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Sleep Paralysis: Definition, Causes, Treatments

Written by Andrew

Posted on June 22, 2020 Leave a Comment

What Is Sleep Paralysis?

Throughout the ages, sleep paralysis has been attributed to the likes of demons, aliens and even the devil himself. Before the advent of modern medicine and the creation of research tools that have allowed us a scientific understanding of brain function, it’s not hard to see why this was the case.

Sleep paralysis is one of the most disconcerting, terrifying experiences a sleeper can have. In its strange blend of sleep and wakefulness, people feel powerless and scared, unable to physically control their own bodies. Even with a 21st century understanding of why and how this phenomenon affects certain individuals, sleep paralysis can still feel like the work of a mystical force.

So what is really going on when we wake up unable to move or sense danger? What causes sleep paralysis? Can anything be done to prevent it? Is sleep paralysis a symptom of a more serious underlying condition?

There are two main kinds of sleep paralysis

Sleep paralysis can be broken down into two distinct types: predormital and postdormital. Predormital paralysis occurs a person is falling asleep and slowly relaxes, and postdormital paralysis occurs as one is waking up.

Both forms of the disorder are characterized by the same symptoms. According to the UK’s National Health Services, during an episode of sleep paralysis you may feel:

awake but unable to move, speak or open your eyes
like someone is in your room
like something is pushing you down
intense fear

These episodes can last for several minutes. Some studies suggest that this disorder is very rare, with just over 6% of people reporting that they have experienced the phenom in their lifetime. While less than 1% of people reporting having episodes once a week. However, other studies have estimated that up to one-third of adults have experienced sleep paralysis at least once.

Sleep paralysis is a form of parasomnia

Like sleepwalking, night terrors, confusional arousal, hallucinations, and others, sleep paralysis belongs to a broad category of disorders known as parasomnias.

These conditions are characterized by unwanted physical activities and behaviors that occur when our bodies and minds enter an abnormal state somewhere between sleep and wakefulness.

During the course of a normal night in bed, our body cycles through discrete stages, marked by slightly different brain and body functions. This is known as the sleep cycle. Though the term parasomnia summarizes a broad category of different behaviors, all of them take place when people get “caught” in between discrete stages of the cycle and become partially awake.

How it is linked to REM

Without getting too deep into the specifics of the different stages of sleep, there are broadly two categories known as rapid eye movement (REM) and non-rapid eye movement (NREM). Sleep paralysis is a REM type of parasomnia, meaning that it affects individuals as they enter into, or are already in, the REM stage.

During this time, dreams are more common and more vivid. Because of this, the body naturally “paralyzes” its muscles so that sleepers cannot act out their dreams in the middle of the night. This freezing of the muscles is responsible for the immobile sensation associated with paralysis.

Causes of sleep paralysis

While there is no clear cut “cause” of sleep paralysis, sleep researchers have linked this parasomnia with certain triggers and other conditions. Significant factors that can contribute to SP include:

Unhealthy or irregular sleep patterns: Not getting enough sleep, or getting it in irregular intervals can lead to SP. Generally speaking, the less routine your nighttime patterns are, the more susceptible to certain disorders you become.
Excess stress: High levels of stress can lead to insomnia, which in turn has been linked to episodes of SP.
Mental health disorders: Some studies have shown that the prevalence of SP is higher among populations that suffer from mental health disorders.
Other sleep disorders: Sleep paralysis has been linked to several other disorders, including narcolepsy, insomnia, and restless legs syndrome (RLS), among others.
Certain medications: Some medications might lead to episodes of paralysis, especially those taken for the treatment of ADHD.
Substance abuse: Along with many other sleep disorders, there seems to be a link between substance abuse and sleep paralysis, though more research is needed to establish a clear causal link between the two.

This phenomenon can happen to any person regardless of age or gender, though the first experiences with the disorder typically occur during the teenage years.

Treatment Options

Often times, this paralysis occurs so infrequently that it does not require a formal diagnosis and treatment by medical professionals. However, if episodes become frequent, or especially upsetting, there are some treatment options available to combat the episodes.

Improve your sleep hygiene: Try to get six-to-eight hours of rest every night. As best you can, try to go to bed and wake at the same time to set a routine your body will naturally adjust to. Avoid alcohol, caffeine, and nicotine in the evenings, as well as electronics with blue light-emitting displays.
Treat underlying conditions: The most important thing you can do is seek treatment for any conditions that might underpin sleep paralysis. Talk to your doctor if you suffer from other sleep disorders like insomnia or narcolepsy, or if you suspect you may have untreated mental health disorders like depression or bipolar disorder.
Relieve stress before bedtime: Anything you can do that makes the journey into sleepless fraught will improve your chances of healthy uninterrupted rest. Try practicing meditation or yoga in the evening, or wind down with a bath and a good book. Avoid things like social media or checking emails.
Talk to your doctor about medication and therapy options: If you take medication for any other condition, speak with your physician about possible side effects that may cause or exacerbate sleep paralysis. They might recommend that you change your prescription. In severe cases, some doctors might recommend cognitive behavioral therapy as treatment.

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Lucid Dreaming: Fact or Fiction

Written by Andrew

Posted on June 14, 2020 Leave a Comment

Imagine lucid dreaming (LD) a bit like this: You walk up to the edge of a cliff. Wind blows through your hair and ruffles your clothes as you peer over into the abyss. But instead of fear, you feel excitement. You bend your knees, raise your arms, and all of a sudden, you shoot up into the sky and begin flying.

Somewhere between your first midair loop-de-loop and the moment when you hover directly across from a plane carrying all of your exes and elementary school teachers you have a realization…you’re not awake, in fact, you’re still in bed.

Such is the purported course of the much-discussed lucid dream—a situation where a person becomes aware that they are dreaming. Most of the time we experience dreams in the same way we experience everyday life, assuming what we see and feel is reality. But in this case, it breaks down, allowing us to navigate the strange world of our subconscious minds with some degree of awareness.

So what exactly is this experience? Are there benefits to it? Could it be dangerous?

What is Lucid Dreaming?

Lucid dreaming refers to the phenomenon in which people having dreams become subjectively aware that they are not experiencing everyday normal reality, but are in fact in a dream state. In its most simple form, a dream can be considered lucid if this awareness check is present. However, these sleepers also frequently report an ability to have control over certain aspects of their dreams, including the setting and people that appear or the actions that take place.

As fantastical as it sounds, lucid dreaming is also surprisingly common. The National Sleep Foundation reports that over half of all people say they have had at least one in their life. Like most, lucid dreams usually begin during the rapid eye movement (REM) portion of the sleep cycle, a time when our brains are extremely active.

However, scientists are still very much unsure about the exact physiological mechanisms that cause this type of dreaming.

One 2008 study examined the hypothesis that lucid dreaming might be a kind of hybrid state between wakefulness and dreaming. The experiment aimed to measure the brain activity of dreamers as they moved from normal REM state into states of lucid dreaming. Their results indicated that lucid dreaming may be a sort of hybrid state in which the brain demonstrates activity usually seen in REM sleep as well.

More recent studies have also confirmed that brain activity during lucid dreaming episodes is measurably different from what is typically seen during REM dreaming.

What are benefits to lucid dreaming?

A quick web search online will net hundreds of thousands of results focused on trumpeting wonders of this strange phenomenon. Videos on the subject rack up millions of views. Why is there so much interest in the subject?

The answer could lie in the purported benefits of the activity.

For one, there is the intangible yet most obvious benefit—a technique to potentially control everything that happens in a fantasy world. This could mean gaining the ability to fly, having romantic encounters with whomever you choose, or any other thing one could imagine. For many people, this is reason enough to attempt lucid dreaming.

Another potential benefit is that lucid dreaming may allow people who suffer from frequent nightmares to confront their fears. In combination with therapy designed to teach people how to respond to nightmare situations, becoming lucid during such an episode can allow people to break their typical response habits, and realize there is nothing to fear by confronting the imagined stressor in your imagination.

Others have pointed out that lucid dreaming could be helpful in reducing anxiety, as well as increasing motor skills. Keeping a journal or log during the night and often performing reality testing can yield better results.

Can LD be dangerous?

First and foremost, there is no evidence that dying during one of these events will result in death, despite mountains of anecdotal examples in pop culture. Falling from the sky mid-flight while sleeping may be terrifying, but you are much more likely to wake with a start when you hit the ground than you are to never wake again. Sorry, Christopher Nolan.

That being said, these types of events have been linked to some negative outcomes due to the way it seems to disrupt the normal sleep cycle. One opinion article by sleep researchers analyzed many of the most prevalent experiments on lucid dreaming and determined that there was significant evidence to, “fear an adverse effect on sleep and health of a regular use of LD induction methods or of an increased LD frequency…”

Since lucid dreaming occurs in a state outside of the normal stages of sleep, they argue, significant time spent lucid dreaming might mean people do not spend the appropriate amount of time in those regular stages while asleep. This in turn could result in sleep deprivation and lead to drop-offs in health and wellness.

Some sleepers who engage in the practice often have also reported difficulty distinguishing reality from dreaming over time, a phenomenon known as derealization. This is relatively uncommon for lucid dreamers, but can be a very dangerous condition that requires medical intervention.

Lucid dreaming has also been linked to narcolepsy, a sleep disorder that has demonstrable negative effects on health. Growing evidence suggests that narcoleptics, who are prone to suffering from disturbing nightmares, could benefit from lucid dreaming as a way to combat the trauma of such disturbing experiences. A 2015 study out of the Max-Plank-Institute of Psychiatry in Germany found that 70 percent of narcolepsy patients reported relief from nightmares when they gained this level of control during their dreams.

With these things being said, there seems to be much more enthusiasm for the potential benefits of lucid dreaming than there is caution against its negative outcomes. Like most things in life, moderation appears to be the key to success when it comes to training your mind on this technique.

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Narcolepsy – Definition, Symptoms, and Treatment

Written by Andrew

Posted on February 24, 2020 Leave a Comment

Narcolepsy is a neurological sleep disorder that causes extreme daytime drowsiness, despite a sufficient amount of sleep. It is commonly known for the symptom in which patients unconsciously fall asleep in the middle of the day, even while occupied in daily tasks. According to the Cleveland Clinic, narcolepsy affects one in every two thousand American adults.

But there is an important distinction between feeling excess tiredness during your day and getting a diagnosis of a disorder. Learning the causes and symptoms of narcolepsy can help you decide if you should speak to a doctor about a possible checkup.

What Is Narcolepsy?

Narcolepsy is defined as a disorder affecting the brain’s control of the sleep-wake cycle. People with narcolepsy may experience the following symptoms:

Extreme tiredness during daytime hours: Even when you’ve had a good night’s sleep, you might feel very tired out of the blue. Feelings of overwhelming exhaustion can come with little warning, no matter the activity you are engaged in.
Falling asleep spontaneously: This follows the extreme tiredness that defines narcolepsy. You can fall asleep any time, anywhere, with little warning. These periods of sleep range from a few minutes to half an hour at a time, and regularly happen many times a day.
Sudden muscle weakness or paralysis (Cataplexy): Cataplexy can bring other symptoms of narcolepsy. They are usually triggered by strong emotions, both negative and positive. You will be unable to control certain muscles or even your entire body for minutes at a time. It is often misdiagnosed as a seizure disorder. Interestingly, NIH notes that the signs of cataplexy are similar to the conditions the body undergoes during REM (rapid eye movement) sleep.
Sleep paralysis: Similar to cataplexy, sleep paralysis renders the patient temporarily paralyzed while fully conscious. The difference is that sleep paralysis affects people who are falling asleep, waking up, or in some realm of the “edge of sleep.”
Hallucinations: Genuine, clear visual hallucinations are common during periods of narcoleptic sleep paralysis. They can be scary, and can sometimes include audible elements as well. Hypnagogic hallucinations happen when someone is beginning to fall asleep. Hypnopompic hallucinations can occur when a person is starting to wake up. Typically, the hallucinations normally last only a few moments.

What Causes Narcolepsy?

Though we don’t know the exact causes of narcolepsy, scientists have linked the disorder to the neuropeptide hypocretin. Orexin helps to regulate our wakefulness and sleep. In patients suffering from narcolepsy with symptoms of cataplexy (known as Type I narcolepsy), there is likely to be extremely low levels of detectable hypocretin.

Hypocretin is especially important in controlling REM sleep. Many of the symptoms of narcolepsy, including cataplexy and sleep paralysis most notably, seem to mimic the actions of our body during REM sleep. Furthermore, the Mayo Clinic explains that narcoleptics seem to enter REM sleep much more quickly than the average sleeper.

There is a greater risk of developing the disorder if anyone in your family already has it. Scientists also link narcolepsy to autoimmune dysfunction and even the H1N1 flu. More research is being conducted to understand what causes Type 2 narcolepsy.

Testing for the disorder

People typically begin to feel the symptoms of narcolepsy when they are young, anywhere from 7 to 25 years old. Usually, the first symptoms to show are excessive daytime sleepiness, which can often be dismissed as simple day-to-day tiredness. However, symptoms will likely advance if left untreated.

If you are concerned that you might be feeling symptoms of narcolepsy, there are several tests that can be done to determine a diagnosis. If the usual in-depth analysis of your medical and sleep histories suggests you might have the disorder, doctors will proceed to administer two tests:

Polysomnogram (PSG): Also known as a “sleep study,” this overnight test is typically administered in a sleep clinic. Doctors will monitor your brain and muscle activity, eye movements, and breathing during the night. The data they record, especially about the timing and length of your sleep cycles, will help them rule out other sleep disorders as the cause of your symptoms.
- Falling into REM sleep early in the night is a good indicator that you may be suffering from Type 1 narcolepsy (narcolepsy with cataplexy). Type 1 includes extreme tiredness during the day, cataplexy, and in extreme cases sleep paralysis, and even hallucinations.
Multiple Sleep Latency Test (MSLT): Immediately following a PSG, patients are asked to take a series of daytime naps under direct doctor supervision. The speed at which they fall asleep and enter the REM stage of the sleep cycle can be used to make a diagnosis of narcolepsy.

Pending the results of these two tests, and especially if patients exhibit symptoms of cataplexy, doctors may follow up with a spinal tap test. This helps to determine the amount of hypocretin in the patient’s spinal fluid. Low levels of the neuropeptide are a strong indicator of Type 2 narcolepsy.

Treatments for Narcolepsy

Narcolepsy is a disorder for which there is no cure, though symptoms seem to decline over time. Managing the symptoms of narcolepsy is a lifelong challenge that requires vital changes to lifestyle, and significant help from family or friends.

The NIH lists a few medications which have shown promise in treating the symptoms of narcolepsy:

Modafinil: A low-level nervous system stimulant that helps improve alertness and reduce drowsiness.
Amphetamines and other stimulants: Stronger than modafinil, these can be effective at combating sleepiness during the day. Though it is important to monitor patients using these drugs for significant side effects, ranging from irritability to heart conditions.
Some types of antidepressants: These may be effective in combating cataplexy, and pose fewer risks than amphetamines.
Sodium oxybate (Xyrem®): This extremely strong sedative is prescribed to treat cataplexy and daytime drowsiness.