Sleep paralysis is often a symptom of another sleep disorder, like narcolepsy. But you can still experience this phenomenon if you do not have narcolepsy.
Have you ever woken up and temporarily couldn’t move? If so, you’ve experienced sleep paralysis.
This parasomnia (a type of sleep disorder) is fairly common: Some research suggests roughly
- anxiety disorders
- post-traumatic stress disorder (PTSD)
- other sleep disorders
Sleep paralysis frequently shows up as a symptom of narcolepsy, a condition involving extreme daytime sleepiness. Some evidence suggests
Below, learn how sleep paralysis with narcolepsy differs from isolated sleep paralysis, plus get tips to cope with this sleep issue.
Sleep paralysis often happens as part of rapid eye movement (REM) sleep — the stage of sleep where you dream. You’ll typically enter REM sleep
During the REM stage, your brain “freezes” your muscles so you don’t get up and start acting out your dreams. This muscle atonia, as it’s called, occurs naturally to protect you.
If you happen to wake up while transitioning between sleep stages, you may find you’re still unable to move for a brief period of time. This is when you might experience isolated sleep paralysis, or sleep paralysis that happens when you do not have narcolepsy. These episodes don’t last long — usually only several seconds to a minute or two.
But if you have narcolepsy, sleep paralysis might show up a bit differently.
If you have narcolepsy, your brain has difficulty controlling your sleep-wake cycles. As a result, you might slip into REM sleep very soon after falling asleep. If this happens, you might experience an episode of sleep paralysis just as you begin to drift off, instead of later in the night or as you’re waking up.
With narcolepsy, you may also have sleep paralysis somewhat regularly, instead of every once in a while.
If you do have narcolepsy, you’ll have other symptoms beyond sleep paralysis.
You’ll most likely also experience some of the following:
- Daytime sleepiness: You’ll experience sudden episodes of extreme sleepiness. You may feel an overwhelming urge to fall asleep right away and have trouble keeping your eyes open. These “sleep attacks” will happen even if you get plenty of sleep.
- Hallucinations: You may experience very vivid and realistic hallucinations as you fall asleep or wake up. These can involve any of your senses, but they’re usually visual.
- Cataplexy: During an episode of cataplexy, some or all of your muscles suddenly go weak when you’re awake. Cataplexy usually only lasts a few minutes and typically occurs after you experience intense emotions like excitement, anger, or fear. It only happens with narcolepsy type 1 (narcolepsy with cataplexy).
- Automatic behaviors: You may fall asleep for just a few seconds at a time. If this happens, you might keep doing whatever you were doing when awake like talking with a friend. You “wake up” feeling recharged and energized — but then your friend says you suddenly started mumbling into the phone.
- Fragmented sleep: If you have narcolepsy, you may have trouble falling or staying asleep. Many people with narcolepsy also have other sleep issues like sleep apnea, restless leg syndrome, or insomnia.
If you have symptoms of narcolepsy, consider connecting with a healthcare professional. Your primary care doctor or another clinician can refer you to a sleep specialist who can help you get the right diagnosis.
They’ll do an exam and take your health history to help rule out any other sleep disorders or other health conditions.
Make sure to let them know about all your symptoms, especially cataplexy — this symptom is very rare in people who do not have narcolepsy.
A sleep specialist will likely suggest you keep a sleep journal for a week or two to track:
- when you fall asleep
- how long you stay asleep
- how much sleep you get at night
- when you feel sleepy during the day
- unusual images, sensations, or other experiences when drifting off or waking up
- episodes of sleep paralysis
From there, you’ll participate in two specific diagnostic tests at a sleep clinic.
First, you’ll do a polysomnogram (PSG), or sleep study. This test monitors brain activity, breathing, and muscle and eye movements over the course of a night. It also shows when you experience REM sleep.
Next, you’ll take a multiple sleep latency test (MSLT). This test involves taking 5 naps in 1 day, with each nap spaced 2 hours apart. Sleep specialists use this test to track how quickly you fall asleep and when you enter REM sleep during each nap.
In some cases, your care team may also recommend a lumbar puncture to test your spinal fluid for a hormone called hypocretin.
This hormone helps regulate sleep and wakefulness, and experts have linked low hypocretin levels to narcolepsy type 1.
If you have narcolepsy, getting treatment may help ease all of your symptoms, including sleep paralysis.
These tips may also help minimize sleep paralysis episodes.
- Aim to get a full night’s sleep: Lack of sleep can play a part in any number of sleep issues, and sleep paralysis is no exception. Getting 7 or 8 hours of sleep each night may help prevent sleep paralysis. Following a regular sleep schedule, or going to bed and getting up at the same time every day, can also help.
- Take time to unwind before bed: A bedtime routine could help you get more restful sleep. As a start, consider setting aside the hour before bedtime for relaxing activities like meditating, journaling, or soaking in a warm bath.
- Avoid drinking alcohol and caffeine in the evening: These substances do not just make it harder to fall asleep. They can also disrupt your rest and potentially contribute to sleep paralysis. Nicotine may also
raise your riskof sleep paralysis.
- Create a comfortable sleep environment: A cozy bed and soothing bedroom can do a lot to boost the quality of your rest. You might consider investing in a mattress that meets your comfort standards (or add a budget-friendly topper), setting your thermostat to a cool temperature, updating your sheets, or adding a few new pillows to the mix.
- Try sleeping on your side: Anecdotally, sleep paralysis seems to happen more often when sleeping on your back. While back sleeping does offer plenty of health benefits, rolling onto your side will not hurt — especially if it helps improve your rest.
Sleep paralysis usually does not pose any lasting health consequences. Still, these episodes may feel uncomfortable or unsettling, and if you experience them often, you might start to worry about falling asleep.
A sleep specialist can help diagnose sleep disorders that involve sleep paralysis, like narcolepsy. But if you do not have narcolepsy, it may be worth reaching out to a therapist. Mental health professionals can offer more guidance with exploring daytime concerns that factor into sleep paralysis and other sleep issues.