Frightening sleep paralysis and scared to go to sleep...

Hi lily thanks for the reply, it seems you have some very similar symptoms to me. I'm starting to wonder if what i call the electrocuting feeling in my head is similar or the same to the extreme vibrations you mentioned.the ones you have. Would you consider them overpowering and painful, almost as if an electric current is being passed through your head/torso? I spoke to me mum a few minutes ago about this as I havent told anyone in my family yet, and she admitted to me she had sleep paralysis but never spoke about it for fear of sounding 'crazy'. so maybe there is a hereditary link after all. she didnt give much insight into hers apart from the feeling of being pinned down and terrified, but no pain like me.

I only have one cup of coffee a day, i quit smoking 2 years ago and i dont use any illicit substances. I do drink but not every day and in moderation, I seem to have SP attacks when i dont drink. usually if i have 2 or 3 drinks i sleep okay (well as best an insomniac can sleep). But i dont want to get caught in the trap of drinking myself to sleep every night as that leads down a bad road. i was given mirtazapine a while back for my insomnia but i didnt like the way t made me feel the next day. very groggy and disorientated. do you think that might help me sleep though Sp or do you think it would possibly worsen the attacks? i ask because of your medical background and the amount of experience you stated you have. all i really want is some sleep, im so exhausted

Also i dont know if this is just sleep deprivation or an actual thing, but it seems like today ive had faint murmurs of that vibration/electric feeling in my head for like a split second n then its gone intermitently while awake since my last SP episode

Oh yes, forgot to mention - the electrocution thing too. Though I get it in my limbs and stomach rather than my head. We all get a different subset of symptoms. I can't say I've ever had it during the day, but I have on two occasions in my life had that terrible "sinking" feeling you get in the solar plexus at the start of an attack, but while wide awake. Both times I dropped to the ground from a standing position, momentarily paralysed. This is known as cataplexy (nothing to do with catalepsy, which can occur in schizophrenia).

Cataplexy, which can be triggered by stress, is associated with narcolepsy, when people suddenly fall asleep during the day. In my neuro nursing days, it was thought that narcolepsy, cataplexy and sleep paralysis always went together, but this has now been disproved. However, a lot of sleep paralysis subjects, though not suffering from true narcolepsy, do suffer hypersomnolence - a tendency to nod off during the day if not being actively stimulated. This is certainly true in my case, and even more for my dad, who twice fell asleep while riding his bike! I've never dared drive because of this.

As this has only happened to me twice in my whole life - once on the day of my father's death and on another occasion when something scared me in the street - I don't know a lot about cataplexy. I did, however, note both times that the momentary loss of power was preceded by the exact sinking sensation I often experience in dreams immediately before the onset of an SP attack. I'm speculating here, but I'm wondering whether something similar was happening to you with the electrocution feeling when you were awake. Did you experience any fleeting muscle weakness at the same time? But it could equally be sleep deprivation, which can produce all kinds of symptoms.

I really don't know whether mirtazapine might help. A few years after the SP started I was prescribed one of the older antidepressants (amitriptyline) for depression. That didn't make the slightest difference to the SP - or the depression for that matter - and I stopped taking after a couple of months as I couldn't stand the side-effects. However, some of the people I talked to on the SP project found this group of drugs helped a bit. The one most often mentioned was sertraline, 

Oops! the site gremlins got to me again. Posted that last one before I intended to. I'm still getting used to my Mac, and sometimes get caught out by the hidden keyboard commands. To start the last sentence again:

...The one most often mentioned was sertraline, as far as I remember. However it only seemed to help around half the people who took it.

My saviour in the days when I had frequent bad attacks was Phenergan. This is one of the older OTC antihistamines - the type that make you sleepy. I used to take a ridiculously small dose - 2.5mg, which is half the dose a five-year-old can take three times a day! I used to buy the 10mg tablets and cut them in quarters. I'm sure it was all psychological, but it usually worked. But it's no good taking such a mild sedative at the point of going to bed, as it takes at least an hour to have any effect at all. I think you can still get them in the UK, though you can't here on the Continent. I last bought a packet in the Big B in the UK about five years ago. A word of warning though - don't rely too heavily on antihistamines, as you can develop tolerance to them and find yourself taking ever-increasing doses.

And alcohol? I readily admit to that one - though my liver doesn't have to last as long as yours! I drink wine most evenings and have always found it very helpful in helping me to relax before bed, though I have to be careful with the amount. I find there's quite a narrow margin between not enough and too much - and drinking too much of any alcohol late in the evening is likely to trigger an attack for me.

Interesting to hear your mum has it too, but not surprising. Sad, though, that someone of her generation still feels the need to keep it a secret because of fears of "craziness". The fact that she doesn't feel any pain doesn't mean a thing. We all get different effects. I sometimes feel excruciating pain during my attacks, but my father had no tactile hallucinations at all. He used to see and smell things - usually disgusting things. The latter is very rare but SP hallucinations can affect all the senses. I've even heard of one person who experienced strange tastes during attacks.

Your replies are always great even though your knowledge base comes from you having to endure and suffer with this awful condition.

Thumbs up for mirtazipine it has given me myself back! It's fantastic!

Hope your okay lily and it's great your on this forum xx xx

god bless

I see there's the term "narcoleptic tetrad" comprising cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness. I guess there must be some association between them even if it's only one of categorization!

REM-sleep-reducing drugs are often tried it seems, which include nearly, but not quite, all the anti-depressants. Mirtazapine can produce near hallucinogenic visual experiences of its own, in high doses anyway. (And there's the weight gain problem with it.) Desipramine and imiprimine are cited in one source on the subject. (The latter has no effect on me at all, never been given the former, but that's not relevant here.)

Robert, I couldn't agree more that antidepressants aren't really the answer for the majority of SP subjects. Way too many side-effects, plus the fact that they don't work for everyone. I understand mirtazapine is the worst for weight gain but they can all pile on the pounds. And then there are the withdrawal problems if you take them for any length of time...

I also agree about medical attention potentially giving psychological reinforcement to the problem rather than providing a solution. Though there's definite psychological input to this condition, it's most emphatically not a mental illness and shouldn't be treated as such. Looking back 50 years, I can see I'm probably lucky that psychiatrist yelled at me to get out (though he could at least have been a bit more sympathetic and helped me understand what was happening to me).

Most people do best by learning to live with and manage the condition, which starts to become easier once they've been reassured. Fortunately, sleep paralysis is a lot more amenable to identification of triggers, and therefore management, than night terrors, which are episodes of total delusion with no possibility of insight and the nightly risk of physical harm. I was lucky in that I only experienced severe night terrors for a period of 18 months, 25 years ago, but there are a couple of guys on another board on this site who are having a terrible time with them. Give me sleep paralysis any time!

Thank you Lorraine. Your replies are very caring too.

I wouldn't really describe myself as "enduring and suffering" with either of my two sleep disorders. Well, three actually - I suffer a degree of sleep apnoea too! Fortunately that's improved since I lost a bit of weight and since my recent house move I have a new GP, who I think might be more ready to refer me to a sleep lab than the old one. Now that's a sleep disorder that's really worth investigating!

I think it's more a question of accepting that I have these minor inconveniences and living with them. And they are minor, in comparison with what some people have to suffer. Sleep paralysis in particular is something of a gift too, as we tend to have lucid dreams, which can be wonderful. I'm sadly losing that ability with age, but still retain vivid memories of transcendental experiences in lucid dreams many years ago.

I'm glad you're finding mirtazapine works for you. One of my reasons for not taking an antidepressant is that they tend to suppress dreams and I didn't want to lose that. We all have our different ways of approaching the condition and no one approach is better than the others.

Lily xx

Hi Lily thanks for the reply, I do sometimes just feel like im going to drop in the day, with feelings of extreme tiredness and/or sickening anxiety sometimes accompanied by a short spell of dizziness in my head (usually resembling the electric feeling) although I've just put it down to sleep deprivation. my energy levels and motivation have been pretty much zero the last few weeks because of it, to be honest even though i havent been sleeping much, i feel so fatigued ive spent most of my time in bed. i'm starting to wonder if maybe my Sp problems are linked to stress and chronic pain. I recently seperated from the mother of my child 4 months ago, which was pretty stressful and ii also have really bad back pain and have had major surgeries on my left arm and left leg from serious accidents and last year was also diagnosed with a degenerative bone disease which seemed to have been causing me most of the chronic pain ive been feeling for the last 10 years. I've never asked or recieved any outside help and tend to go it alone. I take tramadol when I'm in pain but everything else I just kind of bottle up and surpress. I have decided that I'm going to see a counciller just to cover the angle of stress. I have to make a start somewhere i suppose. I'm tempted tonight to try and take a small dose of mirtazapine, maybe just 7.5mg and see if that has any effect on helping me to sleep

Yes, stress can be a massive trigger for SP, though the underlying cause is a minor brain glitch, which is usually hereditary.

During the last nine years of my mother's life, when she was going down to dementia and we couldn't get any help at all, I was constantly back and forth to her place. I lived 200 miles from her and am an only child. We'd never had a good relationship and I didn't want to sacrifice my life - which included a decent career and having taken out a mortgage on a small place of my own - by moving back in with her. I came under huge pressure from family friends over this, of course.

As time went on, I found myself having to spend more and more time with her. I lost one job after another because of constantly having to drop everything and run home, ended up alternating between the dole and temporary work (we can legally do that here) and lost all but one or two friends as I couldn't go out in the evenings without having to field constant phone calls. Mega-stress.

I was OK when I was at home, but had terrible nights whenever I was staying at my mother's place. My SP attacks usually occur towards morning or during daytime naps, when I'm sleeping lightly and can immediately figure out what's happening to me and deal with it. But when I was there, they invariably started only half an hour or so after falling asleep exhausted, when I was groggy and confused so took it all as real. And I had up to half a dozen a night. I put some of it down (rightly, I think) to the fact that there were overhead high-tension cables running just 20 yards from her house, and an electrical substation, that hummed all night, about 100 yards away. But I'm fairly sure most of it was due to stress.

In my opinion, your multiple stresses are clearly triggering this recent wave of attacks, and making them much worse than they'd normally be.

By all means take the smallest possible dose of mirtazapine to help you get an occasional good night's sleep, but please avoid taking them regularly. We're not allowed to post links here but google mirtazapine and Mental Health Daily. There's a forum on there concerning withdrawal and it makes scary reading. As a number of people on the forum point out, most GPs (and even some psychiatrists) have absolutely no knowledge of the side-effects and the truly terrible withdrawal effects of these drugs, and may even tell patients there are none!

I really understand the dark place you're in right now. Try and bear in mind that though SP is for life, it won't always be anything like as bad as it is right now.

Just noticed - earlier on you mentioned seeing a counsellor. Now that would be a really good idea, especially if it was for CBT. That's the best approach to stress. But if it were me, I'd be more inclined to focus on the stress during sessions, rather than the SP. Most counsellors - like most doctors - won't have heard of it or won't want to touch it, and you could end up getting referred back for drug therapy. But that doesn't matter. If you can get your stress levels under control the SP attacks will diminish. After my mother's death, my SP attacks immediately went back to "normal" levels.