According to Wikipedia, Sleep Paralysis (SP) is when a person is aware of him or herself but unable to speak or move, during awakening or falling asleep. It may be a single episode or recurrent and generally could last less than a couple of minutes. During an episode, one may hallucinate, i.e. hear, feel or see things that are not there. Sleep paralysis can occur at either of two times; during waking (hypnoponpic or post dormital form) and when falling asleep (hypnagogic or predormital form).
HOW SLEEP PARALYSIS HAPPENS
Sleep paralysis (SP) occurs when Rapid Eye Movement (REM) – based atonia (a medical condition where the muscle loses its strength) perseverates into wakefulness. The combination of this atonia and waking nightmares make sleep paralysis a very unpleasant experience.
Not surprisingly, sleep paralysis have been linked to many supernatural or superstitious beliefs. This is so especially in Africa, where Nigerians will attribute it to demonic attack or use the popular phrase “na your village people”.
In this article, I will try to conveniently summarize what is known about sleep paralysis in four subheadings; risk factor, causes, prevention and treatment. However, it is worthy to note that due to several factors, the clinical ramifications of sleep paralysis are relatively unknown and is neither routinely assessed nor treated in clinical practice.
A study by Brian, A. Sharpless and Barber, J.P. in 2011 found that 7.6% of the total population of an aggregated data from 35 empirical studies (N = 36,533 subjects) experienced at least one SP episode over the course of their life. Higher lifetime rates were found in students (28.3%) and psychiatric patients (31.9%) with females experiencing SP slightly more often than males. Prevalence in non-whites was also higher than in whites.
According to the College of Medicine, University of Ibadan, there are more than 1.5 million cases per year in Nigeria.
RISK FACTORS
In addition to the demographic factors listed above, other factors include;
1) SLEEP FACTORS: According to a report by Shengli, M. et al in his article “Sleep paralysis in Chinese adolescents; a representative survey”, the presence of poor sleep and/or sleep disruption is associated with SP. Kotorii, et al in 2001 also reported that shift workers are more prone to SP in their report “Questionnaire relating to sleep paralysis”.
2) DIAGNOSTIC & SYMPTOMATIC FACTORS: M.M. Ohayon et al (2000) in his work “sleep disturbances and psychiatric disorders associated with Post traumatic Stress Disorder in the general population” that trauma histories and post traumatic stress disorder (PTSD) are common in those with SP. Anxiety sensitivity, panic disorder, generalized anxiety disorder, death anxiety and social anxiety are symptomatic factors accompanying SP. It is important to note that the causality of these relations is not clearly understood. Thus, it is currently unclear whether PTSD causes SP or if the relationship is mediated by sleep disruptions and hyper vigilance which are common symptoms of PTSD.
3) PERSONALITY FACTORS: Personality factor may also put one at risk. For instance, having higher levels of dissociation, imaginativeness and beliefs in paranormal/supernatural have being linked to SP. This was according to a study by Ramsawh, H.J. et al in 2008 titled “Risk factors for isolated sleep paralysis in an African American sample; a preliminary study”.
CAUSES OF SLEEP PARALYSIS
The exact cause of sleep paralysis is unknown. The most instances of sleep paralysis occur due to difficulty in transition between different sleep stages, particularly moving in and out of Random Eye Movement (REM sleep).
During REM, the human body goes into a state of paralysis known as REM atonia. This is a normal part of the REM sleep stage, major muscle groups and voluntary muscles are paralysed. This paralysis may be to protect from injury because we might act out physically in response to most of our dreams.
The paralysis that happens during REM sleep, when it spills over to other sleep stages and if you wake, your brain becomes aware of your body’s paralysis and the frightening feeling of being unable to move or speak.
Sleep paralysis may include hallucinations, feeling a ghost-like presence in the room, feelings of terror, strange sounds, even smells. Some people get the sensations of falling or flying. Although sleep paralysis does not impair breathing, some persons experience difficulty breathing, a choking sensation and a weighty pressure on the chest. A first time experience can be terrifying.
HOW TO LOWER YOUR RISK
For many people, there is no treatment for Sleep Paralysis. The key is preventing it and treating any underlying causes. You can lower your risk of having sleep paralysis
- Maintain a regular sleep routine.
- Avoid stimulants (especially alcohol, nicotine 3 hours before bedtime).
- Put out every electronic device from your bedroom.
- Limit your intake of caffeine after 2:00 PM
- Exercise regularly.
- Eating well and avoid late night eating.
- Pay attention to your mental health and stress.
Getting a doctor’s appointment after a single episode of sleep paralysis may not be necessary. But if it becomes too frequent, you should see a professional or sleep expert to check if there is any underlying medical disorder.
Remember, sleep paralysis is temporary, harmless and will pass soon enough, so if you experience an episode, DO NOT PANIC. Getting a better physiologic understanding of what is happening to you can help you avoid the unnecessary panic associated with the sleep paralysis phenomenon.
Co-written by: Dorlin Hephzibah
Co-written by: Dorlin Hephzibah
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