Sleep Paralysis 101: Why It Happens & How to Cope

Foreign. Hey there everybody, and welcome to this presentation on sleep paralysis. It's actually more common than you might think. I'm your host, Dr. Donnelly Snipes. What is sleep paralysis? Just like it sounds, it's awakening from sleep and not being able to move because REM paralysis or REM atonia is still engaged. When you're in the REM stage of sleep, your body goes through this process paralysis sort of stage. They call it atonia that prevent you from acting out your dreams. But for some people, when they leave the REM stage, that paralysis persists for a few seconds or even a few minutes. Prevalence in studies indicate that about 30% of people will experience sleep paralysis at some point in their lifetime. So it is more prevalent than we used to think. The statistics used to say it was about 7%. Now they're saying it's about 30%. So what do you need to know? There are a lot of guesses about what causes sleep paralysis. Unfortunately, they don't know for sure. What they have found is there are correlations. That means when this, when something happens, then there's a greater chance of having sleep paralysis episodes. There is a correlation between sleep paralysis and disrupted circadian rhythms. So if your circadian rhythms are out of whack because of an irregular sleep schedule, because of shift work or just poor sleep hygiene, you don't prioritize getting good quality sleep, you are at greater risk for sleep paralysis. Sleep deprivation, which kind of goes along with disrupted circadian rhythms. But if you're not getting sleep because you're afraid to go to sleep after having a sleep paralysis episode, or you've got insomnia for some reason, or maybe you're staying up for days on end studying or doing a project put you at greater risk for sleep paralysis. If you sleep on your back, you actually may be at greater risk for sleep paralysis. Now, I know a lot of people are like, well, I've always been told to sleep on my back. Well, for some people it's not a problem. For others, it may contribute to sleep paralysis. And if that's you, then you may want to consider a slide sleeping position. Chronic pain, it's associated with sleep paralysis. Why? Well, they hypothesize a couple of things. Number one, when you have chronic pain, you have systemic inflammation and your stress response is, is activated most of the time, which can, when your stress response is activated, it means you're not getting that good quality sleep. So that could contribute to it. What we see as an increase in sleep paralysis in those with chronic pain, other Sleep disorders, including narcolepsy or obstructive sleep apnea also increase risk of sleep paralysis. What do we see is similar in, in all of these things that we've talked about? A lack of adequate quality sleep. And when that happens, the, and the stress response kicks off and the hormones get out of whack. People are at greater risk of sleep paralysis. Anxiety disorders, a trauma history, PTSD or CPTSD are also risk factors. Why? Well, all of these are associated with feeling unsafe and powerless, which increase the stress response and keep people from being able to fully relax and get good quality sleep. And finally, they always have to throw this in. Here is genetics. There is something of a genetic component. If nobody in your family has ever had sleep paralysis, it doesn't mean that you won't. But if people in your family have had sleep paralysis, you do have a greater chance of experiencing episodes. So what do you do about it? Sleep position. Try side sleeping and see if that helps address underlying sleep and mood disorders. In order to help regulate your circadian rhythms. In order to prevent sleep sleep paralysis, we need to get your sleep architecture set. We need to improve your circadian rhythms and improve your body's ability to smoothly move through those stages of sleep, which means reducing your stress level so you can relax, so you can feel safe, so you can get that good quality sleep. So address those underlying sleep disorders. If you've got sleep apnea, then stopping breathing multiple times during the night, that's stressful. If you have anxiety, ptsd, cptsd, depression, any of those things that keep your stress up, it's going to keep you from relaxing enough to get good quality sleep. Stabilize your circadian rhythms. This is something practical that you can do, kind of like trying side sleeping. Set a time that you're going to go to bed every night and create a routine that cues your body in an hour before bed, take a shower, then read a book or meditate or play music or whatever it is you want to do. Something calming to help you get ready for bed and then go to sleep. So really focus on good sleep sleep hygiene. Reduce or eliminate stimulants, including nicotine, caffeine, etc, afternoon, so those substances have a chance to get out of your system by 10 o' clock or so at night. Ensure your blood alcohol is zero at sleep time. If you're going to drink, make sure that when you go to sleep, your blood alcohol is zero. If you have alcohol in your system when you sleep, you, you may fall as when you fall asleep, you may fall asleep quickly, but as that alcohol leaves your system, it's going to trigger that stress response, which puts you at risk for sleep paralysis. Now, dealing with it, once you've had a sleep paralysis episode, it can be terrifying to go back to sleep. So one of the things we need to do is reduce anticipatory anxiety. If somebody's had an episode, we need to help them recognize how many other days they went to sleep and woke up and didn't have any problems. After they have an episode, we want to help them notice how many days they go before their next episode, if they have another one. For a lot of people, it only happens once, but for people, there are some people who have it repeatedly and noticing the difference. I have a heart condition called supraventricular tachycardia. And they don't exactly know what causes it to kick off, but when it kicks off, my heart rate goes up to like 200, 220 beats a minute. I feel like I'm gonna die. It's terrifying. And the doctor says, oh, don't worry about it. Nobody's. Very few people have ever died from this. You'll be fine. Well, it's terrifying. So my heart's already racing and I'm like, crap. Actually, I use much more poignant words. But when it happens, I used to get stressed out. I used to start fearing that I was going to die. So I worked myself up into a panic attack on top of the ventricular tachycardia. And it was like, okay, that's not good. I had to learn when I experienced that to say, well, crap on a cracker. And for me, the only way that I found to stop them is to lay on my back with my feet up in the air, which isn't really conducive if you're in the store. I've had to go out to the. To the car and lay in the back seat of my car and put my feet up. But my point being, I learned to recognize it and I learned to accept it instead of fighting against it. There was a period there for a couple of years. I was afraid to go out in public, not. And even afraid to go down to my garden. It wasn't agoraphobia. It wasn't like I was afraid if I left my house, something bad would happen. I was constantly afraid I was going to have an episode. And it was. It took a while before I started feeling confident enough that, okay, if this happens, I know how to make it stop. I am empowered to make it stop. And that was helpful for Me knowing, hearing from my doctor that most of the time this is not gonna, you know, cause you to actually have a heart attack, that was helpful too. But knowing that, okay, if I do this one thing, it will pass, or if I wait a certain period of time, it will pass, helped me feel better. So reducing anticipatory anxiety by recognizing it doesn't happen every night, hopefully creating a safe environment. So if you do wake up and you are experiencing sleep paralysis, you are not feeling completely terrified, unsafe and powerless. You're awake, your brain's going, and you can tell yourself, I'm at home, I'm safe, nothing's gonna hurt me. This will pass in a minute. Whatever distress tolerant self talk script works for you is going to be important. As I mentioned earlier, I have a distress tolerance selft talk script when my SVT's kick off because I know that if I get stressed, it's just going to make everything worse and make it last longer. Now that's not to say that it isn't terrifying. You know, I'm, I'm not. When my heart, heart rate starts racing, especially if it doesn't immediately start getting better as soon as I lay down, it's anxiety provoking. It feels terrifying. However, I have to unhook that feeling from what's going on and say, okay, if I continue to spiral, I may continue to make this worse. Some articles Harvard Health suggested, if you wake up and you're experiencing sleep paralysis, you may try to wiggle a finger or wiggle a toe. As soon as you can wiggle something voluntarily, it breaks the sleep paralysis. According to Harvard Health, you may not be able to wiggle anything. So that may work for you or it may make you feel more disempowered. It's going to be a personal choice. Consider emdr. Eye movement desensitization therapy is really helpful for, for traumatic incidents. If you have had an incident of trauma in your past, that is those feelings of helplessness are reactivated when you wake up and you're paralyzed. Definitely processing that with emdr. Even if you haven't had trauma in your past, waking up and being paralyzed is scary as crap. And it may be worth working with a therapist using EMDR to process the sleep paralysis episodes so they are not as terrifying, so they are integrated more into your brain. I haven't found any research on sleep paralysis and emdr, but it would make sense that if you take away the terror associated with it, if you can unhook the event from the terror, it may help reduce anticipatory Anxiety may help you get better quality sleep and may help reduce the frequency and intensity of sleep paralysis episodes. And finally, keep a log of possible triggers. There may be smells that may be certain times of year when certain allergens are really bad. There can be a variety of things that keep you from getting good quality sleep or disrupt your circadian rhythms. Hey, we're getting ready to turn the clocks back or forward or something I can never remember. But that changing to daylight savings time is screws with a lot of people's circadian rhythms and it can make sleep paralysis episodes more frequent for those who tend to have them. Likewise, if you change time zones, sleep paralysis can become more frequent. So consider keeping a log of triggers not just when you have one, but when you don't have one. Look back over what happened the the day before and go, okay, I did all these things yesterday, all these things happened and I didn't have an episode. So. So those probably weren't triggers. And it can start helping you feel safer in your skin and in your environment. Sleep paralysis can be terrifying and it often increases stress about going to sleep, which in turn increases the likelihood that you're going to have future sleep paralysis episodes because your circadian rhythms start getting all wonked up. Unfortunately, as of right now, there is no medicine or quick fix for sleep paralysis. However, the strategies mentioned earlier may help you reduce the frequency of the episodes and feel empowered to live with this. Live with the disorder.