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Sleep Paralysis

What is it?

Recurrent isolated sleep paralysis is a parasomnia. A parasomnia involves undesired events that come along with sleep. Sleep paralysis causes you to be unable to move your body at either of the two following times:

  1. When falling asleep (hypnagogic or predormital form)
  2. When waking up from sleep (hypnopompic or postdormital form)

Normally your brain causes your muscles to relax and be still as you sleep. This is called “atonia.” Sleep paralysis seems to be when this atonia occurs while you are awake. Sleep paralysis is “isolated” when it appears without any other signs of narcolepsy.

An episode of paralysis may cause you to be unable to speak. It can also make you unable to move your arms and legs, body, and head. You are still able to breathe normally. You are also fully aware of what is happening. An episode can last for seconds or minutes. The episode usually ends on its own. It may also end when someone touches you or speaks to you. Making an intense effort to move can also end an episode. Sleep paralysis may occur only once in your life. It may also happen many times in a year.

It can be very scary when you are unable to move. You may feel anxious and afraid. Some people also hallucinate during an episode. They may see, hear or feel things that are not there. They may even think that another person is in the room with them. These hallucinations may also appear without the sleep paralysis.

Sleep paralysis tends to first appear in the teen years. It then occurs most often when you are in your 20s and 30s. It may continue into your later years. It is not a serious medical risk.

Sleep paralysis can be one sign of narcolepsy. Other signs include disturbed sleep at night and falling asleep suddenly during the day. Recurrent isolated sleep paralysis does not disturb your sleep.

Who gets it?

Sleep paralysis can affect men and women of any age group. The average age when it first occurs is 14 to 17 years. It is a fairly common sleep problem. Estimates of how many people have it vary widely from 5% to 40%. You may be more likely to have it if a relative also has it.

A lack of sleep can make you more likely to have sleep paralysis. It is also more likely if you have a sleep schedule that often changes. Mental stress may also be a factor. It seems to occur more often when you sleep on your back. It may also be related to any of the following factors:


How do I know if I have it?

  1. Are you ever unable to move your arms and legs, body, and head when falling asleep or waking up?
  2. Do these episodes last from only seconds to a few minutes?

If you answered yes to these questions, then you might have recurrent isolated sleep paralysis.

It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:

  • Another sleep disorder such as narcolepsy
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Do I need to see a sleep specialist?

Recurrent isolated sleep paralysis is fairly common. In most cases, it does not affect your sleep or overall health. Talk to your doctor if episodes of sleep paralysis make you anxious. You should see a sleep specialist if the episodes keep you up at night or make you very tired during the day.

What will the doctor need to know?

The doctor will need to know when the sleep paralysis started. He or she will want to know how often it occurs and how long it lasts. The doctor will need to know your complete medical history. Be sure to inform him or her of any past or present drug and medication use.

Also tell your doctor if you have ever had any other sleep disorder. Find out if you have any family members with sleep problems. It will also be helpful if you fill out a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This data gives the doctor clues about what is causing your problem and how to correct it.

Will I need to take any tests?

Doctors do not need any tests to treat most patients with recurrent isolated sleep paralysis. Your doctor may have you do an overnight sleep study if your problem is disturbing your sleep. This study is called a polysomnogram. It charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. An electromyogram (EMG) recording will show the level of electrical activity in your muscles. This level will be very low during an episode of sleep paralysis.

If you tend to be very sleepy during the day, then your doctor may also have you do a daytime nap study. This is called a Multiple Sleep Latency Test (MSLT). The MSLT will measure how fast you fall asleep during the day. It will also show what kind of sleep you have when you take a nap. It will help to show if your sleep paralysis is a sign of narcolepsy.

How is it treated?

Treatment of sleep paralysis is aimed at whatever causes it to occur. Sleep deprivation may trigger sleep paralysis. In this case, try to get at least six to eight hours of sleep per night. People with psychiatric problems may suffer from sleep paralysis. An example is someone who has bipolar disorder. This person would need ongoing treatment with medication. This would be overseen by a physician or psychiatrist. You may notice sleep paralysis occurring with leg cramps. It may also happen after a change in your medicines. Discuss these issues with your doctor.

People with narcolepsy often have sleep paralysis. They normally need an antidepressant medication to reduce or eliminate dream sleep. This will help to ease the sleep paralysis. Taking an antidepressant drug does not mean that you are depressed. It is simply a method to help reduce sleep paralysis.

Reviewed by David A. Kristo, MD
Updated October 21, 2005


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