From the Guidelines
Sleep paralysis at the start of sleep is primarily caused by disruptions in the transition between wakefulness and sleep, with the main causes including sleep deprivation, irregular sleep schedules, stress and anxiety, certain medications, and sleep disorders like narcolepsy, as supported by the most recent study 1.
Causes of Sleep Paralysis
The causes of sleep paralysis can be multifactorial, including:
- Sleep deprivation
- Irregular sleep schedules
- Stress and anxiety
- Certain medications, such as antidepressants and stimulants
- Sleep disorders like narcolepsy, as mentioned in the study 1
Mechanism of Sleep Paralysis
During normal sleep, the brain paralyzes muscles to prevent acting out dreams, but in sleep paralysis, the individual becomes conscious while this paralysis is still active, occurring when REM sleep components intrude into wakefulness.
Prevention and Treatment
Improving sleep hygiene can help prevent episodes, including:
- Maintaining a regular sleep schedule
- Aiming for 7-9 hours of sleep nightly
- Creating a relaxing bedtime routine
- Limiting caffeine and alcohol before bed If sleep paralysis occurs frequently or causes significant distress, consulting a healthcare provider is recommended, as it may indicate an underlying sleep disorder requiring specific treatment, such as medications like sodium oxybate or certain antidepressants for narcolepsy-related sleep paralysis 1.
From the Research
Causes of Sleep Paralysis at the Start of Sleep
The causes of sleep paralysis at the start of sleep are not fully understood, but several factors are thought to contribute to its occurrence. Some of these factors include:
- Sleep deprivation: This is a common precipitating factor for sleep paralysis, as it can disrupt normal sleep patterns and increase the likelihood of entering into a state of rapid eye movement (REM) sleep at the wrong time 2, 3.
- Irregular sleep-wake schedules: Irregular sleep patterns, such as those experienced by individuals who work non-traditional hours or travel across time zones, can increase the risk of sleep paralysis 2, 3.
- Jetlag: Traveling across time zones can disrupt the body's natural sleep-wake cycle, leading to an increased risk of sleep paralysis 2.
- Variations in circadian rhythm genes: Some research suggests that variations in genes that regulate the body's internal clock may contribute to the development of sleep paralysis 2.
- Narcolepsy: Sleep paralysis is a common symptom of narcolepsy, a neurological disorder characterized by excessive daytime sleepiness and disrupted REM sleep 4, 5.
- Other medical conditions: Sleep paralysis has been associated with a range of medical conditions, including posttraumatic stress disorder and psychiatric disorders 2.
Treatment and Management
While the causes of sleep paralysis are not fully understood, several treatment options are available to help manage the condition. These include:
- Cognitive-behavioral therapy: This type of therapy can help individuals address underlying psychological issues that may be contributing to sleep paralysis 6, 3.
- Pharmacological interventions: Medications such as selective serotonin reuptake inhibitors and benzodiazepine hypnotics may be prescribed to help manage sleep paralysis 6, 4.
- Avoiding precipitating factors: Avoiding sleep deprivation, irregular sleep-wake schedules, and jetlag can help reduce the risk of sleep paralysis 2, 3.