Sleep paralysis

People who experience sleep paralysis often have their first episode during their teen years, typically between 14 years and 17 years of age. Having said that, sleep paralysis can affect people of all age groups.

The most prominent symptom of sleep paralysis is not being able to move or speak for some time during sleep or waking from sleep. Apart from this, people with sleep paralysis may have the following symptoms:

• Paranoia
• Difficulty breathing
• Excessive sweating
• Muscle cramps
• A sensation of heaviness in the chest
• Hallucinations
• Feeling as though something is pushing you down

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Sleep paralysis is basically a loss of muscle function. The exact cause remains unknown. However, studies have shown that multiple factors may be responsible for sleep paralysis. These are:

• Lack of sleep or sleep deprivation 
• Severe anxiety
• Insomnia
• Bipolar disorder 
• Post-traumatic stress disorder (PTSD)
• Certain medications like ADHD medication 
• Substance abuse
• Having your sleep schedule disrupted
• Depression
• Sleep disorders like sleep apnea and narcolepsy

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Your general physician will start by asking you questions about your medical history and sleeping patterns. Though there aren’t any medical tests for the diagnosis of this condition, the doctor may have you do an overnight sleep study called a polysomnogram which records various things while you sleep including brain waves, heartbeat as well as breathing.

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Sleep paralysis may not require treatment; in some cases, following a healthy night-time routine, getting adequate sleep, etc., could resolve the issue.

If you are concerned about sleep paralysis or are unable to sleep properly, visit a doctor to check for underlying conditions like narcolepsy that may be causing the problem.

A treatment plan is devised keeping in mind the cause of sleep paralysis. This is as follows:

• Treatment of underlying mental health issues such as anxiety or bipolar disorder by seeking psychiatric help. 
• Low doses of antidepressants to reduce or control REM sleep and hence deal with sleep paralysis. REM is rapid eye movement—a sleep stage when the body is inactive and the brain is active. This stage is associated with vivid dreams.
• If you have recently changed your medication and are noticing symptoms of sleep paralysis, changing the medication should be considered. 
• In case the underlying cause is narcolepsy, the doctors will prescribe drugs for it. The most common medication prescribed in this case is selective serotonin reuptake inhibitors (SSRI), that manage the symptoms of narcolepsy. Stimulants may also be given to help the person stay awake during the day.

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Even though the condition is not harmful, sleep paralysis can be frightening and may result in the lack of a good night’s sleep. You can take the following steps to prevent it:

• Having a fixed sleeping schedule, that is, going to bed at the same time every day
• Getting at least six to eight hours of sleep per night
• Practising breathing exercises or yoga 
• Reducing stress levels 
• Seeking therapy and/or trauma counselling
• Avoiding smoking or drinking a few hours before going to sleep
• Trying a different position if you sleep on your back

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You should consider making an appointment with a general practitioner if:

• There you feel extremely tired
• You get sudden attacks of sleep during the day
• You feel extremely scared or anxious at the thought of going to sleep

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