Sleep paralysis: a real nightmare?

Facing your own demons at night?

Stress and sleep


Owen Wiseman
@AVogel_ca


25 April 2019

What is sleep paralysis?

This condition entails a period of paralysis whereby the body is frozen, but your mind is awake. These moments are often accompanied by extremely realistic hallucinations that range from ghosts and demons, to alien abductions. The episodes often leave the individual feeling very vulnerable and can cause psychological distress in their day to day lives.

What are the causes?

The causes are varied, but episodes of sleep paralysis can be contributed to by multiple factors including, but not limited to:

  • Lack of sleep is the leading cause of sleep paralysis whether from staying up or experiencing repeated nights of insomnia. In those whose rest left them feeling unrefreshed, also known as non-restorative, they experienced sleep paralysis 20.3% more commonly than those who had a restful night.
  • Poor sleep schedule can contribute to the onset of episodes. Researchers looked at the impact of shift work which often creates very chaotic sleep schedules. A study comparing those on shift work vs those on regular hours found that of those experiencing episodes of sleep paralysis, 48% were on shift work and 36% regular hours.
  • Mental health concerns – the World Health Organization estimates that a staggering 80% of those suffering from mental health conditions experience sleep paralysis at some point. In a vicious cycle, those who experiencing sleep paralysis report worsened mental health the following day while those who have mental health concerns report increased episodes of sleep paralysis. These include those with post-traumatic stress disorder, panic disorder and panic attacks, anxiety disorders, bi-polar disorder, and substance abuse.
  • Sleeping position actually had a huge impact on the occurrence of sleep paralysis episodes with 58.07% occurring when the individual was lying on their back. This compared to only 7.95% of episodes occurring while individuals were lying on their front and 16.87% while lying on their side
  • Sleep disorders such as narcolepsy, a condition where the sufferer experiences uncontrollable episodes of falling asleep, as though their power was cut. Those with narcolepsy disorders tend to experience sleep paralysis at about 58.5% compared with those without the condition who experience it at 15.1%.
  • Medications can contribute to sleep paralysis, especially those used to treat ADHD who seem to experience episodes at 8.8% compared to those not taking the medication at 3.0%. As of the research right now, there does not seem to be any association with anti-depressants or hypnotic medications.

When does sleep paralysis tend to occur?

To answer this question, it's important to understand the stages of sleep and wakefulness. When you're going about your day, you tend to fluctuate between alert wakefulness and relaxed wakefulness differentiated by a measure of beta and alpha brain waves, respectively. As you move into sleep, there are two distinct stages known as non-rapid eye movement (NREM) and rapid eye movement (REM) sleep.

  • NREM stage 1 is when those jerking motions happen as you slip away from the waking world with a decreased awareness of your surroundings. This stage is characterized by theta brain waves.
  • NREM stage 2 still sees the individual in theta wave sleep, but the amplitude of the waves increasing as you move towards deep, slow wave sleep.
  • NREM stage 3 is the deepest stage of sleep and therefore the hardest to wake someone from. The delta waves that occur here are very slow and this allows the body to conduct its restorative functions uninterrupted by noise, light, and motions from the waking world.
  • REM stage 4 is where brain activity jumps and mimics almost a woken-like pattern blending beta and alpha waves. In this stage, there is an increase in learning and cognitive function and dreaming occurs. Since dreaming might cause you to move around as you mimic activities such as running or flying, this puts you at risk of injuring yourself. The body, to protect itself, inhibits muscle function leaving you in a state of non-movement, paralysis. If this mechanism fails to keep you sleep, then you may wake during REM to find yourself paralyzed and the dream world bleeding over into your waking world. This allows the vivid imagery in dreaming to follow you and may explain some of the deeply disturbing experiences reported by those visited by aliens or demons in the night.

Who is at risk for sleep paralysis?

As you might have gathered from the causes discussed above, those at risk include shift workers, the sleep deprived, those who sleep on their back, those diagnosed with mental health concerns or sleep disorders, and individual's taking ADHD medication.

What are some remedies?

The most unsurprising answer - sleep. A discussion around sleep hygiene is really starting to take off as primary care providers explain the short and long-term impacts of sleep deprivation on the healthy mind and body. Around the world, people are actively engaging with their health and utilizing far more self-care methods as we understand more about reducing our risk for disease and postponing our inevitable mortality.

Products such as Deep Sleep contain two ingredients that promote sleep.

The first, valerian (Valeriana officinalis), has historically been used for its potent sedative effects. A study involving participants taking 400mg of the herb showed improvements in sleep quality, how quickly they fell asleep, a characteristic known as sleep latency, and other symptoms of insomnia. Another study demonstrated that valerian is as effective as oxazepam, a common medication for treating anxiety and insomnia, with fewer side effects. Of note, the herb does have the potential to interact with benzodiazepines, so a discussion with your primary care provider needs to happen.

The second is hops (Humulus lupulus) which has been studied, commonly in combination with other herbs such as valerian, for its effects on sleep. It has also been shown to help reduce anxiety which could benefit individuals during the day who are suffering from the anticipatory anxiety of falling asleep and potentially waking to another episode of sleep paralysis.

It is important to reach out to those around you for support and ensure you're getting the good night sleep you need. Creating a routine before bed helps the body unwind, especially if this includes leaving those tempting electronics out of the bedroom.

References

http://cms.herbalgram.org/expandedE/Hops.html
http://cms.herbalgram.org/expandedE/Valerianroot.html?ts=1551623169&signature=f9fb134255b75699ac2add88f038759e
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245115/
https://www.ncbi.nlm.nih.gov/pubmed/12028482
https://www.ncbi.nlm.nih.gov/pubmed/27460633
https://www.ncbi.nlm.nih.gov/pubmed/27486325
https://www.ncbi.nlm.nih.gov/pubmed/30464663
https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional/
https://www.sciencedirect.com/science/article/pii/S1087079217301120?via%3Dihub#bib53

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