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Sleep Disorders

Sleep Paralysis

06/30/2009

Question:

I wonder if you could give me some help on this situation. I am a 60 yr old lady and suffer with fibromyalgia, osteoarthritis, and maybe am quite an anxious person. Over the last few years I have suffered with a horrid sleep paralysis. It is always in the morning and I am aware that I am awake, but cannot move my body or open my eyes. I am awake and I feel that if I do not force my eyes open and move i will die. (This sounds stupid, doesn`t it?) My body wants to drift off into sleep and I fight to open my eyes because if I don`t fall asleep, but I always manage to force my eyes open and then after that can go back to sleep quite peacefully. I am very aware that it has happened and dread it happening again the next night, but it doesn`t. Maybe a few weeks or months will pass before it does again. Can you help with this please?

Answer:

Your symptoms sound very real and emphasize just how disturbing sleep paralysis can be to those who experience it. Fortunately, while it is quite scary and disturbing, sleep paralysis is not dangerous.

Sleep paralysis is usually described as the inability to perform voluntary movements either at sleep onset or upon awakening. Individuals often report an inability to speak or move the limbs, trunk or head.

While breathing is actually not affected, the sensation of not being able to breath can accompany the paralysis and can be quite scary. Most individuals will recall the events. The episodes usually only last for seconds up to a few minutes and tend to resolve on their own. Occasionally, the episode will end if the person is touched or spoken to.

Episodes of sleep paralysis can be very anxiety producing. In addition to the sensation of an inability to breathe as noted above, hallucinations, whether hearing or seeing things that are not present, can accompany the event. All-in-all, the experience can be somewhat frightening. Sleep paralysis can be brought on by lack of adequate sleep, keeping an irregular sleep schedule and being under excessive stress. While most of the time sleep paralysis is not associated with other medical conditions, it can be one of the signs of narcolepsy (individuals with this condition are also very sleepy).

Sleep paralysis usually first appears in young adults and tends to disappear with aging. Surprisingly, up to 15-40% of young adults experience this at least once in their lifetime and as many as 5-6% have this occur recurrently. Other than reassurance and avoiding situations that may bring on the episodes, no treatment is needed in most cases.

Other medical conditions that can appear with similar symptoms to sleep paralysis include compressed nerves, cataplexy (sudden loss of muscle control in emotionally charged situations such as laughing), seizures, and panic attacks. Most of these conditions can be separated from sleep paralysis by specific factors from the medical history.

The fact that your sleep paralysis symptoms started late in life is somewhat unusual. A proper evaluation is important and I would encourage you to see your physician about this symptom. They can then decide if referral to a Sleep Specialist is needed for further evaluation. In the meantime, getting adequate regular sleep and avoiding stress may help to reduce the frequency that you have the symptoms.

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Response by:

Meena S Khan, MD Meena S Khan, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
Clinical Assistant Professor of Neurology
College of Medicine
The Ohio State University