Jul 223 min read

Awake but Frozen: understanding sleep paralysis

by Katharina Cangl

Symptoms

You're lying in bed when you suddenly realize two things. One, you're awake. Two, you can't move. Next, you feel a dangerous presence in your room. You panic, but there is nothing you can do, as you are frozen in place. Your fear only worsens when you feel pressure on your chest as though someone is sitting on it. This makes it hard to breathe. What you're experiencing are intruder and chest pressure hallucinations, which are two of the three forms in which sleep paralysis manifests, with the third one being vestibular motor hallucinations, including the illusion of movement and out-of-body sensations. 75% of sleep paralysis episodes include hallucinations.

What happens to the brain and body during sleep paralysis?

Why, you may wonder, is this happening? Sleep paralysis occurs while falling asleep or waking up. During this stage, you are in rapid eye movement (REM) sleep. Because dreams occur at this point, the brain sends out signals that prevent limb muscles from moving to protect you from acting out your dreams and injuring yourself. We don't notice so-called atonia, as we are usually unconscious when it happens. However, during sleep paralysis, you regain consciousness as you are coming out of or going into REM, but your muscles stay paralyzed, which you can feel. Though it isn't certain, experts believe that the hallucinations are caused by the vivid dreams of REM while in an awake state.

Is sleep paralysis dangerous?

The good news is that the nightmare-come-true you are experiencing isn't dangerous. Aside from causing emotional stress, it doesn't happen often enough to have an impact on one's overall well-being, with most people affected only experiencing one episode in their lifetime. These episodes usually last from a few seconds to 20 minutes, with the average being 6 minutes. As a result, they don't last long enough to cause any damage.

What causes sleep paralysis?

There are two sorts of sleep paralysis.

Isolated sleep paralysis can be caused by sleep deprivation, shift work, or high stress, and it only happens once. It is important to know that it is normal to feel tired and anxious after such an event, which is why talking to a loved one or healthcare provider about it is very beneficial.

If you are less lucky, sleep paralysis can reoccur, which may be an indicator of narcolepsy, a sleep disorder that prevents the brain from properly controlling wakefulness. When you see a physician about this problem, they will ask you to describe your symptoms, your sleep schedule, and whether you feel tired during the day. They may need to confirm your diagnosis with an overnight sleep study, which monitors your breathing, heartbeat, and brain activity during sleep. An additional test is the multiple sleep latency test, which measures how quickly you fall asleep and what kind of sleep you experience during a nap. It helps uncover issues like narcolepsy.

How do you prevent sleep paralysis?

After having experienced sleep paralysis, your greatest priority is to figure out how to keep it from happening ever again. Though there isn't any proven method for prevention, here’s how you can significantly lower your risk:

Maintaining a consistent sleep schedule.
Creating a dark, quiet, and comfortable sleep environment.
Removing distractions like phones before bed.
Reducing alcohol and recreational drug use.
Managing stress with calming activities, such as taking a soothing bath before bed.

There are no proven therapies that can stop a sleep paralysis episode while it is happening, but many people who experience it regularly recommend concentrating on making small movements, like moving one finger at a time.

In conclusion, sleep paralysis, as terrifying as it seems, doesn't pose a danger to you, giving you a positive outlook. But remember, it is important to have a good support system in place and see your doctor for questions and concerns.