one in three people will experience sleep paralysis during their lifetime. In order to understand the causes of sleep paralysis, it is important to remember that there is still a transitional phase between the states of consciousness that are awake and asleep.
At this stage, elements of the waking state are still present, such as information about the environment, but information from the dream state is already overlapping. Normally this transition goes smoothly. Sleep paralysis is associated with the REM phase. Even during this phase, the dreams are only lived through the eyes.
It is believed that some psychological or sleep behavior disorders may contribute to sleep paralysis. These include depression, anxiety disorders, stress, narcolepsy, drug or alcohol abuse.
Symptoms, Ailments & Signs
During sleep paralysis, the person affected cannot move. Doctors only speak of clinical sleep paralysis in the sense of a sleep disorder if this condition occurs while the person concerned is awake. Prolonged rigid sleep can occur alone or as part of another sleep disorder. If another sleep disorder is present, additional symptoms are possible, for example problems falling asleep and staying asleep or daytime tiredness.
In predormital sleep paralysis, rigidity occurs before sleep occurs, whereas postdormital sleep paralysis is characterized by paralysis after waking. The affected person is often aware of his surroundings, but he cannot move or speak. Some sufferers feel as if they are outside their own body and are looking at their body from above or from the side.
Neuropsychological symptoms such as hallucinations can occur during sleep paralysis. In a hallucination, the patient perceives sensory impressions for which there is no adequate stimulus. For example, sufferers of sleep paralysis may hear voices or see objects, people, and movements that are not real. Patients may also feel like they are being touched or poked with a sharp object. Such and similar perceptions fall into the realm of tactile hallucinations.
Other possible symptoms of sleep paralysis are anxiety, panic and anxiety. Some sufferers feel their breathing unusually clear or have the feeling of being unable to breathe.
Diagnosis & History
Sleep paralysis is diagnosed by ruling out other sleep disorders based on their individual symptoms. A special focus is placed on narcolepsy, as this disorder is often associated with sleep paralysis.
However, genetic testing for narcolepsy makes it easy to rule out this disorder. When other possible sleep disturbances can be ruled out, the sufferer’s individual experiences and symptoms are compared to the well-documented experiences of countless other patients. If there is a match in several aspects, sleep paralysis can be diagnosed.
In addition, the doctor may ask the patient to keep a journal of their sleep habits and experiences; discuss your own and family’s medical history of sleep disorders; recommend a referral to a sleep specialist who may run some tests that require an overnight stay in a sleep lab.
Complications
Sleep paralysis usually does not cause any major complications. Many sufferers panic when they are awake but unable to move. In combination with the hallucinations and nightmares that sometimes occur, this can sometimes cause a state of shock. Recurring sleep paralysis can lead to sleep disturbances.
In the long term, the symptoms can promote feelings of anxiety, stress and, under certain circumstances, depression. Very rarely, sleep paralysis can cause an acute panic attack. Being startled suddenly can cause accidents and further health complications. Physically weakened people can suffer cardiovascular problems as a result of the sleep disorder. When treating sleep paralysis, the risks come from inappropriate self-treatment.
Those affected take action against the sleep disorder with the help of sleeping medication or alcohol, for example, which can lead to addictive behavior and ultimately to addiction. Overdoses of natural sedatives such as valerian can cause itching, reddening of the skin and headaches. Finally, people with recurring sleep paralysis often stay awake longer or sleep too little – there is a lack of sleep and the stress level increases. In addition, a lack of sleep promotes mental illnesses and often leads to accidents in everyday life and at work.
When should you go to the doctor?
If the person concerned experiences phases of inability to move, he should speak to a doctor. A diagnosis is necessary so that serious illnesses can be ruled out and information can be given on how to deal with the symptoms in everyday life. In the case of anxiety, panic sensations or a sleep disorder, the person concerned needs help. If the inability to move causes stressful situations in everyday life or if there is a change in sleeping habits, a doctor is needed. Tiredness, loss of concentration or alertness are worrisome.
If there is a decrease in cognitive or physical performance, a consultation with a doctor should take place. If everyday requirements can no longer be met, if the person concerned has headaches or migraines and suffers from a general feeling of illness, they need help.
The disease manifests itself in connection with the natural sleep process. Therefore, the symptoms appear immediately before falling asleep and should be presented to a doctor. If the limbs can no longer be controlled at will, this is a sign of a health irregularity. Sensory disturbances, irregularities in sensitivity or changes in breathing perception are characteristic of sleep paralysis and should therefore be discussed with a doctor. Hearing voices, hallucinations or regional paralysis are considered signs of illness. If the symptoms recur, a doctor is needed.
Treatment & Therapy
Sleep paralysis is not dangerous. For most people who have this unfamiliar experience, just being educated on the disorder is enough to know that nothing dangerous is happening to them.
In most cases, sleep paralysis occurs in isolation and without symptoms of other disorders. However, when it occurs together with narcolepsy, a disorder that causes severe tiredness and periods of sleep during the day, sometimes associated with hallucinations, specific treatment must be provided. A major problem with sleep paralysis is certainly the lack of understanding of what is happening to the person affected. Many experience panic, shock, and the fear of going back to sleep.
It is advisable to find out together with a specialist what are the individual causes that can trigger sleep paralysis. Sleep paralysis occurs more often in people when they lie on their backs, and good sleep hygiene should also be observed. This includes various factors, e.g.: the bed should only be used for sleeping, no late meals, etc.
Prevention
In addition to individual treatment for sleep paralysis, many components of healthy sleep hygiene are also considered solid prevention of the disorder. This includes planning in enough sleep during the night. Most people need 7 to 9 hours. Heavy meals, alcohol or caffeine before bed also have a negative effect, as does watching TV in bed.
Aftercare
Sleep paralysis has no physical health consequences, even if it occurs regularly. Nevertheless, follow-up treatment can be indicated, especially if the sleep paralysis occurs repeatedly. It depends on whether the sleep paralysis has caused psychological complications or not.
The conscious experience of one or more sleep paralysis can trigger anxiety disorders and depression, the fear of falling asleep and even the fear of a vegetative state. If such a mental illness arose as a result of sleep paralysis, it must be treated. The treatment should consist of drug therapy with anxiolytics and, if necessary, antidepressants, as well as non-drug therapy in which the fears associated with sleep paralysis are intensively worked on.
In particular, if there is a fear of sleeping, it may also be necessary to administer sleeping pills (Z-drugs, benzodiazepines) at the beginning of therapy in order to enable those affected to fall asleep. Behavioral therapy to help manage anxiety can also be helpful. In addition, certain breathing, meditation and relaxation techniques (progressive muscle relaxation according to Jacobsen, yoga) can be learned, which help to combat anxiety and actively enable falling asleep.
You can do that yourself
Sleep paralysis is usually harmless and goes away on its own after a few minutes. Those affected can counteract the paralysis by consciously moving a part of the body. The eyes should be opened and moved so that the body can adjust to the unfamiliar situation. Mantras that are said after waking up also help.
In 60 percent of cases, sleep paralysis occurs in the supine position. It is best for sufferers to sleep on their stomach or side to reduce the likelihood of sleep paralysis. A sleep phase alarm clock helps to wake up in the sleep phases where sleep paralysis occurs. An active everyday life with sufficient exercise and variety can also reduce the nocturnal signs of paralysis. Calming teas and relaxation exercises before going to bed also help. The progressive muscle relaxation relieves tension and prevents the body from cramping during sleep.
If sleep paralysis recurs, it is advisable to see a doctor. Sometimes the uncomfortable paralysis is due to an illness or the use of medication. The doctor can clarify and treat the causes. If the symptoms persist, the brain waves are measured in a sleep laboratory, which allows psychological triggers of the sleep disorders to be determined. In individual cases, sleep paralysis is based on psychological complaints that need to be clarified.
