Rise and paralyse

I’m seven years old and I can’t breathe.

I’m zooming down a black-and-white track in a red racecar, when I start struggling to catch my chest. I’m inhaling as deeply as I can but it feels like someone is covering my face, pressing down hard, trying to suffocate me.

I wake up and realise that I’m face down on my pillow. It was just a dream, but before relief can set in, I try to roll myself over as quickly as I can, and I’m suddenly, terrifyingly, aware I can’t move. I’m frozen. Panic starts to set in, I don’t know why I feel stuck. I’m awake and I know I’m not dreaming anymore so why can’t I control my body? My breath gets shorter and faster and claustrophobia fills me. My muscles feel so tight and restricted and I am so clammed up.

Is this how I die?

My mum is fast asleep next to me so all I need to do is scream and she’ll wake up and shake me out of this. I try to speak but nothing comes out. I feel like a prisoner in my own skin. I’m desperately trying to fight my body, to draw out movement or a scream, but my muscles tense up even more.

Trying more forcefully to make myself move, I’m eventually able to jolt my body up. I turn my head as fast as I can and take big and fast deep breaths in, relieved but extremely confused, and very frightened.

That was the day I found out I had sleep paralysis.

15 years later I still find myself waking up paralysed every month or two, with intense feelings of panic and claustrophobia.

It never gets easier.

Psychiatrist Dr Cycle Johnson describes sleep paralysis as a parasomnia that occurs when the muscle atonia of rapid eye movement sleep extends into wakefulness and can be accompanied by intense fear and hallucinations.

Michael Prichard is a respiratory and sleep physician at Mounts Bay Hospital.

“Although it’s referred to as sleep paralysis, you’re actually awake but you don’t make that transition from normal paralysis of REM sleep into waking up fully and losing the paralysis,” he says.

“It, therefore, represents a form of sleep state dissociation where fragments of sleep, in this case, the paralysis, which is normally part of REM sleep, will carry on after you wake up.”

“So, you can be conscious but simply not able to move.” 

Melissa Ree, clinical psychologist at the Sleep Matters Clinic in Perth, describes what happens during REM sleep.

“REM sleep happens towards the end of each sleep cycle, and it’s when we do our most vivid dreaming,” she says.

“Interestingly, when we’re in REM sleep, although our brain is active, the body is very quiet – our limb muscles are pretty much paralysed, which is a safety mechanism so that we don’t act out our dreams.”

Dr Prichard also mentions the two main conditions where sleep paralysis occurs.

 “It’s a key feature of a condition called narcolepsy which is characterized by excessive daytime sleepiness,” he says.

“The other, which is probably more common is isolated sleep paralysis where there’s no other associative problem.”

Dr Cycle Johnson has gathered data from 35 studies on the condition, and has found that 8% of the general population will have regular episodes of sleep paralysis, with certain ethnicities experiencing higher rates than others.

Nearly 40% of the people who experience sleep paralysis are college students of Asian descent, and psychiatric patients of African descent.

Dr Prichard mentions the Hmong society in Laos has higher rates of the disorder, and talks about how other parts of the world may view the sleeping disorder more significantly than others.

“Many cultures around the world have traditions about how they interpret events of sleep paralysis, particularly because of the sensations or the associated dream recall they have with it, it’s often associated with nightmares,” he says.

The review also found over 30% of psychiatric patients have been estimated to have a lifelong prevalence of the disorder too, with higher rates among patients with panic disorder.

Sleep Medicine Reviews, a peer-reviewed medical journal which covers research on sleep medicine has also conducted an investigation on the common variables associated with sleep paralysis, basing their findings on 42 studies which found people with the disorder were more likely to have dealt with substance use, feelings of stress, anxiety or trauma, illnesses, or other sleeping disorders.

This review too had higher rates of sleep paralysis among patients with panic disorder or post-traumatic stress disorder.

As someone who can’t relate to having any of the above symptoms, I struggle to understand why I regularily get sleep paralysis.

If I could explain what it feels like trying to shake yourself out of an episode, it almost feels like you’re trying to push a door down. You constantly run into it harder and faster each time but in the process, you’re getting worn out and more frustrated. Eventually, you kick the door and it falls down and that’s when you can regather and calm yourself and try to move back into a relaxed sleep state.

I really value having a good night’s sleep, so dealing with a sleeping disorder isn’t ideal.

Dr Pricard says proper sleep is key for functioning adequately during the day.

“Sleep is useful because there are functional improvements when you have sufficient sleep and you have a whole bunch of symptoms around tiredness sleepiness, memory loss, impaired concentration, irritability, risk of depression, and so on when you don’t have sufficient sleep,” he says.

“People who stay up all night don’t function as well during the day time, it affects people physically as well in terms of their mental function and cognitive ability.”

What it feels like to have sleep paralysis; not being able to move or speak. Photo: Jess Antoniou.

Trevoun Smalls, a sleep paralysis sufferer from San Diego, California, says he began experiencing episodes of sleep paralysis as a child before the age of 10 and describes his very first sleep paralysis experience, where he hallucinated and saw an entity.

Trevoun Smalls shares terrifying details of his first sleep paralysis experience as a child. Video: Supplied.

Mr Smalls says he’s had several episodes of sleep paralysis since, but fortunately has not experienced another visual hallucination associated with the disorder.

He says he has however started to experience episodes of astral projections, an outer body hallucinatory experience where someone sees their own body placed in an external visual space.

“I haven’t had sleep paralysis since I astral projected and I used to get it a lot,” he says.

Within the Sleep Medicine Reviews study, they also looked at factors surrounding hallucination experiences during sleep paralysis, finding it was most common in people who had high rates of social anxiety or dealt with intense feelings of distress and panic during their paralysis episode.   

According to the Sleep Foundation, 75% of sleep paralysis episodes will involve hallucinations.

Dr Prichard says there are three main types of hallucinatory experiences that people have associated with their sleep paralysis episodes; visual, auditory, and tactile.

“If it occurs occasionally it doesn’t have to be alarming,” he says.

“The expectation is either you learn to live with it if it’s occasional and it’s not a bother or it gets less as you get older.”

Dr Prichard explains the hallucinations associated with sleep paralysis as well as the treatments, and students at Curtin University demonstrate that sleep paralysis is not as rare as people may think. Video: Jess Antoniou.

Dr Prichard says the disorder may be scary, but it shouldn’t be forever.

“There’s a reasonable expectation that it’d go away,” he says.

For sufferers, an end to the episodes would be a dream.