In short
Sleep paralysis is waking up, or falling asleep, and being unable to move or speak for a few seconds to a few minutes. Many people also sense a presence in the room or feel pressure on the chest. It is frightening but harmless, and about 1 in 13 people have it at least once. Regular, sufficient sleep is the best prevention.
On this page
What is sleep paralysis?
Sleep paralysis is a brief period, as you fall asleep or wake up, when you are conscious but can’t move or speak. It lasts from a few seconds to a few minutes and passes without any treatment.1
It happens when a normal feature of dreaming sleep spills over into wakefulness. During REM sleep, the brain switches off most of the body’s muscles so you don’t act out your dreams. In sleep paralysis you wake before that switch flips back, so your mind is awake and your body is still in dream mode.5
The “sleep paralysis demon”
Many episodes come with vivid hallucinations, because part of the dreaming brain is still running. Researchers who studied thousands of reports found they fall into three groups:2
- An intruder. A strong sense that someone or something threatening is in the room, sometimes with footsteps, voices or a shadowy figure
- Pressure on the chest. A feeling of being sat on, crushed or unable to breathe
- Floating or movement. Sensations of flying, falling or leaving your body
The first two usually occur together and bring intense fear. Cultures around the world have explained them as a night-time visitor: an old hag, a spirit or a demon. The experience is the same everywhere, which points to how the brain works, not to anything in the room.2
Sleep still not right?
Talk it through with an Australian doctor online. No referral needed.
How common is sleep paralysis?
More common than most people realise. A review of 35 studies covering more than 36,000 people found that 7.6 per cent of the general population had experienced it at least once. The figure was 28 per cent among students and 32 per cent among people with a mental health condition.3
Can sleep paralysis kill you?
No. It can feel as though you can’t breathe, but the muscles that control breathing keep working throughout. Episodes are frightening, but they are short and they don’t cause harm.1
What causes sleep paralysis?
A review of the research found it was most consistently linked with:4
- Too little sleep and poor-quality sleep
- Irregular sleep patterns, including shift work and jet lag
- Stress, and symptoms of anxiety
- Post-traumatic stress disorder and, to a lesser degree, panic disorder
- A family history of sleep paralysis
Many people also notice it happens more when they sleep on their back.
Occasionally it is a symptom of narcolepsy, a neurological sleep disorder. The clue is overwhelming daytime sleepiness, sometimes with sudden muscle weakness triggered by laughter or strong emotion.5
What to do during an episode
- Remind yourself what it is, and that it will pass within a minute or two
- Don’t fight it. Struggling tends to increase the fear and the sense of pressure
- Focus on slow breathing, or on moving one small part of your body such as a finger or toe
A small pilot study in people with narcolepsy tested an approach along these lines, combining reassurance, emotional distancing and relaxation during episodes, and found fewer and less distressing episodes. It needs larger trials, but it costs nothing to try.6
How to stop sleep paralysis
- Get enough sleep. Most adults need seven to nine hours
- Keep regular hours, going to bed and getting up at about the same time
- Try sleeping on your side
- Cut back on alcohol and caffeine in the evening
- Deal with stress and anxiety, which make episodes more likely. See anxiety symptoms
For most people, understanding what sleep paralysis is and improving their sleep is all that is needed. For frequent, distressing episodes, psychological therapy and some prescription medicines are used, though neither has been tested in large trials.7
When to see a doctor
- Episodes are frequent or leave you afraid to go to sleep
- You are very sleepy during the day or fall asleep without warning
- Your muscles suddenly go weak when you laugh or are startled
- Episodes began after a traumatic event
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Sleep paralysis.
- Cheyne JA, Rueffer SD, Newby-Clark IR. Hypnagogic and hypnopompic hallucinations during sleep paralysis: neurological and cultural construction of the night-mare. Conscious Cogn. 1999;8(3):319-37.
- Sharpless BA, Barber JP. Lifetime prevalence rates of sleep paralysis: a systematic review. Sleep Med Rev. 2011;15(5):311-5.
- Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2018;38:141-157.
- Scammell TE. Narcolepsy. N Engl J Med. 2015;373(27):2654-62.
- Jalal B, Moruzzi L, Zangrandi A, et al. Meditation-Relaxation (MR Therapy) for Sleep Paralysis: A Pilot Study in Patients With Narcolepsy. Front Neurol. 2020;11:922.
- Sharpless BA. A clinician's guide to recurrent isolated sleep paralysis. Neuropsychiatr Dis Treat. 2016;12:1761-7.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.