Sleep paralysis

It can affect anyone. It often first appears in childhood or the teenage years, and episodes are more common in people’s 20s and 30s.

Women report it slightly more often than men.

Pooled studies suggest about 7.6% of people have had an episode, but rates are much higher in some groups and some countries.

For many people it happens once or rarely. For others it comes back often and starts to cause fear of going to sleep. That is when support is worth seeking.

Sensing a dangerous person or presence in the room is one of the most common experiences. Some people see a shadowy figure; others only feel that someone is there.

Some people feel pressure on their chest or a sense of suffocation. Across history and cultures, this is often described as something sitting on the sleeper.

Some people feel as if they’re moving out of their body or floating. These sensations can be strange but are part of the same sleep-wake mix.

Fear, panic and helplessness during an episode are common, often followed by confusion and tiredness.

• Brazil: Pisadeira, a crone who lurks on rooftops at night
• Inuit communities in Canada: uqumangirniq, linked with a shapeless presence
• Mexico: “se me subió el muerto”, meaning “a dead body climbed on top of me”
• Newfoundland, Canada: the Old Hag, a witch who sits on the sleeper
• United States: some modern accounts describe it as an alien visit

• Cambodia: khmaoch sângkât, “the ghost that pushes you down”
• China: traditionally described as ghost oppression
• Hmong communities: a pressing spirit that sits on the chest
• Japan: kanashibari, “being bound as if by metal chains”
• Thailand: phi am, a ghost that visits the half-asleep

• Egypt: often linked with jinn
• Ethiopia: dukak, a spirit that troubles sleep
• Yoruba people of Nigeria: ogun oru, a night-time attack during dreaming

• Ancient Greece: ephialtes, “to pounce upon”
• Ancient Rome: nocturna oppressio, “night-time pressing”
• Catalonia: pesanta, an animal that steps on the sleeper’s chest
• Medieval Europe: blamed on an incubus or demon

One therapy for sleep paralysis starts by helping people reframe what the episode means, then step back from it emotionally. This suggests that how you interpret an episode matters.

Across cultures, people cope with sleep paralysis through prayer, reading scripture, music, meditation or having a trusted person nearby.

Hallucinations during sleep paralysis happen at the edge of sleep and come from REM sleep spilling into waking. That is very different from hallucinations during the day.

Not enough sleep and broken sleep are strongly linked with sleep paralysis. So are irregular sleep times, like shift work and jet lag.

Sleep paralysis seems especially common in PTSD, and to a lesser degree in panic disorder. It is also linked with anxiety and stressful life events.

Having relatives who experience sleep paralysis makes it more likely. Genes seem to play a part.

Sleep paralysis is linked with narcolepsy and obstructive sleep apnea. Between 30% and 50% of people with narcolepsy experience it.

The NHS suggests trying not to sleep on your back. Some experts also suggest avoiding sleeping on your stomach.

The four steps

1. Reappraise: remind yourself what the episode really is.
2. Distance yourself: you don’t need to engage with fear or images.
3. Focus inward on something positive and calming.
4. Relax your muscles.

In a small pilot study, people who used this approach for 8 weeks had about half as many days with sleep paralysis. It needs larger studies.

Waking someone who is in an episode is safe. Touching or talking to them can help them regain movement.

• Get up briefly or change position
• Notice your breathing slowing down
• Remind yourself it’s over and you’re safe
• Switch on a soft light

• Avoid joking about ghosts or demons if it scares them
• Let them know it’s common and has a name
• Listen without judging what they saw or felt
• Offer to help them keep regular sleep times
• Respect their beliefs about what it means

It’s safe to wake someone during an episode. Some people like a gentle touch or their name said softly. Ask them in the daytime what they would prefer.

Across cultures, people cope with support from family, faith leaders and trusted people in the room. Community can make a frightening experience feel shared rather than secret.