Sleep paralysis is a temporary inability to move or speak while falling asleep or waking up. Your awareness remains active, but your body is still in the muscle-relaxed state linked to rapid eye movement, or REM, sleep. Episodes can last from a few seconds to several minutes. Regular sleep and 7 to 9 hours of sleep each night may help reduce them, although sleep paralysis can happen without an obvious trigger.
Sleep Paralysis at a Glance
| Feature | What it means |
|---|---|
| When it happens | As you fall asleep or wake up |
| Main symptom | Temporary inability to move or speak |
| Awareness | You are usually conscious and aware of your surroundings |
| Possible sensations | Chest pressure, fear or a sense that someone is nearby |
| Possible hallucinations | Seeing, hearing or sensing something that is not there |
| Typical duration | A few seconds to several minutes |
| Usual risk | Distressing but generally not dangerous |
Why Does Sleep Paralysis Happen?
Sleep paralysis occurs when your brain becomes alert before the muscle relaxation of REM sleep has ended. During REM sleep, the brain normally limits voluntary muscle activity so that you do not physically act out your dreams. If the two processes fall out of sync, you may feel awake but remain unable to move or speak.
Sleep paralysis can happen as you fall asleep. This is called hypnagogic sleep paralysis. It can also happen as you wake up, which is known as hypnopompic sleep paralysis.
What Does Sleep Paralysis Feel Like?
Common experiences include:
- Being unable to move your arms, legs or body
- Being unable to speak or open your eyes
- Feeling awake but trapped in your body
- Feeling pressure on your chest
- Sensing that someone or something is in the room
- Seeing, hearing or feeling dream-like images or sounds
- Feeling intense fear or panic
These experiences can seem completely real because you remain conscious. Hallucinations during sleep paralysis are sleep-related perceptions that occur as the brain shifts between REM sleep and wakefulness.
You may also feel as though you cannot breathe. Sleep paralysis does not normally stop breathing, although the sensation can be frightening. The American Academy of Sleep Medicine states that breathing remains unaffected during sleep paralysis.
How Long Does Sleep Paralysis Last?
Most episodes last a few seconds to one or two minutes, although they can feel much longer. Sleep paralysis usually ends without treatment. Being touched or spoken to may sometimes help end an episode.
During an episode, remind yourself that the paralysis is temporary. Calm, steady breathing may help. You can also try moving a small part of your body, such as one finger or toe.
What Causes Sleep Paralysis?
The exact cause is not fully understood. Several factors are linked to sleep paralysis:
- Not getting enough sleep
- An irregular sleep schedule
- Shift work or jet lag
- Insomnia
- Psychological stress
- Sleeping on your back
- Anxiety, panic disorder or post-traumatic stress disorder
- A family history of sleep paralysis
- Narcolepsy and other sleep disorders
These factors may increase the chance of sleep paralysis, but no single factor causes every episode.
When sleep paralysis occurs without another underlying sleep or medical condition, it is often called isolated sleep paralysis.
Is Sleep Paralysis a Sign of Narcolepsy?
Yes, sleep paralysis can be a symptom of narcolepsy, but having sleep paralysis does not mean that you have narcolepsy. Narcolepsy is a neurological sleep disorder that commonly causes severe daytime sleepiness. It may also cause sudden sleep attacks, hallucinations around sleep and cataplexy, which is a sudden loss of muscle control triggered by emotions.
Speak with a healthcare professional if sleep paralysis occurs with:
- Extreme daytime sleepiness
- Unintentional falling asleep
- Sudden muscle weakness when laughing, feeling surprised or becoming excited
- Frequent sleep-related hallucinations
- Repeated episodes that disrupt sleep or make you anxious
How Can You Reduce Sleep Paralysis?
Improving your sleep habits may reduce episodes:
- Aim for 7 to 9 hours of sleep each night.
- Go to bed and wake up at consistent times.
- Limit alcohol, caffeine, smoking and large meals close to bedtime.
- Exercise regularly, but avoid intense exercise immediately before sleep.
- Manage stress and seek treatment for insomnia or anxiety when needed.
- Try sleeping on your side if episodes tend to happen while you are lying on your back.
These steps may help because sleep deprivation and disrupted sleep schedules are linked to sleep paralysis.
When Should You See a Doctor?
Make an appointment with a healthcare professional if sleep paralysis happens often, makes you afraid to sleep, causes ongoing sleep loss or occurs with severe daytime tiredness. A clinician may review your sleep schedule, medications, mental health and other symptoms.
Repeated episodes may need assessment for narcolepsy or another sleep disorder. Treatment focuses on the underlying problem. Treating insomnia, anxiety or post-traumatic stress disorder may reduce sleep paralysis. In persistent cases, a sleep specialist may consider cognitive behavioral therapy or medication.
Seek urgent medical help if paralysis or weakness happens while you are fully awake, affects one side of your body, or causes problems with breathing, speaking or swallowing. These symptoms may indicate a medical emergency rather than typical sleep paralysis.