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Terrifying Disease| Sleep Paralysis | Trapped Within a Nightmare
What happens when you wake UP in the middle of the night, feeling like something is watching you – and you’re unable to move? Prof. Dr. Krieger explains the terrifying phenomenon of Sleep Paralysis.
Khaleej Times | Weeknd Magazine | December 11, 2015 | Janice Rodrigues
When UAE resident Prithvi Raj woke up in the middle of the night, roughly a year ago, he was filled with an overwhelming sense of panic. This could be credited to many factors – he had woken abruptly, he lived alone, the lights were switched off, his apartment was ‘creepy’ during the night – but the most alarming factor was that he could not move a muscle.
“Think of it as being under anesthesia,” he explains. “You wake up and find you just can’t move. I could see the ceiling above me, and I suddenly had this overwhelming feeling that someone or something was walking around, watching me. I felt like there was some creature – crouched just outside my field of vision – and yet, no matter how much I tried, I could not get up to defend myself… It was like being stuck in a horror movie. You’re trying to convince yourself it is not real, that it is an irrational fear but, at that point, it’s hard to do so.”
Prithvi eventually managed to go back to sleep, but the incident was so vivid that it remains etched in his memory even today. When he woke up the next morning, he immediately looked up the strange phenomenon, and identified it as sleep paralysis, a condition wherein a person awakes from slumber, but is unable to move, speak, or react in any way. A normal episode usually takes place during the span of a few seconds or minutes, although there have been very rare cases that go on for hours. Sleep paralysis is also associated with hallucinations that have people believing there’s an intruder in the room, and in some cases, sitting on their chest, causing breathlessness. In extreme cases, the person may also feel a physical appearance, like a force, running through them – and yet be completely paralysed.
Sound like something straight out of a horror movie? Well, that’s probably because the phenomenon itself has spawned many a mystic tale – from alien abductions to ghouls that visit during the wee hours of the night. And that’s not all – numerous artists in the past have taken to creating sculptures and paintings to depict that they could not explain. Just look up sleep paralysis, and you will undoubtedly come across the painting The Nightmare by Henry Fueseli, depicting a creature sitting on the chest of a sleeping woman.
The horror of sleep paralysis has also left its mark on cultures around the world. According to Nordic folklore, sleep paralysis is caused by a woman whose body is mysteriously carried while she is asleep, allowing her to visit others in the night and have nightmares. In Thailand, it is a popular belief that sleep paralysis is caused by a spirit known as Phi Am. In Turkey, it is known as Karabasan. And on and on the list goes.
So what exactly is sleep paralysis? Today, doctors and professionals have narrowed in on the theory that it is caused due to the disruption of our Rapid Eye Movement (REM) sleep, a phase of sleep that is often associated with movement of the eyes and vivid dreams.
“REM sleep is a sleep stage in which the brain is very active (dreaming) but the body is paralysed,” explains Dr Derk Krieger, professor of neurology and cerebrovascular diseases at German Neuroscience Center in Dubai. “Your body usually does it to protect you from moving while asleep, otherwise you would actually start running if, for example, you were having a dream about a race. Normally, when you wake up, the paralysis vanishes. However, in the case of sleep paralysis, the immobility remains even after you are awake and it can be a terrifying experience.”
He’s not wrong. Kate Bridle, who works as a manager and lead technologist with the London Sleep Centre in Dubai, has not only worked with patients who have had such episodes on a number of occasions, but has also experienced it herself. “The first time it happened, I was in the UK,” she says. “I had just started taking up night shifts for work and my sleep cycle was all over the place, as I was trying to sleep during the day. Then, one day, I woke up and I absolutely could not move. At this time, my bedroom was near the stairs, and I became absolutely convinced that someone was walking up the stairs to attack me.”
This was not a one-off incident. Kate had a similar dream again, a few weeks later, and this time, she was convinced someone was in the room with her.
As spooky as it sounds, the condition is also far more common than we think. According to Dr Rashid Nadeem, pulmonologist at American Hospital Dubai, it is a normal physiology and not a disorder, as everyone, while asleep, is ‘paralysed’. “Any normal person may experience sleep paralysis one or two times in his or her lifetime,” he explains, “as anyone who has a reason to wake suddenly from dream sleep can have it.”
Kate voices a similar observation. “Having sleep paralysis once or twice is very common for most people. However, having repeated episodes is rare, and those having it should look for professional help. People suffering from narcolepsy are also much more likely to have repeated episodes, as sleep paralysis is one of the effects. However, if the event is isolated, it is often hard to find the real cause behind it. The most important thing, at this point, is to get people back into a regular sleep pattern again.”
According to a 2011 study conducted from aggregating data on 36,533 individuals, 7.6 per cent of the population, as a whole, would have at least one incident of sleep paralysis, although the percentage increases for students and psychiatric patients.
However, this leaves us with another question. If sleep paralysis is caused because of a disruption to our REM sleep cycle, why does that create an ‘intruder’ in the room? According to Dr Krieger, this could be because of a disturbance in the part of the brain that is responsible for the sensory processing of the body and self. “This part of the brain creates a structure like a homunculus, the figure which tends to be there in hallucinations,” he says.
Jan Dirk Blom, an assistant professor of psychiatry at the University of Groningen in the Netherlands, who has studied sleep paralysis, voiced a similar belief. According to him, people are much more likely to see things that they already fear because the hallucinations ‘stem from what is already inside our heads’. “This happens because the threat-detection systems in the amygdala are activated. After feeling trapped in their own bodies, patients instantly become hypervigilant about their surroundings.”
Unfortunately, as of now, there is no cure for sleep paralysis. “Sleep paralysis itself will break after a few minutes,” says Dr Krieger. “If someone touches the patient and wakes them up, this will also break the sleep paralysis.” Unlike sleepwalking, there are no negative effects of waking someone in this situation.
However, precautionary measures can be taken to ensure sleep paralysis does not happen again. The first thing to do is alter your sleep pattern and ensure you are getting plenty of sleep, advises Dr Nadeem. Not eating heavy meals before going to bed, restricting the use of electronic activities an hour before sleep and improving your sleep environment by changing your bedding and sleepwear can also help.
“However, if the sleep paralysis keeps happening and is frequent (for example, once a week), then you should really see a sleep doctor,” adds Dr Nadeem. “Especially if there are other complaints present, like daytime drowsiness.”
Unlike other sleep issues like sleepwalking or having frequent nightmares, sleep paralysis is not something that you can forget upon waking, and Kate emphasises that. “You will always know when you have an episode,” she says. “The experience is too terrifying to forget.”
