Do you suffer from sleep paralysis? Don’t Be Afraid: That’s Why They Happen and That’s How They Can Be Prevented

The first time this happened to him, Daniel was 16 years old. He remembers that it was nighttime, rather early in the morning, and that he felt particularly tired, which was strange for a boy of that age. But not so much for the day he had just had: this afternoon had been his best friend’s funeral. “He died on New Year’s Eve,” he recalls now at the age of 30.

“The television was on, but my eyes were closed. Out of nowhere, I start to hear a very high-pitched buzzing. It was so unbearable that I couldn’t open my eyes; I also couldn’t move my hands to cover my ears. At one point, I stopped breathing. No air was coming in and I started to despair. I wanted to scream, I couldn’t and I thought I was going to die. I don’t know how long it took for the air to come back, for the noise to go away and for me to regain control of my body,” says Daniel.

Since then, and for the next 14 years, sleep paralysis came and went for Daniel. At first, when they appeared quite frequently, she turned not to a sleep specialist, but to a psychologist. “He told me he was suffering from a panic attack,” he says.

Today the episodes are sporadic, and when they happen he doesn’t despair like before and tries to stop them before they happen. “When I feel like I’m going to have one, I tell my brain to move my arms and legs. It’s a fight, but less than the one I had at the start.

Despite the complexity of treating sleep paralysis, it is not considered a sleep disorder, like insomnia, apnea, or restless leg syndrome. It is also not understood as a pathology, but rather as a symptom. Enough to? Mainly due to poor sleep or sleep deprivation, possibly associated with stress, anxiety, depression or, as in Daniel’s case, a panic attack.

This phenomenon could also be linked to narcolepsy, a chronic neurological syndrome that causes periods of extreme sleepiness during the day, as well as brief and sudden episodes of deep sleep. “One of the manifestations of narcolepsy is sleep paralysis, which occurs with great intensity and frequency,” explains neurologist Leonardo Serra, head of the Center for Sleep Disorders at the German clinic.

Very rarely, sleep paralysis is linked to genetic inheritance.

It is unclear what proportion of the population has experienced such an episode. While you study like him Sleep medical examination , from 2017, establish that approximately 7.6% of the world’s population suffers from sleep paralysis at any given time, Leonardo Serra points out that the figure reaches 15%. Meanwhile, for Pablo Guzmán, neurologist at Clínica Somno, the rate would even reach 60%.

To understand sleep paralysis, Serra says you first need to understand what’s going on in our brains when we normally sleep.

When we sleep, we repeatedly go through, about four or six times during a normal night, a cycle that lasts about 80 to 100 minutes and consists of two phases of sleep: rapid eye movement (REM) sleep and sleep without sleep. DIE.

During REM sleep – known in English as REM (Rapid eye movement)-, our brain works a lot, “sometimes even more than when we are awake”, explains Serra. Generally, during this stage, dreams manifest. In fact, it is easy to distinguish when a third party is in this phase, because you can see the restless movement of the eyes under the eyelids, as if the person is watching a movie of which he does not want to lose a single detail. .

In order for the brain to be able to carry out its processes—such as consolidating memory and learning, while rejecting information that it deems useless—during the REM phase “the muscles of our body must lock up”. Otherwise, we would move to the rhythm of dreams, as if we were playing them, and we could not rest.

Sleep paralysis is then produced by a dissociation between the mechanisms that cause this muscle relaxation and those that maintain vigilance. “It often happens that we suddenly wake up, but our brain is unable to unblock the muscles, so we remain conscious, awake but blocked,” says Serra.

“It’s an incomplete awakening”, completes Pablo Guzmán: “the body is completely disconnected from the brain at the level of the brainstem, and when this incomplete awakening occurs, the person cannot move any part of his body except the eyes”.

It is assumed that sleep paralysis has been around since humans were humans. The absence of scientific medicine, added to the hallucinatory events that can occur during an episode, led to the search in antiquity for all sorts of reasons to explain the phenomenon.

It was common to hear stories of demonic entities, horrific beings that appeared at night to possess bodies, especially men. The Bible even mentions Lilith, “the monster of the night”, a female figure who lured poor households with false sexual promises, much like the succubi people talked about in the Middle Ages.

More contemporary, though equally esoteric, is the portrayal of it by the Swiss painter and poet Johann Heinrich Füssli, also known as Henry Fuseli, through his most famous painting, The nightmarefrom 1781: a woman, lying on a bed, one arm and her head hanging out of the mattress, on whose body is seated an incubus – the male version of the succubus -, while a black horse emerges from behind red curtains decorating the dark bedroom.

One hundred years later, the French writer Guy de Maupassant depicts in his short story time to sleep paralysis like an invisible being who besieges the main character with his presence, a being who is none other than his double, a kind of double who steals his energy at night. Other great names in literature, such as Herman Melville and Ernest Hemingway, also wrote about the subject which was once seen as a spell. This is how Francis Scott Fitzgerald did it in 1922’s “The Beautiful and Damned”:

“I lay there, frozen in the most horrible fear, unable even to move my hand, thinking I could, but not having the strength to move it an inch until the horrible spell was cast. be broken.”

If paralysis has become an interesting subject for art and literature, it is largely thanks to the hallucinations that can accompany it. Feeling that someone is touching your feet or removing the sheets, seeing shadows moving around the room, hearing noises, buzzing noises or even screams, in addition to the feeling of panic and suffocation, are on the menu of possibilities, which seems more efficient than a catalog of Netflix Horror Movies.

Sleep paralysis can occur both when you go from being awake – being awake – to sleeping, and vice versa. If hallucinations occur in the first option, they are called hypnagogic. Hypnopompics, on the other hand, are those that occur when paralysis occurs from sleep to wakefulness. This is not the only difference: hypnagogics are especially characteristic in people suffering from narcolepsy.

In short, as Pablo Guzmán explains, we have an image in which “we can only see what is happening around, without being able to perform practically any physical action, without even asking for help”. And in which, in addition, “factors of a subjective nature, such as hallucinations or the sensation of strange presences” may or may not be present. These, explains the neurologist of the Clínica Somno, “are only the consequences of the transition phase between sleep and wakefulness”.

Despite the horror movie and the bad timing, sleep paralysis is harmless. “Fortunately, they don’t affect vital functions, such as breathing or heart rate,” Guzmán explains. “The important thing is to be informed, and that people know that it is not something serious or dangerous,” adds Leonardo Serra.

However, for many people, this bad moment can have deeper repercussions, especially the first few times it is experienced. “It can trigger significant anxiety disorders or even panic attacks, because this feeling of being locked up in your own body can be very frightening. This can accentuate psychological images,” warns Serra.

Once they have sleep paralysis, some people are afraid to go back to sleep. But this is the importance of understanding that there is no more risk, as well as the need to consult a sleep and mental health specialist, if necessary. As Serra says, although it is not possible to eliminate paralysis forever—“they have no cure”—“it can be improved and make it very sporadic”.

Specialists explain that treatment to reduce episodes of sleep paralysis begins with identifying the causes and possible associated factors. “The images of anxiety should be observed, checking if they are related to the consumption of alcohol or drugs, or if there are associated depressions”, explains Guzmán.

In this sense, each case should be evaluated “with a sleep study or a multiple latency test to rule out narcolepsy or other associated sleep disorders”, he adds.

“If the paralysis occurs very frequently and is bothersome, certain drugs can be used to reduce their frequency”, specifies Leonardo Serra. These include venlafaxine, fluoxetine and sertraline.

On the other hand, the best way to prevent the appearance of paralyzes, spells and demons such as succubus is to take care and improve sleeping habits. Some measures for this are:

• Sleep between 7 and 9 hours each night.
• Go to bed and wake up at around the same time every day. This ideally includes weekends.
• Helps find relaxation before going to bed: reading a book and listening to background music are good alternatives.
• Put screens aside: the brightness and stimuli found in the smart phones, computers and televisions affect sleep. Therefore, it is advisable to turn them off at least two hours before going to bed.
• It is important to be physically active during the day, but it is not recommended to do so within 3 hours of bedtime.
• Avoid large meals, caffeine, chocolate, and alcohol before bed.
• Do not extend naps for more than 30 minutes during the afternoon, or take them very close to night.