Imagine, you are just about to fall a sleep and you start to count sheep in your head when all of a sudden you feel a pressure on your chest and you sense a presence in the room.
You cannot move a muscle but you can see your surroundings and are awake and alert.
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Sleep paralysis is a momentary alertness but loss a voluntary muscle movement that occurs when you are just about to fall asleep or when you’re just waking up from sleep.
It can last anywhere from 20 seconds to a few minutes and it affects about 8% of the general population.
An awareness of your surroundings but inability to move, a sense of physical weight and pressure on the chest, difficulty breathing or a choking feeling, hallucinations or a sensed presence, and an overwhelming sense of fear or dread. Some people even describe hearing footsteps getting closer, seeing intruders, demons, or spirits and feeling as if they are about to die.
Although there is no physical danger to the person experiencing sleep paralysis, they cannot pull themselves out of it and must wait for it to pass. Sleep paralysis is different from nightmares or night terrors in that the brain is awake but the body is in its sleep state and thus cannot move.
Dates back to the 10th century and is prevalent in all ethnicities. In fact, people from many cultures have used sleep paralysis as a way to explain supernatural events and beings such as
witchcraft, ghosts, and alien abduction.
There are two types of sleep paralysis: hypnagogic and hypnopompic. These two terms refer to a difference in time at which sleep paralysis occurs.
Hypnagogic, also known as predormital, is when sleep paralysis occurs at sleep onset or just before falling asleep.
Hypnopompic, also known as postdormital, refers to sleep paralysis that occurs just after waking up at the transition from sleep to awakening.
In order to understand how sleep paralysis occurs, we have to understand what REM sleep is. During sleep, your brain cycles through five different phases: stage 1, stage 2, stage 3, stage 4, and stage 5, which is called rapid eye movement stage or REM for short. A REM sleep cycle consists of 25% of your sleep, which may occur several times throughout the night since
your sleep cycle is repeated. REM is important because this is when dreaming
occurs and when your body becomes energized. During REM, the signals are
sent to your spinal cord and motor neurons to shut off movement creating a
temporary inability to move the muscles of your arms and legs. This serves as a
protective measure to prevent you frominjuring yourself or others while you
dream. Now that we have an understanding of what REM sleep is let’s talk about
its importance to sleep paralysis.
Sleep paralysis is thought to occur due to an
error in the flip-flop switch
controlling REM sleep. REM sleep is
thought to work as a switch between two
stages: REM on, when REM occurs, and REM
off, when it does not. This mechanism
allows for smooth transitions into and
out of REM sleep. This REM switch works
in opposition to the wake-sleep switch.
Normally, REM on occurs at the same time
you are asleep. However, when sleep
paralysis occurs the neurons controlling
the wake side of the wake-sleep switch
and the neurons controlling the REM off
side of the REM switch are weakened. This
allows the REM on neurons to prevent
muscle movement while the body is
somewhat awake which should not be
happening. This can cause sleep paralysis.
Experiencing negative emotions is
another common occurrence during REM
sleep. This is because the area of the
brain known as the amygdala, which is
important in fear processing, is active
throughout REM sleep.
Since it is active during REM and is
closely associated with fear
it is thought to facilitate the
generation of anxiety and fear during
sleep paralysis. So how do you avoid
sleep paralysis? There are a number of
factors that contribute to your
likelihood of experiencing it. A twin
study conducted on 862 participants
showed that genetics are at least
partially to blame for sleep paralysis,
with researchers finding that genes
accounted for 53% of the occurrence of
sleep paralysis. If you have a sleep
disorder, you’re also most likely to
experience sleep paralysis. Sleep
paralysis is a common symptom of the
sleeping disorder called narcolepsy,
which is characterized by excessive and
uncontrollable daytime sleepiness. Sleep
paralysis is also most likely to occur
if you sleep on your back and if you
regularly don’t get enough sleep.
In general, poor mental health is associated
with sleep paralysis. Higher scores on
self-reported measures of depressed mood
and anxiety have been associated with
sleep paralysis. Research focusing on
sleep paralysis and patients with PTSD
showed higher prevalence as well and
another study has linked bipolar
disorder to sleep paralysis. As we have
seen, there are a number of factors
associated with sleep paralysis like
genetics, poor sleep, sleeping disorders, and
poor mental wellness. Aside from avoiding
or treating these specific risk factors
are there other treatments that could
work for avoiding sleep paralysis? Well
there is no universal treatment that
works for treating sleep paralysis. There
are preventative and management
strategies, however, these strategies lack
empirical consensus among researchers.
Some researchers have suggested that
treating underlying sleep related
disorders or mental illness disorders
may help with preventing occurrence of
sleep paralysis and some pharmaceutical
drugs such as antidepressants may help
in managing sleep paralysis due to their
REM suppressing properties. Additional
preventive strategies for sleep
paralysis include having optimal sleep
hygiene, avoiding alcohol and caffeine
before bed, and incorporating pre-sleep
relaxation practices into your nightly
routine.
Although experiencing sleep paralysis
can be extremely frightful, there are no
immediate dangers or health risks
associated with it. We hope that you were
able to learn something from this video
and we ask that you please subscribe to
our Demystifying Medicine YouTube
channel for more videos!
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