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Living With Sleep Paralysis

Artwork by Beth Hoeckel
Having experienced what I now know to be sleep paralysis since childhood, I first passed it off as severe nightmares. But when it struck again in adult life, I quickly realised the limitations of this diagnosis.

It is notoriously difficult to write or talk about dream-like or semi-conscious states, so I will begin with the basics. In its broadest definition, sleep paralysis relates to a sensation of being unable to move or speak in the moments that follow waking up, or less commonly, falling asleep. This will often take the form of being conscious and aware of one's own surroundings, without being able to move, talk, or in some cases, breathe. It can be a one-off or a regular occurrence and is noticeably exacerbated by other sleep-related medical conditions, as well as anxiety and depression. Yet people with no apparent mental health issues will commonly suffer from sleep paralysis too, with estimates varying from a third to a half of all people likely to experience its affects in one form or another at some point in their lives.

I fall into the small category of people who have, at different times, suffered from sleep paralysis on a regular basis. These bouts struck throughout my childhood, and then again in my late teens and early twenties, and seemed always to correspond with times of stress and irregular sleep.

The sensation of paralysis is distressing, but it is the accompanying visions – often explained away as paranormal activity - that transform the condition into a source of acute dread and anxiety for so many sufferers.

I will always remember a bewildering exchange with my GP while still a student. Suffering from sleep paralysis on an almost nightly basis, I had decided to see whether there was a medical explanation, or solution, to the problem.

“I keep waking up and not being able to move and then this strange...”

“Woman appears in the corner of the room,” she replied.

Later, browsing through archive issues of The Lancet, one spine-chilling reader's letter from 1962 jumped out at me - its description an eerie echo of my own, haunting experience. In it, one M. D. Kaye wrote: “…I also believed, falsely, that a close relative was [also] standing over my bed. She was looking down at me, leering, and held a knife poised above me, as if ready to strike."

Some 75% of sleep paralysis sufferers are also thought to experience hallucinations. These vary from sensations of floating and pressure being applied to the chest, to seeing a sinister figure appear in the room. The latter is so common, that the condition has colloquially been referred to as the ‘The Old Hag’ for centuries.

Some 75% of sleep paralysis sufferers are also thought to experience hallucinations. These vary from sensations of floating and pressure being applied to the chest, to seeing a sinister figure appear in the room

Sleep paralysis is also the rational explanation given for supposed alien abductions, due to the vivid feeling of having lost control at the hands of some sinister and all-powerful presence. In St. Lucia it has been attributed historically to the souls of unbaptised children come to haunt the living, and in the Middle Ages in Europe, sufferers believed that they were being raped by evil spirits. It’s a misdiagnosis to say sleep paralysis is just part and parcel of extreme nightmares, but in my experience, it would often follow on from bad dreams. The sense of relief from having woken up, swiftly replaced by an even more intense dread on realising that I am unable to move or communicate.

Head of Anamolistic Psychology at Goldsmiths University, Christopher French, offers a physiological explanation for the phenomenon. Sleep paralysis occurs when we are still in the Rapid Eye Movement (REM) stage of sleep, either at the beginning or the end of the sleep cycle. Our muscles are paralysed to prevent us acting out our dreams, which ordinarily changes as we pass from sleep into a waking state. In sleep paralysis, sufferers wake up only partially, their muscles still incapable of moving and flanked by dream imagery that mixes with their physical surroundings.

The same GP who had predicted my hallucinations said that the tendency for sufferers to describe a hooded figure, often dressed in black, might be the work of an automatic rationalisation process. Dark holes in our vision might readily be translated by the brain into human figures. The fact that these sinister apparitions are usually also women? Well that might just reflect how deep our patriarchal assumptions run…
Beyond that, medical understanding of the condition is still sparse. Understanding of sleep in general is still surprisingly minimal. French also says that, medically speaking, sleep paralysis had gone largely unreported until recently, leaving a lot of people under the worrying misapprehension that it is symptomatic of a disorder connected to mental illness.

But this idea is widely refuted on the basis that sleep paralysis is so common. Sufferers aren’t mad, or at least if they are it is an entirely separate issue. Best advice French offered is to sleep in regular patterns, avoid shift work, long-haul flights, sleeping on your back, recreational drugs and having kids. Or to just go about your life as you always did and remember that if 'The Old Hag' comes knocking, you just have to try and move your little finger to break the state of paralysis. The key thing is to relax, he says, though with that becoming an ever-greater challenge even in waking life, it’s easier said than done.