Parasomnias
Sleep Paralysis
Being briefly unable to move or speak while falling asleep or waking up, sometimes with frightening hallucinations. Episodes pass on their own.
Overview
Sleep paralysis is a brief period, usually seconds to a couple of minutes, when you are conscious but cannot move or speak as you fall asleep or wake up. It happens when the muscle paralysis of REM sleep continues while your mind is awake.
Many people also experience vivid hallucinations during episodes, such as sensing a presence in the room, pressure on the chest or seeing figures. This can be very frightening, but sleep paralysis is not dangerous and breathing continues normally.
Isolated episodes are common, especially with sleep deprivation, irregular schedules or stress. Frequent sleep paralysis, particularly with severe daytime sleepiness, can be a symptom of narcolepsy.
A systematic review estimated that about 7.6% of the general population, and around 28% of students, experience sleep paralysis at least once in their lives.
Common symptoms
- Inability to move or speak on falling asleep or waking
- Awareness of surroundings during the episode
- Feeling a presence or seeing figures in the room
- Pressure on the chest or a feeling of being unable to breathe deeply
- Intense fear
- Episodes lasting seconds to a few minutes
Causes and risk factors
- Sleep deprivation
- Irregular sleep schedules, shift work or jet lag
- Stress, anxiety, panic disorder or PTSD
- Sleeping on your back
- Narcolepsy
- Family history
How it is diagnosed
Sleep paralysis is diagnosed from your description. No tests are needed for occasional episodes. If episodes are frequent or occur with excessive daytime sleepiness or cataplexy, a clinician may recommend a sleep study and Multiple Sleep Latency Test to check for narcolepsy.
Treatment options
Improving sleep habits
Getting enough sleep on a regular schedule reduces episodes for many people.
Treating anxiety or PTSD
Addressing underlying mental health conditions can help.
Cognitive behavioural approaches
Techniques to reduce fear during episodes and change how you respond.
Medication
In frequent, distressing cases or with narcolepsy, a clinician may prescribe medicines that suppress REM sleep.
What you can do yourself
- Keep a regular sleep schedule with enough sleep
- Try sleeping on your side
- Remind yourself during an episode that it is temporary and harmless
- Focus on moving a finger or toe, or slow breathing, to help end an episode
- Reduce stress and limit alcohol and caffeine
When to see a doctor
- Episodes are frequent or very distressing
- You have severe daytime sleepiness
- You have sudden muscle weakness triggered by laughter or emotion
- Fear of episodes is stopping you from sleeping
Frequently asked questions
Is sleep paralysis dangerous?
No. It is frightening but not harmful, and your breathing muscles continue to work. Episodes end on their own within seconds to minutes.
Why do people see a figure or demon?
Dreamlike hallucinations from REM sleep can blend with your awareness of the room, and the brain's threat response can shape them into a frightening presence. Many cultures have folklore explaining this experience.
Is sleep paralysis a sign of narcolepsy?
It can be, but most people with sleep paralysis do not have narcolepsy. Frequent episodes with severe daytime sleepiness or cataplexy should be evaluated.
How do I get out of an episode?
Many people find that focusing on small movements, like wiggling a finger or toe, or concentrating on slow breathing helps end it. Reminding yourself that it is temporary can reduce fear.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.