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Sleep Paralysis is a type of parasomnia.
Sleep paralysis has frequently had a place in popular culture over the centuries, from being attributed to evil, such as unseen night demons, to alien abductors.
Even Shakespeare described sleep paralysis in his work, as the old hag in Romeo and Juliet was described in this way.
Practically every culture across the world has stories of dark creatures in the night that exist to fright helpless humans whilst they sleep.
One rational is that people have long sought explanations for sleep paralysis experiences throughout history, hence the origins of night creatures.
Sleep paralysis is categorized based on how many times it occurs.
If someone just suffers from a one off episode of the syndrome, then it is called isolated sleep paralysis (ISP).
However, if it happens more than a couple of times, then the condition is referred to as recurrent isolated sleep paralysis (RISP).
Cataplexy is an experience similar to sleep paralysis that occurs in individuals who suffer from narcolepsy.
They are practically indistinguishable, creating a slight issue with diagnosis.
Recurrent isolated sleep paralysis is considered to be a chronic condition, reoccurring throughout a person’s lifetime.
Usually, episodes of sleep paralysis only last a few minutes.
However, if your condition is chronic in nature then these episodes may last an hour or longer.
Hallucinations do not occur in every case of sleep paralysis, but they are a fairly common feature of the condition.
They may be auditory or visual in nature, making a person feel a sense of evil in the room.
The length of time that you are paralyzed can vary from person to person, anywhere between a few seconds to minutes.
Once over, you should be able to speak and move as normal.
It is normal to feel unsettled following an episode of sleep paralysis.
It will not have a long term effect on your health.
The majority of people who experience sleep paralysis only get it once or twice in their entire lives.
If it is happening more frequently, several times a month or more, then the condition is known as isolated sleep paralysis.
Although the rest of the body is paralyzed.
A person suffering from a sleep paralysis episode can usually move their eyes.
One possibility is that sleep paralysis is caused by disrupted REM sleep.
REM sleep is the deepest part of the sleep cycle and the time which dreams are most likely to occur.
As a result, to stop us acting out our dreams, the muscles should be paralyzed.
If there is a partial awakening where this aspect of REM sleep is not removed, sleep paralysis is able to occur.
Sleep paralysis has been linked to multiple other disorders, such as migraines, anxiety, narcolepsy.
Sleep paralysis obstructive sleep apnea.
Another potential cause could be that the neuronal regulation of sleep is ineffective and out of balance.
It causing different sleep states, such as consciousness.
It causes REM sleep, to overlap.
In the brain, neurons are like the roads, connecting everything together and passing messages back and forth.
Neurons can signal with one another through the use of messengers, called neurotransmitters.
The cholinergic and serotonergic systems are examples of such messengers within the brain.
cholinergic and serotonergic systems are deemed incredibly important in the regulation of sleep.
It is possible that one messenger is underactive (serotonergic) whilst the other is over-active (cholinergic) in sufferers of sleep paralysis.
This results in the signals being sent to tell the brain to stay fully asleep are disrupted.
Therefore a person may wake up to be conscious without their body having been properly woken up.
Melatonin is the hormone in the body that controls the sleep cycle.
Any problem with this hormone could be responsible for any sleep disorders experienced, including sleep paralysis.
It is possible that the levels of this hormone change abnormally.
By this the brain only partially awakens and the body is paralyzed.
Genetics have been shown to play a role in sleep paralysis.
Twin studies have shown that if one twin suffers from the condition, then the same is likely to happen in the other.
Identification of a possible genetic contribution shows that the condition is likely to have a physical cause within the brain, rather than being a purely psychological condition in its nature.
Further studies are needed though to investigate this.
Very rarely, sleep paralysis may be linked to deep underlying psychiatric issues.
Sleep deprivation may be a cause of sleep paralysis, although it is not certain why.
Sleep paralysis is more common when sleeping on your back.
Some mental health problems may have links to sleep paralysis, such as bipolar disorder or excessive stress.
In people with narcolepsy, a condition where individuals spontaneously fall asleep throughout the day, sleep paralysis is far more common.
Substance abuse, such as alcohol, may be a factor in the cause of sleep paralysis.
People who have sleep related leg cramps are more likely to also have sleep paralysis.
Sleep paralysis is mainly diagnosed by ruling out other potential sleep disorders that could account for the feelings of paralysis.
The main disorder that is checked for is narcolepsy due to the high prevalence of narcolepsy in conjunction with sleep paralysis.
The availability of a genetic test for narcolepsy makes this an easy disorder to rule out.
An isolated incidence of sleep paralysis, despite how scary it might have been, often will need no treatment.
If you feel anxious about your symptoms, then it is best to discuss them with a doctor.
If you recognize that you feel very tired during the day, consulting your doctor is advised as you may have another undiagnosed sleep disorder.
Doctors will likely start by asking you questions regarding your sleep health.
Keeping a sleep diary over a couple of weeks can help both you and your doctor identify factors that may be causing disrupted sleep and sleep paralysis.
A family history will likely be taken as it is believe that there may be a hereditary component to sleep paralysis.
If the condition is ongoing and becoming problematic, referral to a sleep specialist may be required.
A sleep specialist is able to conduct both overnight sleep studies and daytime nap studies.
These help to rule out any other sleep conditions.
In an overnight sleep investigation, your brain waves will be examined.
This is done using an EEG, a non-invasive procedure where a cap is placed on your head and the brain waves are measured through the skull.
The brainwaves in the different phases of sleep look different.
Cameras will record your behavior during a sleep examination, used in combination with EEG technology to map exactly what you do during each stage of sleep.
Anecdotal reports indicate that wiggling fingers or toes upon awareness of the condition may enable the sufferer to move again in some cases.
Medical treatment starts with education about sleep stages and the inability to move muscles during REM sleep.
People should be evaluated for narcolepsy if symptoms persist.
There is currently no drug that has been found to completely interrupt episodes of sleep paralysis a majority of the time.
Fluoxetine, also known as Prozac, is one such medication .
Fluoxetine helps by acting on the serotonin messengers of the brain, increasing their influence where they may be under-active.
A tricyclic antidepressant may be given, however this is usually only tried if Prozac fails.
Prozac fails due to the number of side effects caused by these medications.
It is important to diagnose and address any mental health problems that may be contributing to the sleep paralysis.
It is recommended that you get between six and eight hours of sleep a night.
Several circumstances have been identified that are associated with an increased risk of sleep paralysis.
These include insomnia and sleep deprivation, an erratic sleep schedule, stress, overuse of stimulants, physical fatigue, as well as certain medications that are used to treat ADHD.
It is also believed that there may be a genetic component in the development of RISP due to a high concurrent incidence of sleep paralysis in monozygotic twins.
Sleeping in the supine position is believed to make the sleeper more vulnerable to episodes of sleep paralysis because in this sleeping position.
It is possible for the soft palate to collapse and obstruct the airway.
This is a possibility regardless of whether the individual has been diagnosed with sleep apnea or not.
There may also be a greater rate of microarousals while sleeping in the supine position because there is a greater amount of pressure being exerted on the lungs by gravity.
While many factors can increase risk for ISP or RISP, they can be avoided with minor lifestyle changes.
By maintaining a regular sleep schedule and observing good sleep hygiene, one can reduce chances of sleep paralysis.It helps subjects to reduce the intake of stimulants and stress in daily life by taking up a hobby or seeing a trained psychologist who can suggest coping mechanisms for stress.
However, some cases of ISP and RISP involve a genetic factor—which means some people may find sleep paralysis unavoidable.
Sleeping in the supine position has been found an especially prominent instigator of sleep paralysis.
Sleep hygiene is a vital factor in the prevention of sleep paralysis.
This means changing your habits to make them conducive to a good night’s sleep.
Make sure to reduce your caffeine intake before bedtime.
Some people are more sensitive to caffeine than others, meaning that they cannot drink any after midday for example.
Try to reduce consumption as much as possible as it can affect your sleep negatively.
The sleep environment is very important.
Try to make it as restful as possible, so not too hot or cold.
Invest in a good mattress. A memory form mattress may help aid your sleep.
Only use your bed for sex and sleeping.
Make sure you are getting enough sleep. Adults need between 6 and 8 hours a night.
Try to sleep on your side. Sleep paralysis is more common in those who sleep on their backs.
Keep to a regular schedule, where bedtime is roughly the same each day and you wake up at the same time every morning.
Taking regular exercise, although not right before bed, is considered helpful in reducing sleep paralysis.
You should not drink alcohol before bedtime.
This is because alcohol has action on multiple areas of the brain, some of which are important in sleep.
Giving up smoking may reduce episodes of sleep paralysis.
Nicotine, the main component in tobacco, is a stimulant within the brain.
Up to as many as four out of every 10 people may have sleep paralysis
It usually appears in the teenage years
The condition is most common in people aged 20-30, although may continue later in life.
Students are the most likely to suffer from the condition, perhaps as a result of disrupted sleep and deprivation.
In individuals with panic disorder, up to 35% report having experienced sleep paralysis.
The condition is more common in non-white ethnic groups.
Sleep paralysis is a phenomenon in which a person, either falling asleep or awakening, temporarily experiences an inability to move, speak or react.
It is a transitional state between wakefulness and sleep characterized by complete muscle atonia (muscle weakness).
It is often accompanied by terrifying hallucinations (such as an intruder in the room) to which one is unable to react due to paralysis, and physical experiences.
Sleep paralysis can occur either when you are falling asleep, known as hypnagogic, or when you are waking up, called hypnopompic.
Out of body experiences are far more common in those who suffer from chronic reoccurring sleep paralysis.
The most prominent symptom of sleep paralysis is a temporary inability to move or talk upon awaking or falling asleep.
Being unable to move or speak can in itself induce fear within a person, as they would still be conscious throughout the experience.
Some people experience a sensation of someone else also being present in the room during their sleep paralysis, despite being alone.
Breathlessness may be a symptom experience with sleep paralysis.
In rare cases, some people may feel pressure upon their airways or feel as if they are choking.
The exact causes of sleep paralysis are poorly understood at present.
Upon falling asleep, the brain goes through various sleep phases, where its activity will differ depending on the exact phase it is in.
Once asleep, the body will alternate between non-rapid eye movement (Non- REM) sleep and rapid eye movement (REM) sleep.
Non-REM sleep occurs before REM, and is believed to take up 75% of the total sleep time.
In REM sleep, the mind is lucid yet the body is paralyzed. The eyes move rapidly, hence why the phase was given its name.
The vast majority of people do not require treatment for sleep paralysis.
If there is an underlying condition, such as narcolepsy, then this will require specific treatment outlined by your doctor.
If you suffer from anxiety, medications or talking therapies may help deal with the underlying causes.
Improving your sleep habits is vital to reducing episodes of sleep paralysis.
If necessary, antidepressant medication can be prescribed to help with sleep cycle regulation.