Sleep paralysis can be scary, especially if it happens for the first time. You may wake up and realize that you cannot move or speak, even though you are aware of what is happening around you.
Sleep paralysis happens when your body and brain are momentarily out of sync. During rapid eye movement (REM) sleep, your brain relaxes your muscles so you don’t act out your dreams. During sleep paralysis, this muscle relaxation lasts a little longer than it should, even after waking up. As a result, you are conscious but unable to move for a short time. Episodes usually last only seconds or a few minutes and often end on their own.
Some people also experience vivid dreams or hallucinations during sleep paralysis. This may include seeing people or hearing things that aren’t there, or feeling pressure in the chest. Although these symptoms can feel severe, isolated sleep paralysis is not dangerous and does not mean that something is seriously wrong.
Common factors and risk factors
Sleep paralysis can affect people of all ages, but certain habits and conditions can make it more likely. Common triggers and risk factors include:
- Lack of enough sleep
- Going to bed and waking up at different times every day
- Increased stress or anxiety
- Lying on the back
- Working night shifts or an irregular work schedule
- Drinking alcohol close to bedtime
- Some medications are used to treat anxiety
- Other sleep disorders, such as narcolepsy
Lack of sleep and an irregular sleep schedule are among the most common factors. When you don’t get enough sleep, your body may enter REM sleep sooner or deeper, which can increase your chances of sleep paralysis.
Does sleeping position matter?
Yes, sleeping position can be different for some people.
Sleep paralysis most often occurs when sleeping on the back. This position, also called supine sleep, is associated with a higher risk of episodes. While experts are still learning why this happens, sleeping on your side can reduce the incidence of sleep paralysis.
If you tend to roll over on your back at night, putting a pillow behind you or using body pillows will help you stay on your side.
How is sleep paralysis managed?
For most people, managing sleep paralysis starts with getting better sleep habits and minimizing known triggers. Useful strategies include:
- Follow a regular sleep schedule. Try to go to bed and wake up at the same time every day, even on weekends.
- Get enough sleep. Adults should get at least seven hours of sleep each night.
- Avoid alcohol, especially near bedtime. Alcohol can disrupt REM sleep and increase the likelihood of episodes of sleep paralysis.
- Reduce stress. Relaxation techniques such as deep breathing or gentle stretching before bed can help.
- Change the sleeping position. Side sleeping instead of back sleeping can reduce the frequency of episodes.
- Address other sleep or health conditions. Treating insomnia, anxiety, or sleep apnea can help reduce episodes and provide better sleep quality.
If sleep paralysis is frequent or causes severe distress, your doctor may recommend additional treatment options. In some cases, cognitive behavioral therapy can help improve sleep quality and reduce sleep disturbances that can cause sleep paralysis. There are no recommended medications for isolated sleep paralysis.
Basic overview: Maintaining a regular and consistent sleep schedule and avoiding common triggers are the first steps to managing sleep paralysis.
When talking to a doctor
If sleep paralysis occurs frequently, feels overwhelming, or occurs along with excessive daytime sleepiness, you should talk to your doctor. A health care professional can determine if another sleep disorder or medical condition may be involved and guide you on next steps.
Medical review by Dionne Morgan, MBBS, FCCP
