What Is Sleep Paralysis?

Sleep paralysis, commonly known as "karabasan" in Turkish folklore, is a state where an individual cannot move or speak during the transition between wakefulness and sleep. In this state, the person remains conscious but cannot move their muscles, speak, or react to their surroundings.

During sleep paralysis, individuals often experience intense fear, a feeling of suffocation, and hallucinations. This condition can last from a few seconds to several minutes and resolves spontaneously.

What Causes Sleep Paralysis?

Karabasan (sleep paralysis) occurs when the brain fails to properly manage the transition between wakefulness and sleep stages. This typically happens during REM (rapid eye movement) sleep because the muscles are naturally paralyzed during this stage. When waking up, the brain becomes alert, but the body remains in this paralyzed state, leading to symptoms such as inability to move or speak.

The main factors that can trigger sleep paralysis include:

• Sleeping immediately after eating: Sleeping while the digestive process is ongoing makes it difficult for the body to relax and can disrupt the transition to REM sleep.

• Intensive and irregular working hours: Night shifts, overtime, or irregular work schedules can disrupt the biological clock.

• Frequent napping during the day: Short daytime naps can disrupt nighttime sleep and destabilize the sleep cycle.

• Lack of a regular sleep schedule: Going to bed and waking up at different times each day disrupts the body's natural rhythm.

• Jet lag: Time zone changes can confuse the body's day-night balance and lead to sleep paralysis.

• Narcolepsy: This neurological disorder can cause sudden sleep attacks and frequent episodes of sleep paralysis.

• Stress and anxiety: Mental tension can reduce sleep quality, preventing a healthy transition to REM sleep.

• Depression: Depression disrupts the sleep cycle and makes it irregular.

• Sudden changes in lifestyle: Sudden changes like moving, changing jobs, or traumatic events can create stress.

• Effect of certain medications: Especially sleep aids or antidepressants can affect REM sleep.

• Sleeping hungry: Insufficient nutrition can lead to blood sugar imbalances throughout the night and restless sleep.

• Excessive smoking and alcohol consumption: These substances affect brain waves, disrupting healthy sleep stages.

• Sleeping on your back: This position can cause the tongue to fall back and obstruct the airways, increasing the risk of sleep paralysis.

• Genetic factors: Individuals with a family history of sleep paralysis are more likely to experience it.

The presence of one or more of these factors increases the likelihood of experiencing karabasan.

Who Experiences Sleep Paralysis?

Sleep paralysis can affect people of all age groups, but it is typically more common between the ages of 15 and 30. Individuals with irregular sleep patterns, those who go to bed late at night, or frequent travelers are more susceptible to this condition.

People under psychological stress, or those experiencing mental health issues such as depression or anxiety, also carry a risk of experiencing sleep paralysis. Additionally, individuals with a genetic predisposition may experience sleep paralysis more frequently.

What are the Symptoms of Sleep Paralysis?

During sleep paralysis, the person is awake but cannot move their body or speak. This condition usually lasts between a few seconds and a few minutes.

The following symptoms are common:

• Pressure in the chest or a feeling of suffocation

• Fear of not being able to breathe

• Ability to move the eyes, but inability to move the body

• Hallucinations (e.g., feeling a presence in the room, seeing shadows, hearing voices)

• Intense fear or panic

These symptoms can vary from person to person and often disappear spontaneously shortly after waking.

Why do Tinnitus or Sounds Occur During Sleep Paralysis?

Hearing sounds such as tinnitus, buzzing, or speech during sleep paralysis is a common hallucinatory symptom. This is due to some neurosensory areas, such as the auditory cortex, still exhibiting activity characteristic of REM sleep, even though the brain has transitioned to a state of wakefulness.

This neurophysiological dysregulation during the transition between wakefulness and the dream state leads to the perception of unreal sounds. Auditory hallucinations typically resolve within a few seconds and do not cause permanent hearing impairment.

What to Do During Sleep Paralysis?

During sleep paralysis, it is important not to panic and to act in a controlled manner. Sleep paralysis is a temporary condition, and as long as consciousness is maintained, the following steps should definitely be taken:

• Do not panic. Sleep paralysis is not fatal; it is important to know that the condition is temporary.

• Maintain breathing rhythm. The feeling of not being able to breathe is not real; breathe calmly and regularly.

• Move small muscles. Try to move small muscles like fingertips, toes, or the tongue.

• Use eye movements. Since eye muscles are not affected by paralysis, looking left and right accelerates the awakening process in the brain.

• Give yourself mental affirmation. Internal affirmations like “This is sleep paralysis, it will pass” can psychologically comfort the person.

These steps shorten the duration of sleep paralysis and help the person regain a sense of control.

How to Overcome Sleep Paralysis?

Sleep paralysis resolves on its own; however, certain precautions should be taken to prevent recurrence and reduce its frequency. Paying attention to sleep hygiene and making lifestyle adjustments are effective in this regard.

The fundamental approaches to overcoming sleep paralysis are:

• Establish regular sleep hours. Going to bed and waking up at the same time every day balances the sleep rhythm.

• Avoid sleeping on your back. This position can trigger sleep paralysis. Sleeping on your side is safer.

• Reduce stress. Methods like meditation, breathing exercises, and therapy can be helpful.

• Limit caffeine, alcohol, and nicotine consumption. These substances impair sleep quality.

• Avoid heavy meals before bed. Opt for a light meal instead.

• Seek professional help if necessary. Individuals with sleep disorders should consult a neurologist or psychiatrist.

When these steps are followed, the frequency of sleep paralysis attacks significantly decreases.

How Long Does Sleep Paralysis Last?

Sleep paralysis typically lasts between a few seconds and a few minutes. The average duration in most cases does not exceed 1-2 minutes.

In rare instances, this period might feel longer, but physiologically, an attack ends within a few minutes at most. The duration of an attack can vary from person to person; factors such as stress levels, lack of sleep, and the manner of waking can influence this duration.

Why Does Chronic Sleep Paralysis Occur?

Frequent recurrence of sleep paralysis is usually caused by chronic sleep disorders or lifestyle-related problems. Irregular sleep, stress, extreme fatigue, and psychiatric conditions, in particular, trigger this condition.

For individuals experiencing frequent sleep paralysis, the following reasons should be investigated:

• A neurological sleep disorder such as narcolepsy

• Severe stress, anxiety, or depression

• Insufficient sleep duration or poor sleep environment

• Frequent time zone changes (e.g., shift work, jet lag)

• Incorrect sleep positions (especially sleeping on your back)

• Genetic predisposition

If you are experiencing continuous sleep paralysis, this condition may have gone beyond a simple sleep problem. It is imperative to consult a neurologist or a sleep disorder specialist.

How is Sleep Paralysis Treated?

The primary goal in treating sleep paralysis is to identify and eliminate the underlying causes. Medical intervention may be necessary for recurrent attacks that impair quality of life.

The following methods are applied during the treatment process:

• Establishing a sleep schedule: Going to bed and waking up at the same time every day ensures quality and sufficient sleep.

• Avoiding stimulants: The use of substances such as caffeine, alcohol, and nicotine is limited.

• Managing stress and anxiety: Psychotherapy or relaxation techniques are recommended if necessary.

• Medical treatment: In cases of severe and frequent attacks, antidepressant medications that regulate REM sleep may be prescribed.

• Sleep position training: Sleeping on your side instead of your back is encouraged.

Treatment should be planned individually and, if necessary, conducted by a neurologist, psychiatrist, or sleep medicine specialist.

Frequently Asked Questions About Sleep Paralysis (FAQ)

Why does sleep paralysis occur?

Sleep paralysis occurs when the brain reaches a conscious state during waking, but the muscle system that controls the body remains under the influence of REM sleep. This condition typically arises due to irregular sleep, sleeping on one's back, stress, insomnia, and certain neurological disorders.

How can sleep paralysis be prevented?

To prevent sleep paralysis, a regular sleep schedule should be established. Stress should be managed, and heavy meals and stimulating substances should be avoided before bed. Sleeping in a side position instead of on your back is also an effective preventive measure.

In which position does sleep paralysis occur?

Sleep paralysis most commonly occurs when sleeping on your back. This position can partially obstruct the airways, leading to an unhealthy transition between sleep and wakefulness in the brain and body. Sleeping on your side significantly reduces this risk.

Which doctor should be consulted for sleep paralysis?

Individuals experiencing frequent sleep paralysis should consult a neurologist. If the problem has psychological roots, a psychiatrist's evaluation is also important. Detailed examinations can be conducted at sleep disorder centers.

What happens during sleep paralysis?

During sleep paralysis, the person is aware they are awake but cannot move their body. They cannot speak, react to their surroundings, and often feel a presence in the room or hear various sounds. All these symptoms resolve spontaneously within a few minutes.