Have you felt unable to move or speak when you are falling asleep or waking up from sleep? For some, these experiences also include hallucinations such as seeing a figure pressing them down, being filled with fear, or feeling a presence as well as feeling as if they ‘woke up dead’, among others.

Medical experts call this condition sleep paralysis. However, many people are unaware it is a medical condition. They view it as a very scary experience and have different beliefs about it including believing it is a spiritual attack that needs spiritual solutions. This has also led to several myths about the condition.

It is common to hear some people say ‘they were pressed by a demon or spirit the other night.’

According to Dr Olusola Oguntolu, a sleep specialist, sleep paralysis is a transient sensation of inability to move in the wakeful state occurring right after a person awakens from asleep. “As one can imagine, it is very distressing and various causes have been attributed to the phenomenon, some of which are entrenched in folklore. The sensation is sometimes associated with a dream-like state with or without auditory and visual hallucinations,” he said.

The sleep specialist said the condition is due to a discordance in the transition from REM (Rapid Eye Movement) sleep phase to the wakeful state without the usual cycling through the non-REM phase.
When you sleep at night, you cycle through periods of REM and non-REM sleep.

He explained that during REM sleep, all skeletal muscles are paralyzed by design to allow repair, healing and rejuvenation from the wakeful state to occur. The eye muscles (hence rapid eye movement), heart muscles, the diaphragm and respiratory muscles are the only life sustaining muscles that are active during REM sleep.

He said: “We also dream during REM sleep. One can see how the sensations noted during sleep paralysis events are actually normal phenomena in REM sleep with the exception that they occur in the wakeful state. It is a cardinal symptom of obstructive sleep apnea and can occur in narcolepsy, following sleep deprivation, after alcoholic binges and some parasomnic states.”

The sleep expert said some people attribute the effect to the presence of wall geckos on the ceiling exerting motor control powers over the individual adding “These are of course all incorrect as there is a simple physiological explanation for the phenomenon.”


What should people do when they have, or have had sleep paralysis?

The sleep specialist advised people to remain calm and be reassured, saying it will pass. “However, the person must recognize that it is a potential early symptom of an underlying sleep disorder. They should seek competent help from qualified professionals as soon as practical,” he added.

On treatment, Dr Oguntolu said no specific treatment is indicated for the symptom especially since it abates fairly quickly. He said beyond reassurance, treatment of any predisposing condition is imperative. “The risk of recurrence is high if the condition (e.g. obstructive sleep apnea) is left untreated.

“Also, sleep deprivation, alcoholic binges and sedative abuse should be avoided if possible. See your doctor if sleep paralysis occurs often and/ or routinely prevents you from getting a good night’s sleep,” he advised.