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Sleep Paralysis: The Waking Nightmare

"Which comes first, the paralysis or the fear?"
By: Stef dela Cruz, MDSleep Paralysis: The Waking Nightmare

Sleep paralysis isn’t a mystical occurrence. Paralysis is supposed to be a normal part of rapid eye movement (REM) sleep, the phase of sleep associated with dreams. During the REM stage, the brain causes your body to go into a state of atonia, defined as absent muscle tone.

Albert Berger came up with a couple of theories that may help explain atonia during REM sleep. In a 2008 article published in Sleep, he postulated that motor neurons may be inhibited through other pathways, not necessarily by glycine or GABA. The inhibition may be intense enough to overcome the activation of motor neurons. His second theory revolves around the role of a state-dependent neurotransmitter system. Whatever the mechanism behind atonia, it may malfunction and spill over into one’s waking life as sleep paralysis.

Paralyzed by fear

Which comes first, the paralysis or the fear? It can be either. A 1999 study by Cheyne and colleagues published in Consciousness and Cognition discussed how fearfulness came not only from the helplessness of paralysis, but also from the hallucinations.

Conversely, fear may help cause sleep paralysis. In a 2008 study by Holly Ramsawh and colleagues published in Behavior Therapy, almost a third of people who suffered from isolated sleep paralysis also had panic disorder. This was a far cry from the zero incidence of panic disorder among participants who didn’t suffer from sleep paralysis.

Sleep paralysis: What it isn’t

Sleep paralysis can mean different experiences to different people: an inability to move, a mere symptom of an underlying disorder, or even an occurrence akin to an alien abduction. Because of the terror that it evokes, many even link it to supernatural events, including demonic possession. It’s time to wake up from the real nightmare: ignorance.

Myth #1: Everyone with sleep paralysis has a sleep disorder. The association between sleep paralysis and sleep disorders is never automatic.

Myth #2: If you have sleep paralysis, you have narcolepsy. Sleep paralysis – together with excessive daytime sleepiness, brief and sudden loss of muscle tone (cataplexy), or auditory, visual, or other sensory fantasies that occur while one is switching from wakefulness to sleep (hypnagogic hallucinations) – suggests a diagnosis of narcolepsy, according to the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Myth #3: Sleep paralysis tends to repeat itself. Not all episodes of sleep paralysis are recurrent.

Sleep paralysis? Make your move

Are you or a loved one currently experiencing sleep paralysis? Don’t just sleep on it!

It’s time for you to make your move. Knowledge helps dispel fear, making sleep paralysis less of the unpleasant experience that it is.

A consultation with a psychiatrist or sleep specialist can help determine if sleep paralysis is related to an underlying disorder. Seeking help can help improve one’s sleep and, eventually, one’s life.

With the proper diagnosis and treatment of sleep paralysis, there’s no need for you to be literally paralyzed with fear. Go ahead and empower yourself – that way, you can put your sleep problems to sleep.


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