Learn about sleep paralysis
The girl who was too afraid to sleep
Ann (name changed), a 24year-old software engineer, consulted me a year ago. When she walked through my clinic door, I saw an anxious, fatigued girl, who came in with her mother. Right from the start of the encounter, it was clear that she had little hope of being listened to, having a "why should I even bother telling you what I'm going through, when I know you will think I'm crazy" look on her face. Yet, being prodded by her mother, she told me that she was terrified of falling asleep. Almost every single night, especially at the start of the night, she would wake up with a sense of impending doom. She would be awake, with a clear awareness of her surroundings, with a feeling of a weight placed on her chest, and an inability to move any part of her body to overcome or resist the feeling. She would feel suffocated, would break out into a cold sweat, and feel overwhelmed by the helplessness of her situation. She would feel a presence in her room, being unable to clearly define the shape or form of the presence. She would sometimes start screaming hysterically, being eventually calmed by her parents, who would rush to the sound of her screams. These were the better nights; the worse nights were the ones in which she would want to, but be unable to scream, or sometimes even open her eyes. These episodes, according to her mother, would typically last a couple of minutes, but to Ann, they seemed like forever.
What is sleep paralysis?
Sleep paralysis has been defined by the International Classification of Sleep Disorders (ICSD-3) as “a disturbing temporary inability to perform voluntary movements at sleep-wake transitions. Despite being awake and conscious of the sleeping environment, it is impossible for subjects to move their limbs or even open their eyes. The experience can last for several minutes. Other symptoms can include blurred vision, and double vision.” Hallucinations can accompany the paralysis in 25-75 per cent of such episodes. Among hallucinations, three themes appear common: intruder hallucinations (sense of an evil or malevolent presence in the room), incubus hallucinations (being suffocated or choked), and vestibular hallucinations (the out-of-body, or floating experiences).
Why does sleep paralysis occur?
Sleep is divided into the lighter non-rapid eye-movement (NREM) sleep, and the deeper REM sleep. REM sleep, the stage in which dreams occur, is characterised by a complete paralysis of the voluntary muscles of the body, which prevents an individual from acting out one's dreams and harming oneself. Sleep paralysis is thought to occur due to a REM-intrusion into wakefulness, i.e. the body is still in REM sleep, while the brain has woken up.
How common is sleep paralysis?
The prevalence of sleep paralysis in India is unknown, as sleep medicine is an underresearched faculty in India. Most international studies have reported that around 8-10% of the general population reports at least one episode of sleep paralysis in their lifetime.