Frozen in fear: Sleep paralysis is more common than you think

Three or four nights a week, Ashleigh Crisafi wakes up paralysed and in utter terror.

“I can blink, but otherwise can’t move a muscle and can’t speak,” says the 29-year-old. “I’m enveloped by this overwhelming sense of fear. All I can do is lie there, too scared to move, like a kid hiding under a blanket, but also desperate to move.”

Some sleep physicians estimate most people will experience sleep paralysis at least once in their lives, yet it remains widely under-researched. Credit: Compiled by Marija Ercegovac.

The Melburnian has experienced this phenomenon since she was a child, and was formally diagnosed with sleep paralysis in 2016 – at its worst, it can disrupt half her week’s slumber. She also has parasomnia, in which undesirable events such as nightmares disrupt the sleep, and insomnia, a condition that makes it difficult to fall and remain asleep.

Aaron Schokman, a 33-year-old research fellow from Sydney, also experiences sleep paralysis, though his is paired with narcolepsy, a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles.

“I feel really heavy, but I’m still able to process the things around me,” he says. “I also sometimes see things in the room that aren’t actually there, like someone walking towards me or sitting on the end of my bed. It can make you feel like you’re going crazy.”

“It can make you feel like you’re going crazy”: Aaron Schokman says he sometimes hallucinates while experiencing sleep paralysis.Credit: Louie Douvis

According to a study in Sleep Medicine Reviews, about 7 to 8 per cent of the general population has experienced sleep paralysis at some point, though other individual studies estimate it varies between 2 and 60 per cent. Research on the condition and its prevalence remains limited, leaving some unsure of what they’re experiencing, and how to manage it.

What causes sleep paralysis?

Danny Eckert, director of the Adelaide Institute for Sleep Health, says sleep paralysis usually occurs while falling asleep or waking up.

“The muscles naturally get switched off so that we don’t act out our dreams. In sleep paralysis, the switch gets ‘stuck’, such that the signals from the brain to the limb muscles are still switched off, but the cortex is awake.”

The paralysis is often paired with “hypnopompic hallucinations”, says Sleep Health Foundation chief executive Dr Moira Junge, referring to the state between dreaming and being fully awake.

“Seventy-five per cent of sleep paralysis experiences involve hallucinations, or the feeling that someone is in the room when they’re not. There are also reports of difficulty breathing or chest pressure.”

Frequent sleep paralysis can lead to extreme tiredness during the day, and even a fear of falling asleep.Credit: iStock

Sleep paralysis can be associated with other sleep conditions, Junge says, including parasomnia, sleep apnoea and narcolepsy, and can sometimes run in families. It can also be triggered by high blood pressure, conditions such as PTSD or anxiety, and substance misuse. Sleep physician Dr David Cunnington says jet lag can be a trigger.

However, Junge notes it’s often unrelated to any abnormalities or triggers. “It can just happen.”

Can it have a long-term impact?

Frequent sleep paralysis can increase tiredness during the day, Cunnington says, as well as causing significant anxiety over sleep.

“You have no control over it, so it can quickly establish a fear response. People can become very fearful of going to sleep and fearful of sleeping in dark places,” he says.

For Crisafi, it can often feel like a vicious cycle: the more she experiences sleep paralysis, the more anxious she becomes before going to sleep, which merely increases the chance of paralysis occurring.

Sleep conditions are relatively under-researched. Schokman says there’s often a stigma associated with it, making it difficult to speak about with loved ones and colleagues.

“If something affects your sleep, it’s barely spoken about,” he says. “It’s almost like there’s something wrong with you if you’re tired. Sleep is usually tied to how productive you are. Everyone has their own perception of sleep, so it can be a big hurdle to overcome, especially in relationships.”

Are night terrors a form of sleep paralysis?

Put simply, no.

“Night terrors often occur within the first hour or so of sleep, in the stage of deep sleep known as Non REM stage 3,” Junge says. “The person experiencing night terrors has no recall of it. The person experiencing sleep paralysis is very aware of it, and it occurs at the transition into or out of sleep, the stage known as Non REM stage 1.”

They present differently too. Those experiencing sleep paralysis feel as though they cannot move, whereas those experiencing night terrors often scream, thrash around, sit up, or jump out of bed.

However, Junge says they both fall under the “parasomnia” umbrella, which describes abnormal experiences that occur while a person is sleeping, falling asleep, or waking up. They can also occasionally share similar triggers, such as sleep deprivation and stress or anxiety.

Are there ways to manage it?

Keeping a regular sleep schedule and getting enough sleep can reduce the risk of paralysis, Eckert says. The same goes for treating underlying medical conditions, including other sleep disorders.

It can be difficult to break out of sleep paralysis while it’s happening, Schokman notes. However, he finds that trying to wiggle a toe or finger can ground him and help him slowly ease back into control.

The medications that Schokman and Crisafi take for other conditions appear to reduce the frequency of their sleep paralysis. Schokman notes individuals may react differently to medication, and there’s currently no medication solely for managing sleep paralysis.

General coping strategies may differ, Crisafi says. For example, she found that watching Shrek before bed soothes her. She has also been seeing a sleep psychologist since 2017, having therapy for eye movement desensitisation and reprocessing.

“We map out the nightmares and sleep paralysis,” she says. “You basically put yourself in the dream, and try to change the narrative, or control your emotions while in a safe space.”

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