Does sleep paralysis cause or is it caused by mental illness?

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

More on Sleep paralysis.

Sleep paralysis.
Photo courtesy of pixabay.

Remember this is written from a therapist’s point of view. If there is any chance that you or someone you know has a medical problem, have it checked out by a doctor first. But if the doctor finds nothing medically wrong with you that does not mean you are going crazy. It might mean that you can benefit from some counseling to help you better cope with stress.

Many people who experience sleep paralysis, hypnogogic hallucinations or “exploding head syndrome,” think they are going crazy or fatally ill. Knowing that these are explainable phenomena and have simple treatment can reduce the concerns. Sleep Paralysis and many related sleep problems are often triggered by stress. More stress, good or bad stress, and the chances of an attack increases.

People who become fearful of another occurrence of Sleep Paralysis can “prime the pump” and increase the risks of a second bout in the same way people who experience panic attacks begin to worry about having another episode.

If clients describe these events as dreams the doctor is likely to reassure them that it is normal. Patients who explain these events as demons, spirits or believe they actually saw a supernatural being are likely to be prescribed a psychiatric medication. Antipsychotics, antidepressants and anti-anxiety medications (Benzodiazepines) are all believed to increase the incidence of Sleep Paralysis and Hypnogogic Hallucinations (Gangdev, 2004.)

Other things that have been reported to increase the risks of having an episode of Sleep Paralysis include being physically ill, such as having the flu, watching or experiencing emotionally upsetting events, such as having an argument.

If the paralysis or hallucinations only occur when going to sleep and waking up they are most likely sleep-related and not the result of a mental illness. Gangdev, in his article, asked the question: “It is possible that a small proportion of patients diagnosed with schizophrenia who experience hallucinations may actually be experiencing escaped REM-related dream activity during the wakeful state?”

There is a significant overlap between sleep paralysis and Narcolepsy. Narcolepsy includes not only sleep paralysis but hypnogogic and hypnopompic hallucinations, daytime sleepiness and Cataplexy (sudden unexplained loss of muscle tone.)

Sleep Paralysis without any cataplexy or daytime sleepiness is not considered to be associated with Narcolepsy and is referred to as Isolated Sleep Paralysis (ISP.) Penn reported that 16 % of medical students reported at least one episode of sleep paralysis. That makes me think that long hours and sleep deprivation may be a major cause of many of these events.

Sleep Paralysis is far more common in African-Americans and in one study of Nigerian subjects more than half had experienced ISP. It is also common in Japanese Subjects.

People who have a Sleep Paralysis event find it helpful to get up move about and make sure they are fully awake before attempting to return to bed. People who do not get out of bed have an increased risk of having multiple episodes of sleep paralysis in the same night. Sleeping flat on your back looking up at the ceiling (supine position) is much more likely to cause a Sleep Paralysis experience than sleeping on your side.

Knowing that episodes of Sleep Paralysis and Hypnogogic Hallucinations are relatively common and most often harmless can help someone cope with these experiences.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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 other worldly 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 SSRI’s 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 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.