BENGALURU: Have you ever woken up and unable to move your body? Ever felt that there is something or someone sitting on top of you and stopping you from moving your body? Don't get scared, there is nothing to worry about it. If you are experiencing this, you are just having an episode of sleep paralysis.
Sleep paralysis is an episode of paralysis where you find your body unable to move but be able to hear, feel, or see things that do not exist. It happens mostly during one of the two transitions in the sleep cycle, the onset of sleep where the body is experiencing the transitional state from being awake to going to sleep and a state between sleep and waking up completely, often accompanied by the persistence of dreamlike imagery, seeing vivid images of objects. People having sleep paralysis get the feeling of waking up from dead. In some cases, the condition is more complicated than a nightmare.
Sleep paralysis is often a terrifying experience for people suffering from it not only because of the paralysis but also hallucinations. Several types of hallucinations have been linked to sleep paralysis which can be characterised in three groups:
Intruder (sensed presence) where presence of another person and or entity can be sensed during sleep paralysis either in visual or auditory form.
Incubus also termed as 'Old Hag attack' refer to the thought of an evil witch or old hag sitting on the chest of victims, making it impossible to move. It is characterised by chest pressure, difficulty in breathing, suffocation, thoughts of death and in some cases, perception of physical pain. Some of the incubus symptoms may occur simultaneously with the symptoms that of the intruder.
Vestibular - Motor hallucinations occur during episodes of sleep paralysis, a feeling of entering into another realm of existence or out-of-body experience. People often feel that they are flying during this episode.
Sleep paralysis is not life threatening, it occurs for a few minutes and ends on its own but can be very frightening which results in anxiety. It occurs naturally and can happen to anyone for at least once or twice in their life but certain cases can be found where people experience for a few times a month or more regularly. Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep, it's called hypnagogic or predormital sleep paralysis. If it happens as when you are waking up, it's called hypnopompic or postdormital sleep paralysis.
People of all ages are victims of sleep paralysis but it is mostly common in teenagers, young adults and people with a history of mental illness, and it is frequent during their 20s and 30s.
There is no clear cause of sleep paralysis, which is obviously very frustrating for anyone going through this. Till now it has not caused any physical harm to the body and there are no clinical deaths. Sleep paralysis may run in the families and certain factors are also linked to develop the condition such as:
• Lack of sleep
• Narcolepsy – a long-term neurological disorder that causes a person to suddenly fall asleep at inappropriate times
• Change in the sleep schedule
• Mental conditions such as stress or bipolar disorder
• Sleeping position, sleeping on back
• Substance abuse
Over time sleep paralysis often gets better. A medical diagnosis is not normally considered unless the symptoms are of concern, such as narcolepsy. Once the diagnosis is suspected, your doctor may want to gather more information about your sleep health by asking you to describe your symptoms and keep a sleep diary for a few weeks. He can refer you to a sleep specialist for further evaluation He might conduct overnight sleep studies or daytime nap studies to make sure you do not have another sleep disorder.
Improving sleeping habits and sleeping environment may help to minimise the occurrence. Taking steps at home to control the disorder is found to be helpful for occasional sleep paralysis and using of antidepressant medication under doctor's prescription to help regulate sleep cycles. Engage yourself in stress relieving activities like reading, listening music, taking hot shower bath which helps in relaxing the muscle and body, regular exercise in the evening, especially before bedtime. Wiggling the toes, fingers, or facial muscles, helps to wake up the rest of their body during sleep paralysis.
- The author is a senior consultant, pulmonology, Sakra World Hospital