What is sleep paralysis?

Sleep paralysis is when you cannot move or speak for a short time after waking up or while falling asleep. It may last a few seconds or a few minutes.

About 8 in every 100 people will experience sleep paralysis at some stage. It might happen only once, or recur often. It usually starts in adolescence or early adulthood, around 17 to 20 years old. It does not cause any physical harm, but it can be scary.

During a stage of sleep called ‘rapid eye movement (REM)’ sleep, your body becomes temporarily paralysed. This means you can’t move your muscles. It may be your body’s way of preventing you from acting out your dreams. This paralysis is normal, but you’re not aware of it because you’re asleep.

If this muscle paralysis from REM sleep continues after you wake up, you will be fully aware of being paralysed.

What are the symptoms of sleep paralysis?

During an episode of sleep paralysis, you are awake and aware of what is going on. Episodes can involve:

• not being able to move any part of your body, except your eyes
• not being able to talk
• feeling scared or anxious
• hallucinations — for example, seeing things that aren’t real, sensing there is an intruder in your room or that something is pressing on your chest or choking you
• hearing noises that are not there such as voices, hissing, zapping or buzzing
• sweating

What causes sleep paralysis?

Sleep paralysis may occur on its own or it may be related to other health conditions, including:

• high blood pressure
• mental health conditions — in particular anxiety and post-traumatic stress disorder (PTSD)
• obstructive sleep apnoea
• narcolepsy — a brain condition involving extreme daytime drowsiness even after enough sleep
• alcohol or substance abuse
• Wilson’s disease — a rare genetic condition where too much copper builds up in the body

Sleep paralysis is also linked to:

• not getting enough sleep — for example, because of work hours or insomnia
• irregular sleeping patterns — for example those experienced by shift workers or students, or because of jet lag
• family history of sleep paralysis
• sleeping on your back

When should I see my doctor?

Sleep paralysis is usually harmless and doesn’t need medical treatment. Talk to your doctor if you feel anxious or tired because of repeated episodes of sleep paralysis.

How is sleep paralysis diagnosed?

To diagnose sleep paralysis, your doctor will ask you about your symptoms. They may ask you to keep a sleep diary to record your sleeping patterns and any symptoms of sleep paralysis that you experience.

You usually won’t need any tests to diagnose sleep paralysis. Your doctor might suggest that you do a sleep study to check if you have any other sleep problems, for example narcolepsy.

If your doctor thinks you may have narcolepsy, they will ask you to do a special sleep study called a ‘multiple sleep latency test’. In this test you will be given several opportunities to go to sleep during the day. The test will measure how long it takes you to fall asleep and what kind of sleep you experience.

How is sleep paralysis treated?

Sleep paralysis doesn’t cause serious problems for most people, and no treatment is usually needed. You may find it helpful to learn about sleep paralysis and speak to your doctor for reassurance that there is no cause for concern.

If you need treatment, these measures may help:

• relaxation techniques and meditation
• cognitive behavioural therapy
• some types of antidepressant medicines

Your doctor may refer you to a specialist sleep physician. They can help you to improve your sleep quality.

It’s also important to treat any health conditions that may be causing your sleep paralysis. For example, there are medicines used to treat narcolepsy that may help with sleep paralysis symptoms.

What are the complications of sleep paralysis?

Sleep paralysis doesn’t cause any complications. It generally doesn’t stop you getting enough sleep. Some people may experience reduced sleep quality.

Can sleep paralysis be prevented?

Getting enough sleep may reduce your chances of experiencing sleep paralysis. Most adults need between 7 and 9 hours of sleep a night. It may also help to keep to a regular sleeping pattern, by going to bed around the same time each night and getting up at the same time each morning.

Try these sleep habits to help prevent sleep paralysis:

• Sleep on your side.
• Avoid napping.
• Use a night light.
• Sleep in a cool and quiet environment.
• Try not to go back to sleep after a sleep paralysis episode.

Other ways to improve your sleep hygiene include the following:

• Cut down on coffee and other drinks containing caffeine — avoid them in the evening.
• Get regular exercise, but not too close to bedtime.
• Do not drink alcohol, smoke or eat big meals before bedtime.
• Reduce your stress and create a relaxing environment, especially before bedtime.
• Avoid screens for 1 to 2 hours before bedtime.

There are also techniques that you can try to disrupt sleep paralysis when it occurs. This includes:

• Try to move your fingers and toes.
• Focus on staying calm and breathing.
• Deliberately try to wake yourself up or stay awake.

Resources and support

If you are concerned about sleep paralysis, you can call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

You can also contact a sleep disorder clinic or sleep specialist.

For more information about sleep:

• Visit the Sleep Health Foundation for information on sleep disorders.
• Try MindSpot’s Sleep Course — a free, therapist-assisted online program to improve your sleep.
• Visit Sleep Disorders Australia for more information on sleep disorders.

If you need help with a condition like anxiety or PTSD (post-traumatic stress disorder):

• Contact Beyond Blue if you’re struggling with depression or anxiety.
• SANE Australia offers advice on self-care and online support forums.

Languages other than English

For practical information in a range of community languages about getting a good night’s sleep, visit the Transcultural Mental Health Centre Practical Guide Series.