Sleep Paralysis: Causes, Symptoms, and Solutions

Sleep paralysis in the morning?

Hello, doctor.
First, I want to thank you for taking the time to answer my questions despite your busy schedule! As mentioned, I usually go to bed between 11:30 PM and 12:30 AM, but it takes me until almost 1 or 2 AM to fall asleep.
Occasionally, I wake up at 5, 7, or 8 AM.
However, I have two issues: 1.
My eyes still feel very tired, but I continue to sleep.
2.
After waking up, I lie there for a long time before feeling sleepy again.
For both situations, I consistently sleep until 11 AM.
The first issue is manageable, but the second one is very distressing because I frequently experience sleep paralysis in between.
There was one instance where I was struggling and shaking but couldn't move; I could see my room but heard sounds from a dream.
This has been happening quite often in the past month, and while it occurred before, it wasn't as severe as it is now.
I also have mitral valve insufficiency, and sometimes after an episode, my heart feels heavy, which scares me.
For example, today I experienced auditory hallucinations, hearing screams from my dream, and after waking up, I felt discomfort and tightness in my chest for a while, which was quite unbearable.
Doctor, what should I do? If I wake up in the morning but don't feel sleepy, is it okay not to go back to sleep to avoid creating sleepiness?

Jennifer, 20~29 year old female. Ask Date: 2021/07/16

Dr. Jiang Junyi reply Neurology

Dear Ms.
Jennifer,
Your symptoms may suggest sleep paralysis, as they occur during awakenings in the rapid eye movement (REM) stage of sleep.
Sleep paralysis is more common among adolescents and young adults.
Individuals in this demographic often experience high levels of stress, irregular sleep patterns, frequent late nights, insomnia, anxiety, and prolonged sleep, all of which can contribute to the onset of sleep paralysis.
Additionally, those with underlying health issues may be more susceptible to these symptoms.

Sometimes, engaging in intense physical activity or consuming large amounts of carbohydrates can lead to hypokalemia, which may trigger sleep paralysis.
I recommend consulting a sleep specialist at a sleep center for further evaluation, which may include multiple polysomnographic tests to confirm the diagnosis.

Please ensure to practice self-protection measures, maintain cleanliness and disinfection, and adhere to new health protocols before and after your medical visit.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/07/16

More Info

Sleep paralysis is a phenomenon that many people experience, often characterized by the inability to move or speak while falling asleep or waking up. It can be accompanied by vivid hallucinations and a feeling of pressure on the chest, which can be quite distressing. Understanding the causes, symptoms, and potential solutions for sleep paralysis can help individuals manage this condition more effectively.

Causes of Sleep Paralysis
Sleep paralysis typically occurs during the transition between wakefulness and sleep, particularly during REM (Rapid Eye Movement) sleep. During REM sleep, the brain is highly active, and most of our dreaming occurs. To prevent us from acting out our dreams, the brain sends signals to inhibit voluntary muscle activity, leading to temporary paralysis. However, if a person becomes aware before the brain has fully transitioned out of REM sleep, they may experience sleep paralysis.

Several factors can contribute to the occurrence of sleep paralysis:
1. Sleep Deprivation: Not getting enough sleep can increase the likelihood of experiencing sleep paralysis.

2. Irregular Sleep Schedule: Frequently changing sleep patterns or working night shifts can disrupt the body's natural sleep-wake cycle.

3. Sleep Disorders: Conditions such as narcolepsy, insomnia, and sleep apnea are associated with higher rates of sleep paralysis.

4. Stress and Anxiety: High levels of stress or anxiety can disrupt sleep and contribute to episodes of sleep paralysis.

5. Sleep Position: Some studies suggest that sleeping on your back may increase the risk of sleep paralysis.

Symptoms of Sleep Paralysis
The primary symptom of sleep paralysis is the inability to move or speak while being aware of your surroundings. This can last from a few seconds to a couple of minutes. Other symptoms may include:
- Hallucinations: Many people report seeing or hearing things that are not there, often described as frightening or threatening.

- Chest Pressure: A sensation of weight on the chest, making it feel difficult to breathe.

- Fear and Anxiety: The experience can be terrifying, leading to feelings of panic.

Solutions and Management Strategies
If you are experiencing frequent sleep paralysis, there are several strategies you can employ to help reduce its occurrence:
1. Improve Sleep Hygiene: Establish a regular sleep schedule by going to bed and waking up at the same time every day. Aim for 7-9 hours of quality sleep each night.

2. Create a Relaxing Bedtime Routine: Engage in calming activities before bed, such as reading, meditating, or taking a warm bath, to help signal to your body that it’s time to wind down.

3. Limit Stimulants: Avoid caffeine, nicotine, and alcohol, especially in the hours leading up to bedtime, as these can disrupt sleep.

4. Manage Stress and Anxiety: Consider relaxation techniques such as deep breathing, yoga, or mindfulness meditation to help reduce stress levels.

5. Sleep Position: If you find that sleeping on your back triggers episodes of sleep paralysis, try sleeping on your side instead.

6. Consult a Healthcare Professional: If sleep paralysis persists or is accompanied by other concerning symptoms, such as chest pain or heart palpitations, it’s essential to consult a healthcare professional. They can evaluate your symptoms, rule out underlying conditions, and provide appropriate treatment options.

Addressing Your Specific Concerns
In your case, it seems that you are experiencing significant distress from sleep paralysis, especially with the added concern of your heart condition. It’s crucial to address both your sleep issues and any cardiovascular symptoms you may be experiencing. If you wake up feeling anxious or have chest discomfort, it’s advisable to seek medical attention to ensure that there are no underlying health issues.

Regarding your question about waking up without sleepiness, it’s generally okay to get out of bed if you feel alert and unable to return to sleep. This can help prevent the frustration of lying awake and may help reset your sleep cycle.

In summary, sleep paralysis can be a frightening experience, but understanding its causes and implementing effective management strategies can help reduce its frequency and severity. If your symptoms persist, do not hesitate to reach out to a healthcare provider for further evaluation and support.

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