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Sleep paralysis

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Sleep paralysis

Sleep paralysis is a temporary inability to move or speak that happens when you're waking up or, less commonly, falling asleep. Although you're awake, your body is briefly paralysed, after which you can move and speak as normal. The paralysis can last from a few seconds to several minutes.

Sleep paralysis doesn't cause you any harm, but being unable to move can be very frightening.Some people have sleep paralysis once or twice in their life, while others experience it a few times a month or more regularly. Sleep paralysis can affect people of all ages, but it's more common in teenagers and young adults. Men and women are equally affected.

 

What causes sleep paralysis?

It's normal for your muscles to be paralysed at certain times when you're asleep. Sleep paralysis occurs when the mechanism that causes your muscles to relax during sleep temporarily persists after you've woken up.

 

Sleep paralysis can sometimes be a symptom of narcolepsy. This is a relatively rare sleep disorder, which causes severe disruption to the sleep-wake cycle. An inability to stay awake for more than three or four hours is usually the main symptom.

 

Other things that increase your risk of getting sleep paralysis include:

  • sleep deprivation

  • irregular sleeping patterns

  • age – it's more common in teenagers and young adults


 

If you have sleep paralysis, your GP may be able to suggest ways that you can improve your sleep, such as keeping to a regular sleeping routine and creating a restful sleeping environment.

If your symptoms are severe or possibly linked to another sleep-related condition, such as narcolepsy, your GP may refer you to a sleep disorder specialist (see below).

 

Treating sleep paralysis

The symptoms of sleep paralysis can often be improved by altering your sleep habits and sleeping environment.

Sleep paralysis often affects people who are sleep deprived, so ensuring you get enough sleep may reduce the number of episodes you have. Most adults need six to eight hours of good quality sleep each night.

Going to bed at roughly the same time each night and getting up at the same time each morning may also help.

See your GP if your sleep paralysis is particularly severe. They may refer you to a specialist, such as a neurologist.

A short course of antidepressant medication, such as clomipramine, may be prescribed to treat severe sleep paralysis.

 

Symptoms of sleep paralysis 

The main symptom of sleep paralysis is a temporary inability to move or talk.

The paralysis usually occurs as you're waking up, but it can also sometimes happen when you're falling asleep.

Not being able to move or talk can be very frightening, particularly as you'll be completely conscious throughout the experience. Your breathing may also feel restricted, because taking deep breaths is often difficult.

During an episode of sleep paralysis, you may also experience a very real sensation that there's someone else in the room with you.

These type of hallucinations are a fairly common feature of sleep paralysis, although they don't occur in every case.

The length of time that you're unable to move for can vary from a few seconds to several minutes. After this, you'll be able to move and speak as normal.

Immediately after an episode of sleep paralysis, you may feel unsettled and anxious. However, the condition doesn't pose a risk to your overall health.

Many people only experience sleep paralysis once or twice in their life. If it happens several times a month or more regularly, it's known as isolated sleep paralysis.

 

Causes of sleep paralysis.

Sleep paralysis is caused when parts of the rapid eye movement (REM) state of sleep persist or intrude into wakefulness.

This means that you remain temporarily paralysed, but are fully conscious.

 

REM sleep

Sleep occurs in cycles and each cycle is split into two phases – REM sleep and non-REM sleep.

The brain is very active in REM sleep and most dreams occur during this stage. The body is paralysed, apart from the movement of the eyes and diaphragm (the muscle used in breathing). The paralysis is thought to occur to prevent you acting out the actions in your dreams and potentially causing injury.

Sleep paralysis occurs when the normal muscular paralysis of REM sleep temporarily continues after you've woken up.

 

Increased risk 

Certain factors make you more likely to get sleep paralysis. They include:

  • age – it's more common in teenagers and young adults

  • sleep deprivation – sleep paralysis is more common in people who don't get enough sleep

  • irregular sleeping patterns – people with irregular working patterns, such as those who work shifts, are more prone to sleep paralysis

  • narcolepsy – some people with narcolepsy (where you're unable to stay alert for long periods and sleep is disrupted) may also experience sleep paralysis

  • family history – you may be more likely to have sleep paralysis if another member of your family also has it; however, further research is needed


 

Treating sleep paralysis 

Ensuring you get enough sleep and improving your sleeping environment will help if you have sleep paralysis. In severe cases, medication may be recommended.

 

Sleeping habits

Sleep paralysis is more common in people who are sleep deprived, so getting enough sleep may help to reduce the number of episodes of sleep paralysis you have. Most adults need six to eight hours of good quality sleep each night. Keeping to a regular sleeping schedule, where you go to bed at roughly the same time each night and get up at the same time each morning, can also help.

 

Tips for improving your sleeping habits include:

  • creating a restful sleeping environment that's quiet, dark and not too hot or cold

  • ensuring your bed is comfortable

  • exercising regularly (but not too close to bedtime)

  • cutting down on caffeine

  • not eating or drinking alcohol before bedtime

  • giving up smoking (if you smoke) because nicotine is a stimulant


 

Medication

If your sleep paralysis is particularly troublesome, you may be prescribed a short course of antidepressant medication, such as a tricyclic antidepressant (TA), typically clomipramine.

Antidepressants affect mood and are usually used to treat depression, but are also sometimes prescribed to treat severe sleep paralysis.

By slightly changing some of the neurochemicals in your brain that control REM sleep, the medication alters the amount and depth of REM sleep. This should help to prevent the temporary paralysis when you wake up or fall asleep, and it should also help to reduce any hallucinations you may have.

You may be advised to take the medication for a month or two to see whether it improves your symptoms.

 

Possible side effects of TAs can include:

  • dry mouth

  • constipation

  • sweating

  • difficulty urinating

  • blurred vision

  • drowsiness


Any side effects should ease after 7 to 10 days, as your body gets used to the medication. Visit your GP if the side effects haven't eased after this time.

 

Narcolepsy

Sleep paralysis can sometimes be a symptom of another sleep disorder called narcolepsy, which causes severe daytime sleepiness and an inability to stay alert for more than a few hours.

Although there's no cure for narcolepsy, the condition can usually be managed with appropriate medication.

A number of lifestyle adjustments may also help, including:

  • taking frequent brief naps during the day

  • sticking to a strict bedtime routine where you go to bed at the same time each night

  • ensuring you get at least eight hours of sleep every night

  • avoiding stressful situations, eating a healthy, balanced diet and taking regular exercise (but not too close to bedtime)