Sleep paralysis: What’s behind it & what you can do about it

While we sleep, we go through several sleep phases. In the deep sleep phase, the so-called REM phase, we dream particularly intensively. This can be recognised, among other things, by the increased eye movements. To prevent our body from actually carrying out the movements from our dreams, all our muscles relax and the speech centre is also switched off. So, the sleep paralysis makes perfect sense – while you sleep.

However, if you wake up from REM sleep without the transition to wakefulness, the sleep paralysis can persist for a short time while your brain is already awake and your eyes are open. Your body continues to sleep while your mind is already awake. The sleep paralysis can be frightening, especially when it first occurs, and can cause the following symptoms in addition to body paralysis:

• helplessness

• fear of suffocation due to lack of abdominal muscle tension

• panic attacks

• palpitations

• hallucinations/nightmares

Even if those affected often experience a feeling of breathlessness or an unpleasant pressure on the chest due to the paralysed auxiliary respiratory muscles, this is only imagination. Diaphragmatic breathing ensures that the body continues to be supplied with sufficient oxygen during sleep paralysis.

The most common type of sleep paralysis is hypnopomanic sleep paralysis. This sleep paralysis occurs on waking when the brain wakes too early from the REM phase, but the typical body and speech paralysis has not yet stopped. The hypnagogic sleep paralysis refers to sleep paralysis when falling asleep. In this case, your body already falls into a state of paralysis and falls asleep while your brain is still awake. Symptomatically, hypnopomanic and hypnagogic sleep paralysis don’t differ from each other.

In addition to anxiety and palpitations, hallucinations are not uncommon with sleep paralysis. Those affected see apparitions in the room that are often connected to their previous dreams. These hallucinations are usually perceived as negative and frightening, even if the dream was not necessarily a nightmare. Due to bodily paralysis, those affected often perceive threatening figures during hallucinations. The lack of body control makes them feel powerless and at the mercy of others. A nasty trick of the brain!

Even though sleep paralyses can be extremely frightening, they are at least harmless to the body. If they only occur rarely and for a few seconds, those affected usually do not feel the need to seek professional help for sleep paralysis. Better sleep hygiene is often enough to prevent further sleep paralyses.

In rare cases, sleep paralyses occur very frequently, sometimes every day or even several times a night. If this the case, the sleep paralyses are often due to certain causes that need to be clarified by a doctor. In addition, regular sleep paralyses often cause great psychological stress: Those affected are afraid of going to bed and sleep more restlessly. This in turn can lead to a lack of sleep, which further favours sleep paralysis. A vicious circle begins.

In order to put an end to the psychological stress caused by sleep paralyses, good sleep hygiene and regular bedtimes should first be ensured. It’s also important to exclude possible risk factors or treat them, as sleep paralyses are often just a side effect of other illnesses. But more on this in a moment.

If the sleep paralyses already have an impact on your well-being due to their regularity and there do not appear to be any explicit triggers or accompanying illnesses, this is isolated sleep paralysis. Medical treatment or psychotherapy, e.g. in the form of cognitive behavioural therapy, can be useful.

In cases of extreme psychological stress, treatment with antidepressants may also be prescribed. Some of these medications suppress REM sleep which, in addition to the positive psychological effects, can also reduce the occurrence of sleep paralyses.

Even if the exact causes and triggers of sleep paralyses have not been conclusively clarified, there are some risk factors that can favour the occurrence of the sleep disorder. In particular, psychological factors such as increased stress levels in everyday life, depression, but also other sleep disorders such as sleep apnoea (breathing interruptions) or narcolepsy should be mentioned.

The latter has been observed particularly frequently in people with regular sleep paralyses. This is a condition in which patients are constantly tired despite getting enough sleep at night. In addition, strong positive and negative emptions lead to a loss of body tension – similar to the state of sleep paralysis.

In addition to pathological causes, regular use of drugs, alcohol or medication are also possible risk factors for sleep paralyses. If you regularly take medication, you should tell your doctor about the sleep paralyses and ask about the side effects of your medication.

To prevent sleep paralysis from occurring in the first place and to significantly reduce its regular occurrence, there are a few tricks that we will discuss in a moment. But even if you already seem to be trapped in sleep paralysis, you can follow certain tips to stay calm and regain control of your body more quickly. You can do this to free yourself from sleep paralysis:

• Make your partner aware of you, if possible, e.g. by making noises such as moaning or humming. They can free you from sleep paralysis by touching you.

• Try to move your fingers or toes. Rolling your eyes can also help to “wake up” your body from paralysis. With a little practise, these movements are also possible in a half-awake state.

• Pay attention to your breathing and try to breathe calmly or perform certain breathing techniques. They not only prevent an anxiety or panic attack, but also help you regain control of your body.

To prevent sleep paralysis from occurring in the first place, even the smallest changes in everyday life and sleep hygiene can help. Here are our tips.

To get rid of regular sleep paralysis, there are a few things to bear in mind. Most of our tips are easy to implement and promise great success. If there is no improvement despite these changes, we recommend that you seek medical advice. Your GP can carry out an initial examination and refer you to psychological counselling or other experts.

A regular sleep-wake rhythm with 7 to 9 hours of sleep at night is very important for people affected by sleep paralysis. Not only the duration of sleep, but also the time frame should be adhered to. Depending on the sleep type, this can be from 9 pm to 5 am or from midnight to 8 am, for example. Fresh air in the bedroom, reduced screen use in the evening or separating the work and sleep areas also contribute to good sleep hygiene.

Pressure and stress in everyday life and at work are the main triggers for sleep disorders such as sleep paralyses. So, make sure you take moments of rest during the day and incorporate relaxation sessions such as meditation or yoga into your daily routine to harmonise body and mind.

Sleep paralyses are most likely to occur in the supine position. To avoid sleep paralysis, turn onto your side or stomach as soon as you fall asleep. Your partner can let you know at night when you are lying on your back.

A light source helps you to wake up more quickly and fully awake both during “normal” awakening and when emerging from sleep paralysis. Also, potential hallucinations are perceived as less threatening and frightening is those affected do not only have darkness around them. A small night light can already help.

Alcohol and drugs have a massive effect on our sleep and should therefore be avoided for any type of sleep disorder. The same applies to caffeine in the evening. It can cause more frequent waking, which could lead to sleep paralysis.

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