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Sleep paral­y­sis: Why you can’t move, feel being pressed when wak­ing from sleep

Sleep paralysis: Why you can’t move, feel being pressed when waking from sleep

Have you felt unable to move or speak when you are falling asleep or wak­ing up from sleep? For some, these expe­ri­ences also include hal­lu­ci­na­tions such as see­ing a fig­ure press­ing them down, being filled with fear, or feel­ing a pres­ence as well as feel­ing as if they ‘woke up dead’, among oth­ers.

Med­ical experts call this con­di­tion sleep paral­y­sis. How­ev­er, many peo­ple are unaware it is a med­ical con­di­tion. They view it as a very scary expe­ri­ence and have dif­fer­ent beliefs about it includ­ing believ­ing it is a spir­i­tu­al attack that needs spir­i­tu­al solu­tions. This has also led to sev­er­al myths about the con­di­tion.

It is com­mon to hear some peo­ple say ‘they were pressed by a demon or spir­it the oth­er night.’

Nar­rat­ing his expe­ri­ence with the con­di­tion, Solomon Eyi­ga, (not his real names) said he woke up in the mid­dle of the night recent­ly and felt par­a­lyzed. His friend who slept next to him couldn’t hear him as he tried to scream his name. After a while, he was able to move his body and get out of the bed. He said it hap­pened twice with­in a week and that he was  very stressed that week as he worked long hours cou­pled with the trau­ma of los­ing a rel­a­tive weeks before then.

Accord­ing to Dr Olu­so­la Ogun­tolu, a sleep spe­cial­ist, sleep paral­y­sis is a tran­sient sen­sa­tion of inabil­i­ty to move in the wake­ful state occur­ring right after a per­son awak­ens from asleep. “As one can imag­ine, it is very dis­tress­ing and var­i­ous caus­es have been attrib­uted to the phe­nom­e­non, some of which are entrenched in folk­lore. The sen­sa­tion is some­times asso­ci­at­ed with a dream-like state with or with­out audi­to­ry and visu­al hal­lu­ci­na­tions,” he said.

The sleep spe­cial­ist said the con­di­tion is due to a dis­cor­dance in the tran­si­tion from REM (Rapid Eye Move­ment) sleep phase to the wake­ful state with­out the usu­al cycling through the non-REM phase.

When you sleep at night, you cycle through peri­ods of REM and non-REM sleep.

He explained that dur­ing REM sleep, all skele­tal mus­cles are par­a­lyzed by design to allow repair, heal­ing and reju­ve­na­tion from the wake­ful state to occur. The eye mus­cles (hence rapid eye move­ment), heart mus­cles, the diaphragm and res­pi­ra­to­ry mus­cles are the only life sus­tain­ing mus­cles that are active dur­ing REM sleep.

He said: “We also dream dur­ing REM sleep. One can see how the sen­sa­tions not­ed dur­ing sleep paral­y­sis events are actu­al­ly nor­mal phe­nom­e­na in REM sleep with the excep­tion that they occur in the wake­ful state. It is a car­di­nal symp­tom of obstruc­tive sleep apnea and can occur in nar­colep­sy, fol­low­ing sleep depri­va­tion, after alco­holic binges and some para­som­nic states.”

Michael Breus, a clin­i­cal psy­chol­o­gist and fel­low of the Amer­i­can Acad­e­my of Sleep Med­i­cine explained that sleep paral­y­sis can occur dur­ing one of two tran­si­tions in the sleep cycle. The body must go into REM sleep, and it must come out of it, he said, but sleep paral­y­sis occurs when the body has trou­ble mak­ing these tran­si­tions. “If it hap­pens when you’re falling asleep, it’s called hyp­n­a­gog­ic sleep paral­y­sis, where­as if it hap­pens dur­ing wak­ing it’s called hypnopom­pic,” he said.

Var­i­ous cul­tures attribute the sen­sa­tion to exter­nal forces includ­ing spir­i­tu­al or para-nor­mal activ­i­ty said Dr Olu­so­la Ogun­tolu, say­ing this includes “incubus or suc­cubus attacks and the “old hag” in west­ern soci­eties; witch­craft spells and oth­er demon­ic influ­ences in indige­nous cul­tures. “

The sleep expert  said some  peo­ple attribute the effect to the pres­ence of wall geck­os on the ceil­ing exert­ing motor con­trol pow­ers over the indi­vid­ual adding “These are of course all incor­rect as there is a sim­ple phys­i­o­log­i­cal expla­na­tion for the phe­nom­e­non.”

Dr Ogun­tolu who is also the Chief Cir­ca­di­an Offi­cer, Sleep Consultants/ Sleep Inc. Ikoyi, Lagos, said sleep paral­y­sis is some­times mis­tak­en for patho­log­ic neu­ro­log­ic con­di­tions like strokes or the effect of poi­sons. While some dis­ease states can cause gen­er­al­ized mus­cle weak­ness, they are rarely tran­sient and full recov­ery of motor func­tion in a short peri­od of time would be unusu­al in those con­di­tions, he said.

Asked what caus­es sleep paral­y­sis, the sleep expert said the tran­si­tion from REM sleep to the wake­ful state usu­al­ly due to unplanned sleep dis­rup­tions short cir­cuit­ing the nor­mal tran­si­tion through non-REM sleep results in the sen­sa­tion of sleep paral­y­sis. “Any cause of sleep dis­rup­tion lead­ing to the wake­ful state (unin­ten­tion­al arousals, obstruc­tive sleep apnea and some para­som­nic events can cause sleep paral­y­sis). It can also occur fol­low­ing sleep depri­va­tion, overuse of some seda­tives and fol­low­ing alco­hol and illic­it drug binges,” he said.

The fol­low­ing are some of the ways of pre­vent­ing the con­di­tion, accord­ing to Dr Ogun­tolu:

Good sleep hygiene habit, that is sleep on your side, not your back; avoid heavy meals before sleep; drink herbal tea or a glass of milk, have a reg­u­lar bed­time rou­tine, avoid elec­tron­ics, dark­en your bed­room.

Oth­ers include turn off sound mak­ing devices, reduce or elim­i­nate caf­feine intake, get as much sleep as pos­si­ble, relieve dai­ly stres­sors, avoid alco­hol and overuse of sedat­ing agents are good start­ing points.

He said prompt eval­u­a­tion by a sleep dis­or­ders’ spe­cial­ist for obstruc­tive sleep apnea and oth­er sleep relat­ed con­di­tions are also impor­tant.

What should peo­ple do when they have, or have had sleep paral­y­sis?

The sleep spe­cial­ist advised peo­ple to remain calm and be reas­sured, say­ing it will pass. “How­ev­er, the per­son must rec­og­nize that it is a poten­tial ear­ly symp­tom of an under­ly­ing sleep dis­or­der. They should seek com­pe­tent help from qual­i­fied pro­fes­sion­als as soon as prac­ti­cal,” he added.

On treat­ment, Dr Ogun­tolu said no spe­cif­ic treat­ment is indi­cat­ed for the symp­tom espe­cial­ly since it abates fair­ly quick­ly. He said beyond reas­sur­ance, treat­ment of any pre­dis­pos­ing con­di­tion is imper­a­tive. “The risk of recur­rence is high if the con­di­tion (e.g. obstruc­tive sleep apnea) is left untreat­ed.

Also, sleep depri­va­tion, alco­holic binges and seda­tive abuse should be avoid­ed if pos­si­ble. See your doc­tor if sleep paral­y­sis occurs often and/ or rou­tine­ly pre­vents you from get­ting a good night’s sleep,” he advised.

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