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Sleep Paralysis: The Demon on Your Chest, the Voices in the Dark

Posted by Puneet Patni, M.D. on Apr 5, 2017, 8:43:00 AM

Imagine you’re lying awake in bed when you sense a presence in the room. There’s something moving in the dark. “Who’s there?” you try to ask, but you can’t move your lips to speak. The figure approaches and as you begin to make out the figure, you realize it’s not human. Terrified, every fiber in your being wants to get up and run, but your body won’t move. You desperately try to scream for your life, but you can’t make a sound. There’s no escape.

Here’s the twist: This isn’t some spooky story – it’s an episode of sleep paralysis, in which the sufferer experiences paralysis of the body, usually accompanied by hallucinations, terror and a sense of choking or crushing pressure on the chest.

From the term “pinyin” (literally meaning “ghost pressing on body”) in Chinese culture to the Karabasan’s demonic visitation in Turkish belief and to the “Old Hag” who sits on victims’ chest in British and Anglo North American folklore, experiences of sleep paralysis have been described across the globe for centuries and are often attributed to an evil or demonic presence. Sleep researchers generally conclude that most cases of sleep paralysis simply indicate bumps in the transitional period between stages of the sleep cycle.

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Who Experiences Sleep Paralysis?

This mysterious and scary phenomenon is more common than you might think. In fact, about 40 percent of the population may suffer from sleep paralysis. Although people tend to discover the condition during their teens, anyone at any age can experience sleep paralysis.

While it is a possible symptom of other sleep disorders like narcolepsy, most people who suffer from sleep paralysis are not narcoleptic. If you have been unable to move or speak while falling asleep or waking up, you may have isolated recurrent sleep paralysis. Episodes may be linked to factors including lack of sleep, an irregular sleep pattern, sleeping on your back, certain medications (such as ADHD medicine) and substance abuse. Psychological factors such as stress, anxiety or bipolar disorder may also be tied to sleep paralysis.

How It Works

Sleep paralysis occurs during a transitional stage between wakefulness and sleep. It could happen either as you’re falling asleep (hypnagogic sleep paralysis) or as you’re waking up (hypnopompic sleep paralysis).

As you sink into deep sleep, your body and brain activity slows down until you enter the rapid eye movement (REM) sleep stage, which is when your most vivid dreams take place. As you transition into REM sleep, your brain prevents certain neurotransmitters from being released to induce a state of paralysis called atonia. This temporary state prevents you from acting out the physical movements in your dream-life so you don’t do dangerous things like sleepwalk down the middle of the street to keep your body safe while you sleep.

Normally, atonia ends along with the REM cycle, before you wake up. However, it’s possible for the brain to awaken while the body is still in atonia. People experiencing hypnopompic paralysis are in a transient conscious state, mentally alert but physically paralyzed. Inversely, hypnagogic sleep paralysis occurs when people remain or become mentally aware after their bodies have reached a state of paralysis.

Improving Your Sleep

Schedule an appointment with a Kelsey-Seybold Sleep Medicine specialist who may recommend a sleep study.

In most cases, sleep paralysis doesn’t need to be treated. However, if episodes are giving you anxiety or keeping you up through the night, it may be a good idea to consult with your doctor in case you need to be referred to a specialist. Alternatively, your doctor may want to learn more about your sleep pattern by conducting a sleep study or assigning you to keep a sleep diary to check for the possibility of another sleep disorder or other health problem. Treatments, when applicable, are usually aimed at underlying conditions and may include antidepressant medication to help regulate sleep cycles.

Before you call the Ghostbusters, there are steps you can try to minimize encounters with your night demons. Ensuring that you’re getting the proper amount of sleep is the best place to start. This will help alleviate stress, which may further reduce the likelihood of experiencing sleep paralysis. If you sleep on your back, try sleeping in a different position. If episodes persist, or if they are affecting your sleep and health at any point, then it may be time to talk to your doctor.

Patni_Puneet.pngDr. Puneet Patni specializes in Sleep Medicine and Pulmonary Medicine at Kelsey-Seybold. He cares for patients at Clear Lake Clinic, Main Campus, Pasadena Clinic and the Kelsey-Seybold Sleep Center. His clinical interests include sleep apnea, critical care outcomes, sepsis, medical informatics and obesity. He is board-certified in Internal Medicine and completed a fellowship in Pulmonary, Critical Care and Sleep Medicine.


Topics: sleep paralysis, atonia

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