Why Do I Get Sleep Paralysis

Sleep paralysis is a provisional loss of muscle function, commonly accompanied by hallucinations, and fear, occurring when falling asleep or when awake. Ultimately, an individual remains awake however they are unable to move and so they experience much discomfort. Episodes of sleep paralysis have many signs and symptoms attached to them; however, management of the condition can help to minimise its impact on one’s sleep.

What is sleep paralysis?

Sleep paralysis is described as a temporary loss of muscle function and control (commonly termed atonia) that occurs in the time between awakening and sleeping. Typically, when asleep the body becomes relaxed and voluntary muscles are unable to move as this helps prevent individuals from acting out their dreams in real life. However, when a person awakens whilst their body is in this relaxed state then they are said to be experiencing sleep paralysis. Overall, sleep paralysis is said to be a type of parasomnia (i.e., an undesirable event or abnormal behaviour associated with sleep).

There are two types of sleep paralysis depending on when in the sleep cycle it occurs.

1. Hypnagogic (or predormital) sleep paralysis –  Occurs whilst falling asleep.

2. Hypnopompic (or postdormital) sleep paralysis – Occurs whilst waking up.

Sleep paralysis can also be categorised by case according to how often it appears.

  • Isolated sleep paralysis – Episodes are unconnected to an underlying diagnosis of narcolepsy, a long-term neurological sleep disorder that dysregulates the sleep-wake cycles as the brain is prevented from effectively controlling wakefulness.
  • Recurrent sleep paralysis – Multiple episodes of sleep paralysis occurring across time.

Alternatively, individuals may experience a condition of recurrent isolated sleep paralysis where they do not have the condition of narcolepsy. And they experience ongoing and repeated episodes of sleep paralysis.

Causes of sleep paralysis

The exact cause of sleep paralysis remains unknown. However, various research assessing the condition demonstrates the involvement of multiple factors in provoking sleep paralysis.1 Here are some of those factors:

  • Other sleeping problems/conditions – Generally sleep disorders and other sleeping problems (e.g., obstructive sleep apnoea (OSA),2 insomnia,3 and narcolepsy)4 have strong correlations with isolated sleep paralysis.
  • Disrupted sleep patterns – Unaligned circadian rhythms (i.e., internal body clock controlling the sleep-wake cycle on a 24-hour repeating rhythm) with local day-night cycles. People with jet lag5 or shift work disorder6 are at a higher risk of sleep paralysis.
  • Mental health conditions – There are associations7 between sleep paralysis and anxiety disorders (e.g., panic disorder), post-traumatic stress disorder (PTSD), bipolar disorder and schizophrenia. Moreover, stopping alcohol or antidepressants may also cause sleep paralysis.
  • Family history – In some instances, sleep paralysis appears to run in the family as studies have suggested that a family history of sleep paralysis increases one’s own risk and predisposes an individual to sleep paralysis.8, 9 Although, there remains little scientific evidence to confirm the precise hereditary nature of the condition.
  • Sleep habits and routine – Poor sleep hygiene, improper sleeping habits, lack of sleep and sleeping on your back increase the risk of experiencing sleep paralysis.10
  • Personal traits – Traits of imaginativeness and disassociation in individuals increase their risk of sleep paralysis.11

Signs and symptoms of sleep paralysis

A fundamental symptom of sleep paralysis is atonia (i.e., the inability to move the body) which occurs shortly after falling asleep or waking up. With this, the individual is essentially awake and consciously aware of this loss in muscle control. In addition to this individuals may also experience:

  • Inability to perform basic functions – Being unable to move, speak or open one’s eyes during an episode.
  • Physiological changes – Feeling pressure on one’s chest, difficulty breathing, sweating, headaches, daytime fatigue (hypersomnia), and muscle pains.
  • Psychological feelings – Feeling frightened, as though you are going to die, excessive anxiety and fear, as well as paranoia.
  • Hallucinations – Can be either hypnagogic hallucinations (i.e., occurring when falling asleep) or hypnopompic hallucinations (i.e., occurring when waking up). There are three categories that hallucinations during sleep paralysis can fall into:
  1. Intruder hallucinations – Perceiving a dangerous person/presence in the room.
  2. Chest pressure (incubus) hallucinations – Incites feelings of suffocation.
  3. Vestibular-Motor hallucinations – Induces feelings of movement or out-of-body sensations.

Episodes of sleep paralysis typically last between a few seconds to around 20 minutes, with an average duration of 6-7 minutes.12 They usually end on their own, or when one is interrupted when another person touches/speaks to them, or by personally overcoming the atonia with an intense effort to move.

Following an episode, the details of what was experienced can be recalled after the temporary paralysis disappears.

Management and treatment for sleep paralysis

There is no real need for treatment for sleep paralysis besides the management of the condition. Instead, treating any underlying condition, such as narcolepsy or mental health disorders, that may be the underlying cause for sleep paralysis may help relieve anxiousness and promote restful sleeping. Examples of such treatments include:

  • Improving sleeping habits – Upholding a regular sleep routine/schedule, maintaining good sleep hygiene and getting enough sleep each night.
  • Taking medication – Antidepressant medication, such as tricyclics and selective serotonin-reuptake inhibitors (SSRIs), can help regulate sleep cycles, manage symptoms associated with narcolepsy and manage mental health disorders that may underlie the condition.
  • Treating any other sleep disorder, such as narcolepsy, that may contribute to sleep paralysis.
  • Treating any mental health disorder or problem that may contribute to sleep paralysis.
  • Therapy – A specific form of cognitive behavioural therapy has been developed for sleep paralysis,3 however further research is necessary to validate its effectiveness


How is sleep paralysis diagnosed?

Currently, there is no definitive medical test needed to diagnose sleep paralysis. Instead, a medical professional, commonly a doctor, will assess your situation by asking about your sleeping patterns, medical history, and experience with any sleep paralysis episodes experienced.

In some instances, some of the following tests may be conducted if you are suspected to suffer from a sleep disorder:

  • Overnight sleep study (polysomnogram) – Test that monitors breathing, heartbeat and brain waves/activity during sleep. Such a test helps medical professionals observe an episode of sleep paralysis.
  • Electromyogram (EMG) recording – Recording shows the level of electrical activity in one’s muscles during their sleep.
  • Multiple sleep latency test (MSLT) – It measures how quickly one falls asleep as well as the kind of sleep experienced during a nap. Such a test helps uncover sleeping issues, such as narcolepsy, that is thought to be a cause of sleep paralysis.

How common is sleep paralysis?

Sleep paralysis occurs at any age, although symptoms may begin to manifest in childhood, adolescence or young adulthood, broadly between the ages of 7 to 25 years. The condition affects approximately 7.6% of individuals during their life.13

How can I prevent sleep paralysis?

Integrating a few lifestyle changes can help to minimise the symptoms or frequency that sleep paralysis episodes occur. Examples of such changes include:

  • Reducing life stressors.
  • Regular exercise.
  • Getting sufficient and proper rest.
  • Maintain a regular sleep routine and schedule with specific times to go to bed and wake up.
  • Improving sleep hygiene (i.e., one’s bedroom setting and daily habits influencing sleep).
  • Monitoring medication being taken, their side effects and interaction to avoid potential side effects.
  • Avoid sleeping on one’s back in favour of their side.
  • Therapy, yoga and breathing exercises.
  • Taking antidepressants if suffering from a mental health condition, such as anxiety or depression.

When to see a doctor?

Always consider consulting a healthcare professional, such as a doctor, if you are concerned about your health, any sleep paralysis episodes you may have experienced, and the impact sleep paralysis has on your day-to-day life. In particular, if you feel extremely anxious, fearful to go to sleep or constantly tired due to lack of sleep then consult a GP.


Sleep paralysis is a provisional loss of muscle function, commonly accompanied by hallucinations, and fear, occurring when falling asleep or when awake. Ultimately, an individual remains awake however they are unable to move and so they experience much discomfort. Episodes of sleep paralysis have many signs and symptoms attached to them that are incredibly discomforting and distressing in nature. Nevertheless, the condition can be managed in various ways to reduce its impact and enjoy a restful night of sleep.


  1. Denis D, French CC, Rowe R, Zavos HMS, Nolan PM, Parsons MJ, et al. A twin and molecular genetics study of sleep paralysis and associated factors. J Sleep Res [Internet]. 2015 Aug [cited 2023 Jan 14];24(4):438–46. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jsr.12282
  2. Leschziner G, Howard RS, Williams A, Kosky C. CP4 Isolated sleep paralysis as a presenting feature of obstructive sleep apnoea. Journal of Neurology, Neurosurgery & Psychiatry [Internet]. 2010 Nov 1 [cited 2023 Jan 14];81(11):e34–e34. Available from: https://jnnp.bmj.com/content/81/11/e34.3
  3. Denis D, French CC, Schneider MN, Gregory AM. Subjective sleep-related variables in those who have and have not experienced sleep paralysis. J Sleep Res [Internet]. 2018 Oct [cited 2023 Jan 14];27(5):e12650. Available from: https://pubmed.ncbi.nlm.nih.gov/29280229/
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  5. Snyder S. Isolated sleep paralysis after rapid time-zone change ('Jet-lag’) syndrome. Chronobiologia [Internet]. 1983 [cited 2023 Jan 14];10(4):377–9. Available from: https://pubmed.ncbi.nlm.nih.gov/6661984/
  6. Wickwire EM, Geiger-Brown J, Scharf SM, Drake CL. Shift work and shift work sleep disorder. Chest [Internet]. 2017 May [cited 2023 Jan 14];151(5):1156–72. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859247/
  7. Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev [Internet]. 2018 Apr [cited 2023 Jan 14];38:141–57.Available from: https://pubmed.ncbi.nlm.nih.gov/28735779/
  8. Bell CC, Dixie-Bell DD, Thompson B. Further studies on the prevalence of isolated sleep paralysis in black subjects. J Natl Med Assoc [Internet]. 1986 Jul [cited 2023 Jan 14] ;78(7):649–59. Available from: https://pubmed.ncbi.nlm.nih.gov/3746934/
  9. Dahlitz M, Parkes JD. Sleep paralysis. The Lancet [Internet]. 1993 Feb 13 [cited 2023 Jan 14];341(8842):406–7. Available from: https://www.sciencedirect.com/science/article/pii/0140673693929923
  10. Denis D. Relationships between sleep paralysis and sleep quality: current insights. Nat Sci Sleep [Internet]. 2018 Nov 2 [cited 2023 Jan 14];10:355–67. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220434/
  11. Denis D, Poerio GL. Terror and bliss? Commonalities and distinctions between sleep paralysis, lucid dreaming, and their associations with waking life experiences. J Sleep Res [Internet]. 2017 Feb [cited 2023 Jan 14];26(1):38–47. Available from: https://pubmed.ncbi.nlm.nih.gov/27460633/
  12. Sharpless BA. A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatr Dis Treat [Internet]. 2016 [cited 2023 Jan 14];12:1761–7. Available from: https://pubmed.ncbi.nlm.nih.gov/27486325
  13. Farooq M, Anjum F. Sleep paralysis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Jan 14]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK562322/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Jaskirat Kanwal

Masters of Science – MSc, Applied Neuropsychology. University of Bristol, UK

Jaskirat currently works in pharmaceutical care and in the mental health sector. Given their extensive background in psychology, they’re currently seeking to undertake their DClinPsych. They hope to study further, and continue in academia and research, with hopes to ultimately become an HCPC registered clinical neuropsychologist.

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