Waking up without being able to move can feel very scary. This is one of the hallmarks of a sleep paralysis episode.
The more a person struggles, the harder it is to move, sometimes it feels like there’s someone else in the room. For many people, this experience can feel like a strange person is sitting on one’s chest, this is why people try to explain it by suggesting that it’s a demonic attack.
It is actually not a demonic attack. There is a medical explanation for this ‘witch on chest’ feeling, this is what we’ll be exploring in this post.
What Is Sleep Paralysis?
Sleep paralysis is the inability to move or speak when going to or waking up from sleep. The duration is usually very short spanning seconds to minutes and only rarely does it last hours.
It’s a very common condition affecting over 3 million Americans.
It is part of a group of disorders called parasomnias which means abnormal things occurring during sleep. Sleep paralysis occurs when your body does not move through the various stages of sleep smoothly.
What Is A Normal Sleep Cycle?
To understand sleep paralysis, you must know about the sleep cycles or the phase we pass through when asleep.
There are two parts to the normal sleep cycle: Non-REM and REM. REM is short for Rapid Eye Movement.
Non-REM (NREM) has four stages – stages 1 through 4 where we go from really light sleep (stage 1) to really deep sleep (stage 3&4).
Here, the brain slows down, leaving your body relaxed and increasingly less responsive to outside stimuli. The body then repairs itself and boosts its immune function. In the simplest of terms, it’s a time where the brain is turned OFF and the body is turned ON (strengthening and preparing itself for another day).
After the NREM we enter into REM sleep where the brain is active and the eyes jerk around (which is how the name was derived).
The brain works to consolidate all the information it has gathered throughout the day. During REM sleep, dreams occur and to prevent the body from acting out what it is dreaming about, the body goes into a normal state of paralysis. In simple terms, REM sleep is brain ON and body OFF.
We dream during the Rapid-Eye Movement stage of sleep (REM)
During sleep, we continually cycle between NREM and REM, although most of the time is spent in NREM.
How Is Sleep Paralysis Different From The Normal Sleep Cycle?
Like a lot of things in medicine, the cause of sleep paralysis is not fully understood. However, there are certain generally accepted theories.
The most accepted one is that sleep paralysis occurs when the sleep cycle does not flow from one stage to the next as it should especially when there is a disruption during REM sleep.
Remember that in REM sleep, the brain is ‘ON’ and the body is ‘OFF’, so you wake up near the end of REM sleep but your body hasn’t come out yet.
You are fully aware of what is going on because your brain is active but you can’t move because you are still asleep. This type of sleep paralysis that occurs when waking up from sleep is called hypnopompic paralysis.
The other form of sleep paralysis is the type that occurs when going to sleep- hypnagogic paralysis. In this type, you remain aware as the body enters REM sleep where the brain is more active and the body has entered into the REM induced paralysis.
So, Why The Demons?
Sleep paralysis is a parasomnia with altered sleep cycles. The line between the dreams that occur during REM sleep and wakefulness is erased so it seems like your dream is actually a reality.
Unfortunately, this can be extremely frightening and even more so because your brain is responding to the imagery it has cooked up.
Certain parts of the brain are stimulated causing a response of fear and danger. For that short period of time, you are stuck in a cycle where your brain conjures up a frightening image (usually of impending doom) and then causes you to enter the fight or flight response which induces fear, but you can’t fight or flee because your body is paralyzed which in turn revs up the fear!
The good news is that those things are not real. It’s due to a disruption in your REM sleep. Theoretically, there are 3 types of hallucinations during sleep paralysis and each one has an explanation.
Here you feel there’s a person in the room about to harm you. It is said to be due to overstimulation of the Amygdala (a part of the brain where fear is generated) causing you to be hyper-vigilant, thereby sensing a presence. Similar to when you are walking alone at night and you ‘see’ someone following you.
Incubus or ‘old hag’
Here you feel pressure on the chest making it difficult to breathe. In normal REM sleep, the breathing is shallow so when you wake up in sleep paralysis you feel you aren’t breathing well.
Then you try to take a deep breath but you can’t because your muscles are paralyzed (as REM sleep is still active). The result is a feeling of something or someone sitting on your chest trying to suffocate you.
Unusual bodily experience
Here you have out of body experiences like floating, flying, spinning and more. There’s a portion of the brain called the vestibular system and its function is to appropriately orient the body in its external environment.
When there is abnormal stimulation of this system, it leads to an orientation problem giving an abnormal feeling of movement even when you are lying in bed.
Any of these three types can be combined. Like the man at the beginning of this article had both intruder presence and incubus hallucinations. There could also be a combination of the three. These are called mixed hallucinations of sleep paralysis.
How Does A Person Get Sleep Paralysis?
First of all, anyone can experience sleep paralysis. There are certain conditions and situations that may increase your chances of having sleep paralysis. These include:
1. Narcolepsy: People with this sleep disorder are more likely to have sleep paralysis.
2. Obstructive sleep apnea and other sleep disorders like restless leg syndrome or nighttime leg cramps are associated with an increased risk of sleep paralysis.
3. Sleep deprivation or disruption: when your normal sleep rhythm is disturbed by night shifts, working late or lack of sleep. This disrupts the flow of your sleep cycle, increasing your risk.
4. Substance use: alcohol, caffeine or drug use just before bed has been linked to higher incidences of sleep paralysis.
5. Anxiety and depression: these are mental health conditions that are associated with an imbalance in the chemical transmitters in the brain. This may cause abnormal stimulation of the sleep centers of the brain causing sleep paralysis.
6. Post-traumatic stress disorder (PTSD): studies have shown that people suffering from PTSD have a higher chance of getting sleep paralysis.
7. Family history: sleep paralysis has been shown to run in families, with parents passing the genes on to the children.
8. Sleeping on your back: when sleeping on your back, as your muscles relax during sleep, your airway may become partially blocked. This increases your risk of having the incubus type of hallucination. Studies have shown that up to 60% of sleep paralysis happened while sleeping on the back.
How Can I Prevent Sleep Paralysis?
If you don’t have a medical condition that makes you prone to having sleep paralysis, then there are some things you can do to keep it from happening.
- Maintain good sleep hygiene by having a set time to sleep and adequate sleep of 6 to 8 hours every night.
- Avoid sleeping on your back, reduce your risk by sleeping on your side.
- Don’t take alcohol, caffeine or drugs just before going to sleep.
- Try not to eat heavy meals before going to sleep.
- Don’t sleep with your phone or computer beside you, the radiation from your devices can affect your sleep.
- Avoid stimulating yourself just before sleep with things like exercise and video games.
- Practice meditation and relaxation techniques just before bed.
- Sleep on a comfortable surface. You can get yourself a comfortable mattress and pillow. For people who prefer to sleep on recliners, you can read a review of top recliners at thehomedweller.com.
I Have Sleep Paralysis, What Do I Do?
Recurrent sleep paralysis that is not due to any medical condition is pretty common. The good news is that it mostly doesn’t affect your overall health. It’s one of those conditions where you learn to cope with it because it really doesn’t affect your daily life.
The first thing to do is to rule out medical causes.
This is done by visiting your doctor and letting him know your symptoms. From the questions asked and physical examination, the doctor should be able to figure out if you have a medical condition that should be addressed or if you have sleep paralysis due to other non-medical causes.
A sleep study may also be done on you to determine why you are having the symptoms.
If there is no associated medical condition then apply the tips for preventing sleep paralysis. If sleep paralysis still persists then you may find some of these coping strategies helpful.
- Relax and accept that you are having a very brief episode of sleep paralysis.
- Focus on your breathing and try to control it. This helps relieve the pressure on your chest.
- Try to move a part of your body like one of your fingers or toes.
- Think happy thoughts to ward off the fear.
- Keep a sleep journal where you document your dreams, hallucinations, length of the episode and if you are keeping to your sleep schedule.
Although it may be easier for people who have had multiple episodes of sleep paralysis to cope with it, persons new to the condition can use these coping strategies to overcome an episode especially now that you are adequately informed about the condition.
No matter the cause of your sleep paralysis, the first step is to see your doctor. Let medical conditions be ruled out/in first before trying to cope with it.
5 Tips To Wake Up From A Sleep Paralysis Episode (Infographic)
- Don’t fight. Struggling to get up will increase the feeling of being pinned down, thereby increasing fear. Having control over fear is the most important skill to learn.
- Relax! Tell yourself that you are aware this is sleep paralysis and you are okay. Don’t resist the pressure you feel on your chest.
- Clench and wiggle. Try to wiggle your toe or clench your fist.
- Breathe, breathe, and breathe again! Although breathing is automatic, focus on your breathing and don’t be overcome by fear that you forget to breathe. You could also try to cough.
- Make a face. When you realize you are in sleep paralysis, make a face like you just smelled something bad. Scrunch up your face and squint. Repeat this two or three times in a row and the paralysis will break almost immediately.
Is There Treatment For Sleep Paralysis?
There is no treatment for primary sleep paralysis. However, the condition is not life-threatening and can be managed with the above prevention tips and coping strategies.
If sleep paralysis is occurring due to a medical condition like Narcolepsy, Obstructive Sleep Apnea or Mental illness, then treatment is available in the sense that when the cause is addressed, the sleep paralysis should resolve.
If you don’t have a medical condition but the sleep paralysis is bothersome (causes daytime tiredness) or causing anxiety then you may need to see a sleep specialist. You may also need psychotherapy to help you learn to deal with the condition.
I am certain you can discover there are no demons involved in sleep paralysis. If you ever have sleep paralysis again, remember to RELAX! It would soon pass; and if you haven’t already seen your doctor about it, book an appointment when you wake up.
- Understanding Sleep Cycles. (n.d.). Retrieved June 18, 2019, from https://www.sleep.org/articles/what-happens-during-sleep/
- Parasomnia & Sleep: Causes & Treatment. (n.d.). Retrieved June 18, 2019, from https://www.sleepfoundation.org/articles/sleep-and-parasomnias
- Sleep Paralysis: Causes, Symptoms and Treatments. (n.d.). Retrieved June 18, 2019, from https://www.sleepassociation.org/sleep-disorders/more-sleep-disorders/sleep-paralysis/
How helpful was this post?
We are sorry that this post was not helpful to you!
Let us improve this post!
Thanks for your feedback!
Latest posts by Oyinkansola Kolawole, MD (see all)
- Sleep Apnea Test– What You Need To Know - June 26, 2019
- Pain Behind Knee: Causes, Treatment and Prevention - June 19, 2019
- Inner Knee Pain: Causes, Treatment & Prevention - June 18, 2019