The Bogeyman in Your Mind

mysterious figure looking in windowImagine waking up in the middle of the night to an unearthly figure with blood dripping down its fangs. You try to scream, but you can’t. You can’t move a single muscle! If this sounds familiar, you’ve probably experienced an episode of sleep paralysis, which involves the inability to move or speak upon falling asleep or awakening and is often coupled with hallucinations.

Up to as many as four out of every 10 people may have sleep paralysis. This common condition is often first noticed in the teen years. But men and women of any age can have it. Sleep paralysis may run in families. Other factors that may be linked to sleep paralysis include:

  • Lack of sleep
  • Sleep schedule that changes
  • Mental conditions such as stress or bipolar disorder
  • Sleeping on the back
  • Other sleep problems such as narcolepsy or night time leg  cramps
  • Use of certain medication, e.g. for ADHD
  • Substance abuse

However, despite its prevalence, it has largely remained a mystery. For centuries, cultures across the world have attributed these hallucinations to black magic, mythical monsters and  paranormal activity.

pond surrounded by trees with a hand sticking out of pondThese hallucinations—often involving seeing and sensing ghostly bedroom intruders—are interpreted differently around the world. In Egypt, sleep paralysis is often thought to be caused by a jinn, i.e. a genie. In Italy, some interpret sleep paralysis as an assault by the so-called Pandafeche, a figure described as a malevolent witch or terrifying giant cat. In South Africa, Indigenous people believe the state to be caused by segatelelo (black magic), involving menacing dwarflike creatures called tokoloshe, and in Turkey, it is the karabasan—mysterious spirit-like creatures. In contrast, the Danes offer a less imaginative explanation: they largely attribute sleep paralysis to physiological risk factors such as stress.

However research, conducted over roughly a decade in six different countries, suggests that beliefs about sleep paralysis can dramatically shape the physical and psychological experience, revealing a close relationship between mind-body responses.

What Causes Sleep Paralysis?

The brain has a “switch” (actually a handful of neurochemicals) that tilts you between sleep and wakefulness. Sometimes the “switch” fails, however—your brain inadvertently wakes up while your body is still under the “spell” of REM paralysis, leaving you stuck in a state between wakefulness and REM sleep. During sleep paralysis, the dream comes alive before your eyes—fanged figures and all.

Sleep paralysis is caused by what appears to be a basic brain glitch at the interface between wakefulness and rapid eye movement (REM) sleep. During REM dreams are intensely lifelike; In order to prevent the acting out these realistic dreams – and possibly hurting yourself and others – your brain temporarily paralyzes your entire body.

These explanations—scientific and sensationalist—can have a profound impact on how people experience sleep paralysis. When directly comparing the phenomenon in Egypt and Denmark, we found that Egyptians fear it much more than Danes do. In fact, more than 50 percent of Egyptians who experienced the condition were convinced that sleep paralysis was deadly. Egyptians also believed that the episodes lasted longer—and remarkably, they occurred three times more often for this group. Beliefs about sleep paralysis among Egyptians appeared to have dramatically shaped their experience. Those who attributed it to supernatural forces suffered greater fear of the experience and longer paralysis. A pattern was revealing itself. Paired with particular beliefs, sleep paralysis had gone from a simple “brain glitch” to a chronic, prolonged and potentially fatal supernatural event.

Research suggests that cultural beliefs about the phenomenon may make it more terrifying to experience. It appears that the more people fear sleep paralysis, the more they experience it, and the stronger its effects are. Anxiety and stress predispose people to an attack, so those who dread it are often more likely to experience it. Indeed, sleep paralysis is nearly twice as common in Egypt, compared with Denmark. In addition, researchers in Italy discovered that those who believe their sleep paralysis may have a supernatural cause are also more likely to hallucinate during the attack—including experiencing a ghostly “sensed presence.”

boy sitting on sofa with three cushions covering him

New findings raise the intriguing possibility that sleep paralysis, if accompanied by certain beliefs, is not just frightening but may also be potentially traumatizing. The effects can linger long after an episode ends. Notably, in an Egyptian study, it was found that people who have experienced the phenomenon have elevated trauma and anxiety symptoms, relative to those who have never experienced it. Those with visual hallucinations—seeing “demonic beings,” say—are even more at risk. Another study in Italy showed that fear during sleep paralysis, and fear of dying from the attack, was linked to trauma and depression symptoms.

For those suffering from sleep paralysis, sleep is not an escape from reality; for some, “sleeping” can potentially lead to a mental disorder.

Treatment Options for Sleep Paralysis

A first step in treating sleep paralysis is to talk with a doctor in order to identify and address underlying problems that may be contributing to the frequency or severity of episodes. For example, this could involve treatment for narcolepsy or steps to better manage sleep apnea.

Overall, there is limited scientific evidence about the optimal treatment for sleep paralysis. Many people don’t know that the condition is relatively common and thus see themselves as crazy or shameful after episodes. As a result, even just the acknowledgement and normalization of their symptoms by a doctor can be beneficial.

Because of the connection between sleep paralysis and general sleeping problems, improving sleep habits is a common method to prevent sleep paralysis.

Examples of healthy sleep tips that can contribute to better sleep hygiene and more consistent nightly rest include:

  • Following the same schedule for going to bed and waking up every day, including on weekends.
  • Setting up your bedroom to have limited intrusion from light or noise.
  • Reducing consumption of alcohol and caffeine, especially in the evening.
  • Putting away electronic devices, including cell phones, for at least a half-hour before bed.

Improving sleep hygiene is frequently incorporated into cognitive behavioural therapy for insomnia (CBT-I), a specific type of talk therapy that works to reframe negative thoughts and emotions that detract from sleep.

Some medications are known to suppress REM sleep, and these may help to stop sleep paralysis. These medications can have side effects, though, and may cause a rebound in REM sleep when someone stops taking them. For these reasons, it’s important to talk with a doctor before taking any medication in order to discuss its potential benefits and downsides.