The Quick Report

The Science Behind Night Terrors and Sleep Paralysis

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If you’ve ever suffered from night terrors or sleep paralysis, you understand what a dreadful experience it can be. We separate myths and fiction to deliver the science and facts to uncover the causes and how to stop it.

What Are Night Terrors?

Although night terrors, also called sleep terrors, are most common during childhood years, they can affect people of any age, according to Johns Hopkins.

Night terrors are a common sleep disorder described as waking quickly from sleep in a terrified state.

Although they are similar to nightmares, they differ in that nightmares typically occur during rapid eye movement (REM) sleep. They tend to be most common in the early morning. Conversely, night terrors usually happen during the first half of the night, typically during the first hours of stage 3-4 non-rapid eye movement (NREM) sleep.

How prevalent sleep terrors are among the population in general remains unknown. However, among children who experience night terrors, around 36.9% of them occur at 18 months of age, with 19.7% occurring at 30 months. For adults, the prevalence is much less, around 2.2%.

Diagnosis and Treatment

The good news is that treatment for infrequent sleep terrors is usually unnecessary, according to the Mayo Clinic. However, if you are having frequent night terrors, you should discuss them with your doctor. He may refer you to a sleep specialist who might prescribe an overnight study in a sleep lab. 

Should further treatment be necessary, a doctor may first choose to treat any underlying conditions. Your doctor will address any anxiety or stress issues you may have.

Another remedy that may be tried is known as “anticipatory awakening.” This involves waking a person fifteen minutes before the time they usually experience a night terror event.

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In other situations, a doctor may prescribe medication, but this is rare.

What Is Sleep Paralysis?

Have you ever had the experience of falling asleep (hypnogogic) or just waking up (hypnopompic) where you find yourself unable to move or speak? This terrifying situation is known as sleep paralysis. This brief loss of muscle control is known as atonia.

Episodes of sleep paralysis can last for a moment or several minutes. What makes it so terrifying is that the person is fully aware of what is occurring. The fear comes from the inability to move or stop the paralysis.

Records of sleep paralysis go back centuries. In ancient times, various cultures associated sleep paralysis with monsters, creatures, paranormal forces, or dark magic.

Luckily, sleep paralysis is usually only temporary. Most people only experience it once or twice in their lifetime. However, for some unfortunate people, it can recur often. Sleep paralysis has been linked to some sleep disorders and certain mental health conditions.

Sleep Paralysis and Hallucinations

According to sleep experts, sleep paralysis usually begins with a brief loss of muscle control just after falling asleep or just before waking up. Unfortunately, 75 percent of sleep paralysis episodes involve hallucinations. The hallucinations fall under three categories.

  • Intruder hallucinations: The perception that a dangerous person or presence is in the room.
  • Vestibular-motor (V-M) hallucinations: Perceptions of movement or out-of-body experiences. Someone may also have the sensation of flying.
  • Chest pressure hallucinations: Feelings of suffocation or that someone is sitting on or putting pressure on your chest. These types of hallucinations also frequently occur in tandem with intruder hallucinations.

Frequency of Sleep Paralysis

Researchers estimate that roughly 20% of people experience sleep paralysis at some point in their life. Symptoms most often show up in childhood, adolescence, or young adulthood. However, episodes may occur more frequently when a person is in their 20s and 30s.

Types of Sleep Paralysis

Medical and sleep experts typically group sleep paralysis into two distinct categories.

  • Isolated sleep paralysis: These are one-off episodes of sleep paralysis that are not connected to an underlying diagnosis of narcolepsy. Narcolepsy is a neurological disorder that prevents the brain from controlling wakefulness. This condition can often lead to sleep paralysis.
  • Recurrent sleep paralysis: This is when someone has multiple sleep paralysis episodes over time. Recurrent sleep paralysis can also be associated with narcolepsy. 

What Causes Sleep Paralysis?

Although the exact mechanism or cause of sleep paralysis is unknown, studies have revealed certain factors that increase the risk of experiencing sleep paralysis. Overall, studies have had mixed results. Nonetheless, sleep experts have found four factors that are most commonly involved in the onset of sleep paralysis.

Narcolepsy

Narcolepsy can alter the function of neurotransmitters in the brain, which may cause complications during REM sleep. Researchers have found that episodes of sleep paralysis occur more frequently in those who have narcolepsy.

Existing Sleep Disorders

People who have existing sleep disorders, such as obstructive sleep apnea (OSA), tend to have higher rates of sleep paralysis. Those who suffer chronic insomnia, circadian rhythm dysregulation, or nighttime leg cramps, are also more commonly prone to sleep paralysis.

Mental Health Disorders

Medical experts have connected certain mental conditions to sleep paralysis. The strongest associations were found with post-traumatic stress disorder (PTSD). Connections are also common with those who suffer from certain anxiety disorders, such as panic disorder.

Suddenly Stopping Alcohol or Antidepressants

Those who abruptly stop the use of alcohol or antidepressants can cause REM rebound, which may cause sleep paralysis.

How to Stop Sleep Paralysis

While there is no definitive method for stopping sleep paralysis, researchers have found various techniques that can be effective.

One study showed a 54 percent reduction in recurrent sleep paralysis episodes by participants who engaged in meditation and relaxation techniques at home. They also reduced hallucinations by 34 percent.

It’s also helpful to try sleeping on your side. Sleeping on one’s back triggers sleep paralysis in most people.

Stopping Sleep Paralysis Within the Moment

Sleep experts recommend various techniques that can help you escape or get out of sleep paralysis within the moment it is occurring.

  1. The first step is to remain calm and concentrate on your breathing. Resist the urge to panic.
  2. A common technique is to focus on a small muscle, such as a finger, thumb, or toe. Focus on that one muscle and try to wiggle or move it. Next, try to wiggle your toes and fingers at the same time.

When to Get Help for Sleep Paralysis

Sleep paralysis is not considered dangerous for most people. However, it’s estimated that roughly 10 percent of people have recurrent or unpleasant episodes of sleep paralysis.

If you are having trouble with recurrent sleep paralysis you may want to consider seeing a sleep specialist — someone who is a board-certified physician, most commonly a neurologist.

Habits for Better Sleep

There are a few things you can do that could help you achieve better sleep and potentially reduce your episodes of sleep paralysis.

  • Establish sleep routine: Create and follow a sleep schedule, including on weekends. Engage in a pre-bed routine to help you relax.
  • Remove distractions: Disconnect from electronic devices and smartphones for at least an hour before bed.
  • Decrease usage of certain substances: Reduce your consumption of alcohol and caffeine, particularly in the evening.
  • Optimize your space for sleep: Make sure you have a comfortable bed and pillow. Reduce the intrusion of light and noise into your sleeping space.