Old Hag Syndrome: What Causes Sleep Paralysis?

People who have experienced old hag syndrome (sleep paralysis) at one time or the other would describe it as a very scary thing.

Unfortunately, some people experience it multiple times and frequently, while others may have just one or two episodes in their entire lifetime.

If you have experienced this before, you are not alone, about one in four people would experience it at one point or the other.

The purpose of this article is to explain what causes sleep paralysis, give you practical tips to help you wake up from it and tell you how to prevent another episode from happening.

So, let’s dig in!

What is sleep paralysis?

Sleep paralysis is a feeling of being unable to move, speak or react while at the same time, being aware of one’s environment. This can happen either while falling asleep or while waking from sleep.

It could be a very scary experience because the person is fully conscious but ‘paralyzed’. Another name for this disorder is Old Hag Syndrome.

The term “Old Hag Syndrome” comes from the superstitious belief that a witch or an old hag sits on the chest of the victims, making them immobile. 

What causes sleep paralysis?

To understand what causes sleep paralysis, you need to understand the different stages of sleep.

There is REM sleep and Non-REM sleep.

REM stands for Rapid Eye Movement. During REM sleep, your eyes move swiftly from side to side. It is during this sleep stage that dreaming happens.

During REM sleep, your brain causes a temporary paralysis of your muscles. This is very important so that you don’t attempt to act out your dreams.

Sleep paralysis happens when you wake up before your body completes the REM sleep cycle. That is, you become conscious before your body’s ability to move is restored. 

There are some factors that make it more likely for you to have a sleep paralysis episode. Here are some:

  • Sleep deprivation
  • Changing sleep schedules
  • Mental stress and anxiety
  • Sleeping on your back
  • Narcolepsy
  • Bipolar disorder
  • Some medications.


What are the symptoms of sleep paralysis?

Some of the symptoms associated with sleep paralysis include the following:

  • Inability to move or speak while trying to sleep or immediately after waking up.
  • Perceiving strange smells or hearing sounds of approaching footsteps.
  • Experiencing an out of body feeling or imminent death.
  • Hallucinations of a strong feeling of a presence in the room or an intruder in the room, seeing ghost-like shadows or glowing eyes. This causes a strong sense of danger and panic.
  • The feeling of someone stepping on your chest, making movement impossible (described as the oppressive weight on the chest).
  • The feeling that your face is being pressed with a pillow, making breathing difficult or impossible.

How is sleep paralysis treated?

Treatment is usually not needed except in cases where there are any underlying conditions such as narcolepsy and anxiety disorders. Treatment of these underlying conditions includes lifestyle changes, use of medications and even joining counseling and support groups.

Sleep paralysis can be a very scary experience, so here are some of our best tips to help you wake up from an episode.

5 Tips to wake up from a sleep paralysis episode (infographic)

  1. 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.
  2. 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.
  3. Clench and wiggle. Try to wiggle your toe or clench your fist.
  4. 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.
  5. 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.

Read Also: Why Do People Snore? Find Out What Causes Snoring

How do I prevent sleep paralysis?

The next time you experience an episode of sleep paralysis, be sure to try out these tips and remember you can prevent it altogether by avoiding stress and getting enough sleep.

Read Next: How To Fix Your Sleep Schedule And Get Rid Of Insomnia

Dr. Oyinkansola Kolawole

Dr. Oyinkan has a degree in medicine and surgery. Her passion in life is to help people in all the ways she can including breaking down difficult to understand medical facts into simple and fun bits of information.
Dr. Oyinkansola Kolawole