Sleep paralysis

Sleep paralysis is fairly common. Many people have at least one episode during their lifetimes.

The exact cause of sleep paralysis is not fully known. Research shows the following are linked to sleep paralysis:

• Not getting enough sleep
• Having an irregular sleep schedule, such as with shift workers
• Mental stress
• Sleeping on your back

Certain medical problems can be associated with sleep paralysis:

• Sleep disorders, such as narcolepsy
• Some mental conditions, such as bipolar disorder, post traumatic stress disorder (PTSD), and panic disorder
• Use of certain medicines, such as for attention deficit hyperactivity disorder (ADHD)
• Substance use

Sleep paralysis that is not related to a medical problem is known as isolated sleep paralysis.

The normal sleep cycle has stages, from light drowsiness to deep sleep. During the stage called rapid eye movement (REM) sleep, your eyes move quickly and vivid dreaming is most common. Each night, people go through several cycles of non-REM and REM sleep. During REM sleep, your body is relaxed and your muscles don't move. Sleep paralysis occurs when the sleep cycle is shifting between stages. When you wake up suddenly from REM, your brain is awake, but your body is still in REM mode and can't move, causing you to feel like you're paralyzed.

Episodes of sleep paralysis last from a few seconds to 1 or 2 minutes. These spells end on their own or when you are touched or moved. In rare cases, you can have dream-like sensations or hallucinations, which may be scary.

Your health care provider will ask about your symptoms, focusing on your sleep habits and things that may affect your sleep. You may be asked to fill out a questionnaire about your sleep to help your provider reach a diagnosis.

Sleep paralysis can be a sign of narcolepsy. But if you do not have other symptoms of narcolepsy, there is usually no need to have sleep studies done.

In most cases, sleep paralysis occurs so rarely that treatment is not needed. If the cause is known, for example, due to lack of sleep, correcting the cause by getting enough sleep often resolves the condition.

Sometimes, medicines that prevent REM during sleep are prescribed.

In people with mental health conditions, such as anxiety, medicine and behavioral therapy (talk therapy) to help treat the mental health condition may resolve sleep paralysis.

Discuss your condition with your provider if you have repeated episodes of sleep paralysis. They may be due to a medical problem that needs further testing.

Parasomnia - sleep paralysis; Isolated sleep paralysis

American Academy of Sleep Medicine. Sleep education: sleep paralysis. sleepeducation.org/sleep-disorders/sleep-paralysis/. Updated August 2020. Accessed April 27, 2023.

Sharpless BA. A clinician's guide to recurrent isolated sleep paralysis. Neuropsychiatr Dis Treat. 2016;12:1761-1767. PMCID: 4958367 www.ncbi.nlm.nih.gov/pmc/articles/PMC4958367.

Vaughn BV, Basner RC. Sleep disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 374.

Updated by: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutgers New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.