Sleep Paralysis – What causes it? Is it related to PTSD or demons?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Sleep paralysis.
Photo courtesy of Pixabay.com

Is Sleep Paralysis related to PTSD or the supernatural?

Imagine awakening suddenly in the middle of the night. Sitting on your chest is a demon; there are ghosts, dead people, or spirits standing around your bed. You try to scream but nothing comes from your throat. You would run if you could but your legs won’t work. You are awake and paralyzed. Looking up at the demons you are helpless to do anything beyond saying a silent prayer inside your head. You are experiencing Sleep Paralysis.

Sleep Paralysis is one of those unusual problems. This condition is especially terrifying to someone who has the disorder.  If you have a belief in the supernatural you may dread falling asleep.

Sleep Paralysis has long been more the province of legends and the supernatural than included in the area of mental health. This experience has been connected to many otherworldly phenomena. Similar experiences were described during the Salem witchcraft trials.

Today we have a scientific explanation that satisfies some, some of the time, but are we sure?

In Sleep Paralysis you can see, move your eyes and breathe, but the rest of your body is unable to move.  Some episodes of Sleep Paralysis last seconds. The average is six minutes. Occasional an episode of sleep paralysis will last longer than 6 minutes or on rare occasion’s hours.

Many people with Sleep Paralysis, up to 30% also have a history of Panic Attacks. It is more common among those with PTSD or anxiety disorders. Sleep Paralysis is also most common among those with minority status, especially African-Americans (Sharpless et al 2010.)

Other researchers have suggested that dissociation may be related to the old or “Lizard brains” freeze response to threat or danger. The same mechanism might explain the inability to move despite overwhelming terror found in Sleep Paralysis. Fear and anxiety may both cause and be the consequence of Sleep Paralysis.

Sleep paralysis is more common with overtired or sleep-deprived individuals. It is also associated with taking Antidepressants, Benzodiazepines, and some other medications. Ohayon et al., 1999 (Cited by Sharpless) also suggested a relationship between SSRIs and Sleep Paralysis but Sharpless did not find a connection.

Sleep paralysis can occur when falling asleep or when awakening from sleep. Its main characteristic is not being able to move for an extended period of time. This condition occurs naturally during REM sleep but we don’t know we are becoming paralyzed when we are asleep.

The episodes of paralysis while awake are most often accompanied by very vivid hallucinations. The more vivid the hallucinations the more terrifying the Sleep Paralysis. Sometimes the person will experience hearing sounds. Even when experiencing the full symptoms of Sleep Paralysis, both the visions and the inability to move, many people describe the experience as a “dream” (Fukuda et al, 2000.)

If the hallucinations occur when falling asleep they are called Hypnogogic. Hallucinations that occur when awakening are called Hypnopompic.

Sleep paralysis may be connected with a physical disorder such as Narcolepsy. Reports suggest that those who hear sounds are most likely to also have narcolepsy. Sleep paralysis has also been associated with Migraines. If this occurs more than once or causes significant distress it is wise to seek medical attention.

Sleep paralysis is more likely to occur when someone has moved to a new location, is under stress, or has consumed an excessive amount of alcohol.

Mental health practitioners, therapists, and counselors are mostly concerned with two relationships between sleep and mental health. Is the problem with sleep caused by a mental illness? Symptoms of depression include changes in sleep and appetite. Depression can be seen as the cause of a sleep problem.

Sometimes sleep issues can create symptoms that are diagnosed as mental illness. Nightmares play a role in maintaining depression and PTSD.

Beyond those two alternatives, most other sleep issues are in the providence of medical doctors. There are plenty of sleep problems that are in the International classification of sleep disorders that are not directly included in the DSM.

The following are past posts on connections between sleep and mental health issues.

Getting Rid of Nightmares that Maintain Depression and PTSD

Trauma Steals Your Sleep 

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