What it’s really like to have sleep paralysis

Imagine this: You wake up from sleep and you notice that your bedroom is filled with smoke. You get up and open a window, but as soon as you try to climb through to safety, you can’t move anymore. That’s how Diego Villena, editor of the sleep review site Dozy Owl, describes living with sleep paralysis.

“You see salvation, you see normalcy, but you feel trapped in the smoky cloud of fear,” he says.

Sleep paralysis is a condition where people wake up shortly after falling asleep or near the end of their sleep cycle and find they can’t move or speak. At the same time, they’re often having scary hallucinations.

Sometimes Villena senses the presence of a deceased loved one. But instead of it being a comfort, it’s something evil and sinister, he says. Not surprisingly, he considers the hallucinations to be the most troubling part of sleep paralysis.

“Oddly enough, it’s not the sensation of being paralyzed that’s scary but the frame of mind you’re in when you experience it,” he says. “A night with sleep paralysis is going in and out of the same dream, blurring the line between what’s real and what’s not.” And when the sleep paralysis episode is done, Villena says he’s left with a haunting, lingering dread.

Sound like a nightmare you want to avoid? Us too. That’s why we called on sleep experts to explain why this common experience happens — and how to treat it.

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What is sleep paralysis?

During the night, you toggle between 2 main sleep phases: non-REM sleep and REM sleep. (REM stands for rapid eye movement.) Non-REM sleep is when you sleep deeply. This is the phase when your body builds bone and muscle and repairs tissue.

When you enter REM sleep, your brain activity increases. It’s when you process the day’s events and log memories into long-term storage. REM sleep is also when you have intense dreams.

Even though your brain is active during REM sleep, you still don’t have control over your arms and legs. And that’s a good thing. It helps keep you from acting out your dreams, according to the American Academy of Sleep Medicine (AASM).

Sleep paralysis happens somewhere between being fully awake and REM sleep. You’re still aware of your surroundings, but you can’t move. That’s why it typically happens when people are falling asleep or waking up.

Chicago resident Carly Newman, who started experiencing sleep paralysis a few years ago in her mid-20s, says the only thing she can control during sleep paralysis is her breathing. “I’ve tried screaming and no one hears me. I try to move my limbs and I can’t,” she says. “I can change my breathing, but fast breathing only worked 1 time for someone to notice and wake me up.”

These episodes can last for seconds or minutes, according to the AASM. Episodes typically end on their own. But they can also end if someone touches you or speaks to you.

“Some people may experience sleep paralysis only once or twice in their lives, while others may experience it a few times a month or even more regularly,” says Joshua Tal, PhD. Tal is a psychologist in New York City who specializes in sleep issues. Though these episodes are scary, they aren’t inherently harmful.

What causes sleep paralysis?

The exact cause of sleep paralysis is somewhat of a mystery. But often there’s a connection to a sleep disorder such as sleep apnea or narcolepsy. (For more on sleep apnea, read our beginner’s guide.)

Sleep paralysis is actually a symptom of narcolepsy, a neurological disorder in which the brain has a hard time controlling the sleep-wake cycle, Tal says. Many people who have narcolepsy also experience sleep paralysis.

According to the National Library of Medicine, other factors that are connected to sleep paralysis include:

• Insomnia or not getting enough sleep
• Disrupted sleep cycles caused by travel or night-shift work
• Mental health issues such as anxiety or post-traumatic stress disorder (PTSD)
• Sleeping on your back
• Use of certain medications, such as those for ADHD (this is what it’s like to have ADHD as an adult)

Stress and substance abuse (especially alcohol) can also trigger sleep paralysis, Tal says.

How is sleep paralysis treated?

There is no direct treatment for sleep paralysis. Instead, your health care team might treat the sleep or mental health issues that are causing the sleep paralysis.

“The first step would be ruling out narcolepsy through a diagnostic review or a sleep study,” Tal says. If someone doesn’t have narcolepsy but they have stress, anxiety or PTSD, seeing a therapist and trying cognitive behavioral therapy might help, adds Tal.

Healthy sleep habits also can go a long way toward preventing a sleep paralysis episode.

And that starts with paying attention to — and avoiding — your triggers, says Newman. “It happens when I’m too hot,” she says. “It also happens to me when I’m lying on my back. Now I always try to sleep on my side.”

Newman also knows she has to follow a very predictable sleep schedule. She estimates that 50% to 70% of her sleep paralysis episodes happen when she oversleeps by at least an hour. “I’m very careful now never to oversleep because sleep paralysis is very stressful,” she says.

The Centers for Disease Control and Prevention recommends these healthy sleeping tips:

• Go to bed and wake up at the same time every day.
• Follow a relaxing and comforting bedtime routine every night.
• Avoid alcohol and caffeine, especially at night.
• Remove electronic devices, including cellphones and computers, from the bedroom.
• Be physically active during the day.

Try to keep your bedroom “quiet, cool and dark, and reserved for sleep only,” adds Tal. These are pretty typical better-sleep tips, and you hear them often because they work.

Tal has another one, though, for people with sleep paralysis: He recommends keeping a “grounding” item near your bed to “help you feel safe and secure during an episode.” This could be a calendar or something comforting such as a family photo.

Anything you can do to improve your mindset near bedtime is also worth trying.

“Find ways to vent the day’s stressors before getting into bed, be it exercise, meditation or simply applying yourself to a hobby, game or craft,” says Villena. “Do everything you can to set yourself up for a good night’s rest.”

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