What Are the Symptoms of Sleep Paralysis?

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Sleep paralysis is sometimes called "old hag" syndrome. It's a pretty common experience, but can still be frightening if you don’t know what it is.

You might have hallucinations, feel afraid, or be unable to move. These episodes can happen when the transition between rapid eye movement (REM) sleep and waking up is disrupted.

This article goes over what causes sleep paralysis and some of the common symptoms.

Common Symptoms of Sleep Paralysis

Verywell / Brianna Gilmartin

Causes of Sleep Paralysis

First, it's important to understand what sleep paralysis is. It's the presence or persistence of features of REM sleep during the transition into or out of sleep.

It can take place when you're first falling asleep (hypnagogic state). But it can also occur when you're waking up (hypnopompic state).

About 20% of healthy people experience sleep paralysis. Most people with sleep paralysis experience it without any related conditions. But it can happen along with other symptoms if you have narcolepsy, a sleep disorder that causes excessive sleepiness.

During REM, your mind is active. You might vividly imagine sights, sounds, and other feelings as part of a dream. You might even feel afraid like you would in a nightmare.

At the same time, your body is paralyzed so you can't act out your dreams. This is called muscle relaxation or atonia. When these features happen during wakefulness, you're experiencing sleep paralysis.

Recap

Normally, you have a smooth transitions between the different phases of sleep. But when a transition is interrupted, you might experience sleep paralysis. This can happen either when you first fall asleep or when you're about to wake up.

Common Features and Symptoms

Sleep paralysis is described as being unable to move or talk during sleep transitions. It may last for several minutes.

Some people try to scream or call out for help, but this comes out only as a soft voice. For example, you might only be able to whisper, squeal, grunt, groan, or whimper.

The ability to move your eyes is also limited.

A sense of suffocating or breathlessness is also common during sleep paralysis.

During REM sleep, the diaphragm—a large muscle below your lungs that's involved with your breathing—acts as a bellows to help you inflate your lungs and breathe. While the diaphragm is active, other breathing muscles (like around the rib cage) aren't as active.

This limited activity may cause these symptoms, as well as a feeling like someone is standing or sitting on your chest.

The level of awareness during sleep paralysis varies. Some people claim they're completely awake and aware of their surroundings. Others describe only partial awareness.

Less often, people can have an out-of-body experience. They might, for example, feel like they're floating above the bed and looking at themselves.

Hallucinations

Vivid hallucinations may be part of this experience. With these, you feel like you are experiencing something that isn't not actually occurring—like you're dreaming while awake. 

The hallucinations linked to sleep paralysis fall into four categories based on the senses they affect:

  • Visual (vision)
  • Auditory (hearing)
  • Olfactory (smell)
  • Tactile (touch)

Visual Hallucinations

The visual experience can be quite intense. Many people report the presence of a human figure, often described as being a dark figure, shadow, or ghost. This figure may be standing at the bedside, just at the edge of their vision. Some people report seeing several people in the room.

Others describe seeing flashes, bright colors, or lights.

Sometimes the visual hallucination can be really detailed. For example, some have reported seeing a hand not attached to a body, a gargoyle, bugs, or even a cat.

In other cases, people have vague visions that are blurry or shimmering. They might also have a sense that things in the room are floating.

Auditory Hallucinations

Similarly, the auditory (hearing) hallucinations in sleep paralysis can range from routine to bizarre.

Many people hear various noises, but hearing voices is the most common. The voices may sound like whispers, screams, or laughter.

Almost as often, people report hearing a loud buzzing or static noise. It sounds like a radio that's on but not tuned to a station. Some people hear breathing, footsteps, knocking, or a ringing sound.

People might hear unusual sounds like a horse carriage or growling.

The sounds heard aren't always specific. They can be hard to describe or remember.

Recap

During sleep paralysis, you might think you see something that isn't actually there. Sometimes it looks like a person, animal, or even an odd figure. You might also see flashes of color or light, or hear unusual noises like a buzzing or growling.

Tactile Hallucinations

Tactile hallucination is the experience of being touched when you're not. It's one of the most common aspects of sleep paralysis. Many people say they feel pressure or contact. It's like something or someone is holding them down.

Some people with sleep paralysis report tingling, numbness, or a vibrating sensation. Others describe a sense of floating, flying, or falling. A few people report feeling chilled or freezing.

Less often, people feel like they're being physically moved or dragged from their beds. Some people report feelings of sexual contact, including physical sensations involving their genital areas.

Other physical experiences that people have reported include: 

  • Sense of getting bitten
  • Bugs crawling on the skin
  • Breathing in the ear
  • An uncontrolled feeling of smiling

Olfactory Hallucinations

The least common hallucination in sleep paralysis is olfactory (sense of smell). Like the other types of hallucinations, the intensity of the smells ranges.

Recap

During sleep paralysis, you might smell things that aren't there or feel like someone or something is touching you when it's not.

Emotional Components

An important and lasting element of sleep paralysis is the emotional component.

For many, the experience of sleep paralysis is a waking nightmare. The dark figure you sense in the room seems to be an evil presence, intent on real harm. The stranger standing over you or sitting on top of you is up to no good, and so on.

Most people who experience sleep paralysis describe it as a scary, terrifying, horrifying, or frightening experience. This is often related to the hallucination of a stranger’s presence. Some people have a sense of impending doom, or the feeling that real harm or death is about to happen to them.

When you first experience sleep paralysis, it may feel like you had a stroke that resulted in locked-in syndrome. With this, you're conscious but unable to move anything except for your eyes.

Many people describe how real everything seems when it's happening. It's common for people to use the words "weird" and "strange" to describe their experiences.

People might summarize their sleep paralysis as shocking, worrisome, or disgusting. They may say it left them scared, angry, or helpless. Rarely, the experience actually feels comforting to some people. 

It may be helpful to have a better understanding of the symptoms of sleep paralysis. Knowing what's happening to you may give you comfort. For some people, it's enough to tolerate these infrequent episodes.

For others, this information can help end triggers of sleep paralysis. If these episodes are especially disturbing to you, there are effective treatment options. 

Summary

Sleep paralysis happens when there's a glitch in your sleep, usually between REM sleep and waking up.

During sleep paralysis, you might hallucinate and think you're seeing, hearing, smelling, or feeling something that's isn't actually there.

It can be a scary feeling, but it's usually not a sign of anything serious.

A Word From Verywell

Sleep paralysis doesn't always happen often. Once you understand what it is and why it happens, you might forget about it. If it doesn't go away, consider ways to optimize your sleep. Make sure you're getting enough sleep with a regular sleep pattern. Avoid alcohol in the hours before bedtime. It may also be helpful to try to sleep on your sides as much as possible.

In some cases, you might have to do a sleep study. This could find other factors that cause sleep fragmentation, like sleep apnea. If you need help, talk to a board-certified sleep doctor about your concerns.

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2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Olunu E, Kimo R, Onigbinde EO, et al. Sleep paralysis, a medical condition with a diverse cultural interpretationInt J Appl Basic Med Res. 2018;8(3):137-142. doi:10.4103/ijabmr.IJABMR_19_18

  2. Waters F, Blom JD, Dang-Vu TT, et al. What is the link between hallucinations, dreams, and hypnagogic–hypnopompic experiencesSchizophr Bull. 2016;42(5):1098-1109. doi:10.1093/schbul/sbw076

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