Nightmares or a crippling reality? A review on sleep paralysis.

Abstract

Sleep Paralysis (SP) is a state that occurs during the hypnagogic or hypnopompic period in which one finds themselves unable to move despite being conscious. During an episode of SP, the individual experiences muscle atonia, as they would during normal sleep, but they remain conscious. SP is also largely associated with three types of hallucinations - the 'intruder', the 'incubus', and an out of body experience. It can induce tremendous fear in the individual experiencing it, and cause significant distress. SP has been found to co-occur with chronic conditions such as hypertension and obstructive sleep apnea, and is also associated with Post-Traumatic Stress Disorder. SP has also been depicted in folklore for centuries, leading to various superstitions surrounding its occurrence. Given the sense of fear associated with episodes of SP, as well as the role culture and folklore have played over centuries in using superstition to explain this phenomenon, it is imperative for the primary care physician to empathetically address the patient's concerns and scientifically, yet sensitively, help dispel myths pertaining to SP. The fact that SP co-occurs with various comorbid conditions, as well as its association with serious psychiatric conditions such as Post-Traumatic Stress Disorder (PTSD) warrants ascertaining a history of its episodes during routine clinical interviews and, if needed, liaising with the appropriate specialists to provide the best therapeutic outcome to the patient.