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The Causes and Treatment Of Sleep Paralysis

What Is Sleep Paralysis?

This is a sleep disorder that affects the body’s ability to achieve restful sleep, since a person who experiences sleep paralysis will feel conscious, yet will be unable to move. Although your eyes and brain are working hard during sleep cycles, the rest of your body stays incredibly relaxed, as if your muscles are “turned off”. This loss of muscle control is known as atonia.

Sleep paralysis occurs when your body cannot move smoothly through the stages of sleep, and will happen as you either move into or out of the REM sleep cycle. Sleep paralysis is often connected to an issue with the ability to stay asleep. If it occurs while you are falling asleep, this is referred to as hypnagogic sleep paralysis; if it occurs as you are waking up, this is called hypnopompic sleep paralysis.

Hypnagogic paralysis happens due to the body relaxing when you enter a deep sleep. Normally, you are supposed to become less aware as this happens, so you will not notice the change. During hypnagogic paralysis, you retain this awareness while falling asleep, so you are actually able to notice that you cannot move or sleep.

Hypnopompic paralysis happens due to shifts in the REM cycle. During sleep, your body switches between rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep. One cycle of REM and NREM sleep lasts about 90 minutes, with NREM sleep occurring first and taking up three-fourths of your overall sleep.

During NREM sleep, your body relaxes and restores itself before switching to REM sleep. In this stage of sleep, your eyes move quickly while your brain activity is heightened and more dynamic, creating vivid dreams. If you regain awareness before the REM cycle is complete, you may notice that you cannot move or speak. The combination of atonia and visual images from REM sleep persist even in a conscious state.

Types Of Sleep Paralysis

While hypnagogic and hypnopompic categorize which cycle you experience sleep paralysis in, these terms differ from the actual types of sleep paralysis. There are two terms that are commonly used to categorize different cases of sleep paralysis.

Isolated sleep paralysis is defined by episodes of sleep paralysis that are not connected to a separate diagnosis of narcolepsy, which is a sleep disorder that prevents the brain from regulating sleep correctly. Narcolepsy causes a person to fall asleep randomly and be drowsy during the day. People with narcolepsy have difficulties staying awake for extended periods of time, which can lead to sleep paralysis. Yet with isolated paralysis, the cause can be due to a variety of other factors.

Recurrent sleep paralysis is a pattern of paralysis that occurs over an extended period of time. With this type of paralysis, it is not just a one-time occurrence, but a persistent problem that affects sleep quality.

In many cases, people can experience a combination of these two types, leading to a condition called recurrent isolated sleep paralysis. This is categorized by ongoing episodes of sleep paralysis in someone who does not suffer from narcolepsy.

Causes Of Sleep Paralysis

Sleep paralysis can affect both men and women, regardless of age. This condition typically occurs for the first time during teenage years, with the average being 14-17. Sleep paralysis can also be a genetic trait. Other causes for this condition include other sleep disorders such as insomnia, narcolepsy and obstructive sleep apnea.

Restless leg syndrome (RLS) has also been linked to paralysis. This condition causes an uncontrollable urge to move your legs, often resulting in nighttime twitching. Since these disorders are linked to poor sleep quality, the likelihood of experiencing sleep paralysis greatly increases.

However, sleep paralysis can also be caused by factors entirely unrelated to sleep. This includes mental health conditions such as anxiety disorders, especially panic disorders, post-traumatic stress disorder (PTSD), and bipolar disorder. Substance and alcohol abuse are also connected to paralysis, along with disruptions in your circadian rhythm.

Symptoms Of Sleep Paralysis

The main symptom for someone experiencing sleep paralysis is atonia during an episode, during which you will be aware of your inability to move. Almost three-fourths of episodes also involve hallucinations that are different from regular dreams. You may experience either hypnopompic or hypnagogic hallucinations, and these hallucinations fall into three categories.

Intruder hallucinations refers to the impression that there is a dangerous presence in the room with you.

Chest pressure hallucinations, sometimes also known as incubus hallucinations, refers to the feeling of suffocation. These often occur along with intruder hallucinations.

Vestibular motor (V-M) hallucinations refers to the feeling of movement or out-of-body sensations.

The combination of atonia and distressing hallucinations cause sleep paralysis to be a very unpleasant experience. Episodes last anywhere from a few seconds to 20 minutes, although they typically last between 6 and 7 minutes. Usually, an episode will end on its own but occasionally they can be disrupted by another person’s touch or voice, or an intense effort to move that overcomes the atonia.

Treatment For Sleep Paralysis

The first step in treating this condition is talking to your doctor to determine what the underlying cause of the issue could be. Treatment may involve the management of other sleep disorders. Sleep paralysis can be caused by and contributes to poor sleep quality, so it’s important to practice good sleep hygiene in an effort to prevent and manage this condition.

Sleep hygiene refers to your daily habits that can influence sleep quality. Some tips for improving sleep hygiene include setting a nightly routine, making sure your bed is comfortable, and checking that your room has little to no light and noise intrusion. It may also help to avoid alcohol and caffeine in the evening, along with reducing consumption overall, as well as putting away all electronic devices at least half an hour before bed.

How Gwinnett Sleep Can Help

Gwinnett Sleep offers services that can help diagnose other sleep disorders that may be causing sleep paralysis. We provide consultations, conduct sleep studies (known as polysomnography), and offer a CPAP clinic. If you suspect that you may have sleep paralysis, you should get tested for other sleep disorders as well. Learn more about our services here, or schedule an appointment to talk to our doctors.