Sleep Disorders Insomnia & More Disorders Print Sleep Paralysis Overview Medically reviewed by a board-certified physician Written by facebook twitter Written by Brandon Peters, MD Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial policy Brandon Peters, MD Updated on November 21, 2019 Blend Images - JGI / Jamie Grill / Brand X Pictures / Getty Images More in Sleep Disorders Insomnia & More Disorders Symptoms Causes & Risk Factors Diagnosis Treatment Living With Sleep Apnea Healthy Sleep Habits In This Article Table of Contents Expand Symptoms Causes Treatment View All Back To Top Sleep paralysis sounds unbelievable: As you lie in bed, trying to fall asleep or just beginning to wake, you feel like someone is standing over you. You try to move your head to look, but you can't. It feels like someone – or something – is holding you down. You try to thrash your arms and legs, but you are frozen in place. Sheer panic washes over you and you may even fear you will die (or that you're already dead!). Though this may sound like a scene from a horror movie, sleep paralysis is a very real experience. While it can be terrifying, it's not harmful. Here's everything you need to know about what causes sleep paralysis, how it can be managed, and what you can do if you experience it. Sleep Paralysis and Night Terrors Symptoms By definition, sleep paralysis refers to the transient inability to move or speak as you go from sleep to wakefulness without symptoms of narcolepsy. If you have experienced something similar while awake, you are familiar with the unforgettable horrors of sleep paralysis. Sleep paralysis can occur when awakening (hypnopompic) or when falling asleep (hypnagogic), though the latter is more common in narcolepsy. One reason people may be more likely to experience sleep paralysis closer to the morning is that this is when rapid eye movement (REM) sleep, which is associated with vivid dreaming, predominates. There are some common features that characterize sleep paralysis, including: Eye movements are typically preservedOccurs more often when sleeping on the backVisual and auditory hallucinations frequently occur (such as sensing an "evil presence," a feeling of being touched hearing voices or noises in the room, or seeing people or faces at the bedside)Feeling of breathlessness or chest pressure, like someone standing or sitting on the chest (however, the diagram is still functional during sleep paralysis so breathing is possible) Common Symptoms of Sleep Paralysis Prevalence Sleep paralysis typically occurs in people in their 20s and 30s, but someone may have had their first episode as a teen. People with certain medical or mental health conditions may be more likely to report episodes of sleep paralysis. Several studies have proposed sleep paralysis has a strong genetic component and may run in families. Sleep paralysis is believed to be fairly common. A 2011 review of the literature estimated that around 7% of people have experienced sleep paralysis. The study also noted that reported rates were higher in students (28%) and people with panic disorder (34%). A 2018 study published in the online supplement to the American Academy of Sleep Medicine and the Sleep Research Society's journal Sleep found that sleep paralysis was commonly reported by student-athletes. The study also found that that reports of sleep paralysis from students were strongly associated with depression. Causes Sleep paralysis is thought to be precipitated by sleep deprivation, stress, and sleep schedule disruption. It's also been associated with anxiety disorders (which can lead to lighter or fragmented sleep and insomnia). In experiments, sleep paralysis has been shown to occur with disruption of rapid eye movement (REM) or dream sleep. Although there may be specific triggers, sleep paralysis is believed to be a problem with the regulation of REM. During this phase of sleep, the body is kept relaxed so that dreams are not physically acted out. When this type of relaxation (called atonia) occurs while a person is awake, it can cause temporary paralysis. Other elements of vivid dream sleep can also persist into wakefulness and may be experienced when the REM period is disrupted. Obstructive sleep apnea can trigger awakenings when breathing is disrupted, which in turn may result in an episode of sleep paralysis. The association may also explain why sleep paralysis is more likely to occur when someone is sleeping on their back. The presence of other symptoms of sleep apnea such as snoring, teeth grinding (bruxism), witnessed pauses in breathing, gasping or choking, daytime sleepiness, and frequently waking to urinate at night (nocturia) would suggest the condition as an underlying cause. Causes and Risk Factors of Sleep Paralysis Treatment While it can be a truly terrifying experience, sleep paralysis is harmless. It will come to an end within a few minutes, either when someone goes back to sleep or fully awakens. Most people find they are able to cope after getting reassurance that they aren't in any danger. People who experience sleep paralysis don't typically have it frequently. When they do, the cause is usually relatively benign and there are no serious risks. Though these episodes may be frightening and a person might even be afraid of dying during them, sleep paralysis is not harmful and generally resolves on its own without treatment. If you're prone to episodes of sleep paralysis, avoiding sleep deprivation, stress, and following other sleep hygiene guidelines may be helpful. How to Fix Your Sleep Hygiene In rare cases, people may suffer from repeated episodes and find they are unable to tolerate the associated psychological distress. Medications that suppress the REM cycle of sleep, such as selective serotonin receptor inhibitors (SSRIs), sometimes help. It's important that you are evaluated by your doctor to address any sleep, mental health, or other medical disorders that can disrupt sleep. For example, having a condition like sleep apnea or narcolepsy. If you have multiple or recurring episodes of sleep paralysis and these strategies don't effectively address your distress, your doctor might refer you to a board-certified sleep specialist or have you do a sleep study. A Word From Verywell Sleep paralysis can be terrifying while it's happening, but the experience is harmless and won't cause any lasting harm. However, if it's causing you distress, talk to your doctor about the possibility of medication or seeing a sleep specialist. Most people who experience sleep paralysis don't need any specific treatment, but good sleep habits can help. Some people find mindfulness practices and muscle relaxation techniques helpful for coping with sleep paralysis. When you experience sleep paralysis, focus on trying to relax your mind. Reassure yourself that you are aware of what is happening, that it is not real, that you are not in any danger, and that the sleep paralysis will soon resolve. Some people even like to engage in the experience, such as by pretending they're an actor in a scary movie. This can give you a sense of control over an experience that can otherwise make you feel powerless. If you can reassure and distract yourself enough to fall back asleep, the experience will quickly end. The mind is a strange and powerful thing, and sleep paralysis is another manifestation of its wondrous abilities. Awake or Asleep? The Paradox of False Awakenings Was this page helpful? Thanks for your feedback! Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Sleep Medicine. Sleep Paralysis - Overview And Facts. Sleep Education. Published 2019. Sehgal A, Mignot E. Genetics of Sleep and Sleep Disorders. Cell. 2011;146(2):194-207. doi:10.1016/j.cell.2011.07.004 Sharpless BA, Barber JP. Lifetime prevalence rates of sleep paralysis: A systematic review. Sleep Medicine Reviews. 2011;15(5):311-315 doi:10.1016/j.smrv.2011.01.007 Liu S, Athey A, Killgore W, Gehrels J, Alfonso-Miller P, Grandner M. 0964 Sleep Paralysis and Hypnogogic/Hypnopompic Hallucinations: Prevalence in Student Athletes and Relationship to Depressive Symptoms. 2018;41(suppl_1):A358-A358. doi:10.1093/sleep/zsy061.963 Sharpless B. A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatric Disease and Treatment. 2016;Volume 12:1761-1767. doi:10.2147/NDT.S100307 National Sleep Foundation. What Causes Sleep Paralysis During REM Sleep? Published 2019. Leschziner G, Howard RS, Williams A, Kosky C. CP4 Isolated sleep paralysis as a presenting feature of obstructive sleep apnoea. Journal of Neurology, Neurosurgery & Psychiatry. 2010;81(11):e34-e34. doi:10.1136/jnnp.2010.226340.69 U.S. National Library of Medicine. Sleep Paralysis - MeSH Database. National Center for Biotechnology Information. Originally published 2000. Jalal B. How to Make the Ghosts in my Bedroom Disappear? Focused-Attention Meditation Combined with Muscle Relaxation (MR Therapy)—A Direct Treatment Intervention for Sleep Paralysis. Front Psychol. 2017;7. doi:10.3389/fpsyg.2016.00028 Additional Reading American Sleep Association. Sleep Paralysis: Causes, Symptoms And Treatments. Sleep Disorders. Published 2019. Denis D. Relationships between sleep paralysis and sleep quality: current insights. Nature and Science of Sleep. 2018;Volume 10:355-367. doi:10.2147/NSS.S158600 Loddo G, Provini F. Sleep Paralysis. MedLink Neurology. Updated May 5, 2019. Continue Reading