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What is Sleep paralysis?
Imagine you are about to wake up from a deep sleep but you could not move or speak. You are hearing some unusual humming sounds and some strange visuals are flashing before you. This is nothing but sleep paralysis (The patient is awake but unable to move or speak accompanied by intense fear and hallucination). This phenomenon occurs when a person is about to asleep or when he is about to wake up from a deep sleep. It occurs in healthy individuals as well as people who are suffering from chronic neurological disorders or it may also be due to genetic changes. Lack of sleep and psychological stress may trigger this condition.
Symptoms
Symptoms of
this condition include, being unable to move or sleep, the person experiencing
sleep paralysis may hear some unusual humming, hissing sounds, strange vocals, and
whispers. He or she may hallucinate a dark figure or intruding presence in the
corner of the room.
Causes
The exact
cause of this condition is still unknown but some theories suggest that it may
be due to overlapping of REM and waking stages of sleep. Studies show that
people experiencing sleep paralysis have short REM, NREM, and fragmented REM
sleep cycles. Other theories suggest that when the serotonergic neural population has difficulty in overcoming
the signals sent by the cells which keeps the brain in the sleep state. During
sleep paralysis, the cholinergic neural population is hyperactivated and the serotonergic neural population is deactivated. This means
that cholinergic neurotransmitters such as Acetylcholine which maximizes REM
sleep are increased in number and Serotonergic neurotransmitters such as serotonin
which promotes wakefulness are decreased in number.
People
experiencing paralysis may hallucinate a feeling of floating or a presence of an
intruder in the room. The Cerebellum, which is responsible for the coordination
of body movements experiences a myoclonic spike (Sudden discharge of electrical
impulse in the Brain) which induces a floating sensation.
Diagnosis
Sleep
paralysis can be diagnosed by clinical interview and by ruling out any sleeping
disorders. Sleep paralysis may occur due to any neurological disorders or
hypokalemia or due to any substance use. If the cause of sleep paralysis does
not fall under any of the above-mentioned conditions, then it is termed as “Isolated
Sleep Paralysis” (ISP). If the episodes of sleep paralysis are recurrent then
it is termed “Recurrent Isolated Sleep Paralysis” (RISP).
Prevention and Treatment
An adequate
amount of sleep may prevent this condition. Treatment for sleep paralysis includes
drugs such as tricyclic antidepressants or selective serotonin reuptake
inhibitors. Though these drugs are prescribed there are currently no drugs that
completely interrupt the episodes of sleep paralysis.