Sleep Paralysis: diagnostics, prevention and treatment

Justė Gaižauskaitė1, Laura Grincevičiūtė1 

Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania



Sleep paralysis is a sleep disorder that is defined as a transient paralysis of the whole body that occurs during the rapid eye movement (REM) sleep. The prevalence of sleep paralysis is about 8% in the general population, but data from individual studies indicates that between 2% and 60% of people have experienced sleep paralysis at least once in their lifetime [4,5]. It is characterized by an atonement of the whole body’s muscles, while ocular and respiratory movements remain unaltered, and perception of the immediate environment is clear [2]. Most of the episodes of sleep paralysis occur together with hallucinations that can occur in three different types [7]. Risk factors for this sleep disorder include poor sleep quality and hygiene, insomnia, sleep deprivation and circadian rhythm disorders, obstructive sleep apnea, obesity, hypertension, alcohol consumption and smoking. It has been found that most of the episodes of sleep paralysis are associated with poor psychological condition, while anxiety disorders, panic attacks and post-traumatic stress syndrome are important factors for its etiology [4,7-9].

Currently there is no “gold standard“ measure of sleep paralysis. For successful diagnosis, it is important to find out all the complaints, as well as to analyze the risk factors and anamnesis vitae [8]. It may also be helpful to use the established questionnaires to help identify this phenomenon, for example “Fearful Isolated Sleep Paralysis Interview”. Differential diagnosis: narcolepsy, hypersomnia, insomnia, focal epilepsy seizures, cataplexy, post-traumatic stress syndrome, schizophrenia, panic attacks. [2, 8]. Most important measures for managing this condition are the quality of sleep, its hygiene, changes in sleeping posture and other possible prevention methods. If necessary, treatment measures may be applied that can contribute to the prevention of sleep paralysis, such as treatment with SSRIs (Flouxetine, Femoxetine, etc.) or tricyclic antidepressants (Clomipramine, Imipramine, etc.), as well as cognitive behavioral therapy [4, 11]. This article also describes the proposed method of cessation of sleep paralysis, using a self-oriented meditation method with muscle relaxation, which is divided into four stages.

The purpose of this literature review is to introduce the latest articles on sleep paralysis and to draw attention to this phenomenon.

Keywords: Sleep paralysis; Parasomnia; Risk factors; Prevention