I need some advice about sleep

Hi Betty,

There's absolutely no need to worry about this completely harmless phenomenon. It's called sleep paralysis. Most people will get it once or twice in their life, but about 5% of the population experience it on a regular basis. I'm one of the 5%, having had SP for more than 50 years, and I also happen to be a former neuro nurse so I know quite a bit about it, one way or another.

If you've only had it a few times it's too early to say whether you're going to be stuck with it for life. The repeat attacks could just be down to anxiety about having another episode. The regularly-occurring kind usually starts between the ages of 15 and 25, though it can sometimes start later in life.

What is it? Well, when we sleep we go through regular phases of dreaming and non-dreaming sleep. And everyone dreams, regardless of whether or not they remember their dreams when they wake up. This phase is often called REM sleep, after the Rapid Eye Movements that can be observed in someone who's dreaming. During the REM phase, the brain - everyone's brain - secretes a hormone that paralyses all the voluntary muscles in the body (except those that move the eyes) to stop us jumping up and acting out our dreams. If you think about it, this is a pretty good idea, isn't it?

There's no need to be afraid of this perfectly normal paralysis, which only affects our voluntary muscles. The muscles of the autonomic system, which control things like heartbeat, breathing, automatic swallowing, digestion etc., aren't affected by the paralysis. This means your life is never in danger while you're sleeping.

Every now and then - and more regularly in the 5% of us who get regular sleep paralysis - the secretion of the paralysing hormone gets slightly out of sync. This means it continues pumping out for a few seconds (or even a couple of minutes) after we wake up or, more rarely, it starts up just before we fall asleep. This results in the scary realisation that we can't move any of our voluntary muscles.

The best thing to do when you wake up in this state is to remain calm and wait it out - which can be easier said than done, as I know from experience. Attempts at violent struggling can actually make things worse. If you feel you want to do something, it can help if you concentrate very hard on moving the last joints of your fingers, or wiggling the tip of your tongue.

Once you do come out of it, it's a good idea to move immediately - sit up or turn over. You may have noticed that you feel abnormally sleepy when you come out of it, and feel as if you're being sucked back to sleep. This isn't harmful, but it can lead to you going straight back into another episode.

It may well be that you won't get any more attacks now that you've (hopefully) been reassured. However, if it does start becoming a regular event, there's quite a lot you can do about it. The main thing is to identify what it is that triggers these episodes, then avoid your triggers as far as possible.

There are almost as many triggers as there are people who have sleep paralysis, so it's a very individual thing. However, I'll cover a few of the more common ones. Sleeping too much is quite a common trigger. I'm more likely to have an episode if I'm sleeping late or taking an afternoon nap. This is because the longer we sleep, the more time we spend in REM sleep, where sleep paralysis arises. Some people find the opposite though - they're more likely to have an attack if they're sleep-deprived. Getting overheated when sleeping is another fairly common one. I can never sleep under a duvet or quilt, even in very cold weather, as this will guarantee an attack. Recreational drugs - especially cannabis - can trigger episodes in susceptible individuals, as can too much alcohol drunk too late in the evening. Some people also find they can identify certain foods that can trigger an attack if eaten late in the day. Sleeping too close to electronic equipment of any kind can be another trigger - which isn't surprising when you realise that the brain functions via electrical impulses - so you need to switch off your phone at night, or at least keep it well away from your bed. And any kind of stress or anxiety - especially anxiety about having another attack - is a common trigger.

In summary - don't worry about this, you're not going to die in your sleep. As already mentioned, you may never have another attack anyway, if you can manage to calm your anxiety.

If you have any more questions, please don't hesitate to post them here.