What it is, why it happens – and how to prevent it.

Imagine a state where you are both partially asleep and awake. Aware, but unable to move or speak. Perhaps trapped in a terrifying hallucination. Sleep paralysis is usually nothing to be worried about. Frequent, more severe episodes, however, can cause intense anxiety, especially around bedtime, resulting in sleep deprivation and the potential health problems that come with it.

What is it?

Sleep paralysis is a relatively common phenomenon – an estimated 8% of people experience it at some point in their life. Episodes typically occur while falling asleep or waking up, and last from a few seconds to as long as 20 minutes – but usually around six to seven minutes.

This under-researched condition involves a mixed state of consciousness – combining both wakefulness and the rapid eye movement (REM) stage of the sleep cycle. This means that the mental imagery of REM sleep and atonia (an inability to move that helps keep us from acting out our dreams) carries on even while we feel awake. Being aware of this loss of muscle control can be frightening, especially when combined with hallucinations. In fact, 75% of sleep paralysis episodes include hallucinations. They can involve a perception of an intruder or dangerous presence in the room – often combined with a sense of suffocation – or a feeling of flying or out of body sensation

Sleep paralysis is categorized as Isolated (where episodes are not connected to narcolepsy) or Recurrent (multiple episodes over time). These can be combined to reflect a condition of Recurrent Isolated Sleep Paralysis (RISP).

What triggers it?

The exact causes of sleep paralysis are not fully understood. Researchers believe that multiple factors are involved in triggering sleep episodes. There is, however, a strong association between sleep paralysis and poor sleep quality. It also seems that episodes can occur together with other sleep experiences, like nightmares.

People with sleeping disorders, such as narcolepsy and obstructive sleep apnea, also report higher rates of sleep paralysis. In addition, studies indicate that sleep paralysis is particularly prevalent in people with post-traumatic stress disorder (PTSD) or who have experienced physical and emotional distress.

Other factors that may increase the risk of sleep paralysis include substance use, stress, jet lag, and shift work.

How can I treat it?

A good start to treatment is to speak with your doctor about your episodes. For many people, it is a big help simply to hear that sleep paralysis is relatively common and nothing to be ashamed about. Your doctor can also check for any underlying sleep problems, such as narcolepsy or sleep apnea.

Often the most effective way to treat sleep paralysis is by maintaining good sleep quality. This means finding ways to improve sleep hygiene so that your bedroom and daily habits encourage and promote a healthy night’s sleep.

According to one study, successful prevention techniques include: changing sleeping patterns, having a more regulated sleep schedule, no more napping and falling asleep in a different position. Sleeping on your back, for example, may increase the risk of a sleep paralysis episode.

Living with sleep paralysis

Being able to disrupt sleep paralysis episodes as they occur by attempting to move your extremities, mouth or torso might also help you manage sleep paralysis. This helps reduce fear and distress – and improve sleep quality.

Although further research is needed to better understand the causes of this condition, one thing is clear — good sleep hygiene and healthy sleep patterns are at the heart of living with sleep paralysis.