Sleep Paralysis and Severe Shaking Sensations

Feeling severe shaking while sleeping and experiencing tinnitus?

This issue has persisted for over 10 years, with the first episode occurring during middle school.
I have documented common symptoms.
1.
On the night of an episode, I initially experience insomnia, tossing and turning in bed for about an hour without being able to sleep.
2.
Sleep paralysis is always present.
3.
I periodically feel a violent shaking of my head (the shaking I describe is truly intense, akin to having a massage gun set to maximum pressure against my brain), accompanied by dizziness and tinnitus.
4.
In a completely dark room, as soon as I close my eyes and am about to fall asleep, I see intense white light.
5.
Nightmares are always present (most often involving someone continuously passing by my bed).
6.
Even if I wake up from sleep paralysis, if I immediately go back to sleep, I will definitely continue to experience these symptoms.
There have been a few particularly severe instances where I was too afraid to go back to sleep afterward, which I have documented: 1.
I feel as if my entire body is being moved significantly, like when you close your eyes on a pirate ship ride; even if you can't see, your brain's sense of balance knows your body is moving drastically.
2.
I can distinctly feel a shock originating from the brainstem, with a sensation of paralysis spreading from the brainstem to my scalp, ears, and entire head, accompanied by extremely severe tinnitus as it passes through my ears, along with an uncertain feeling of the balance issue being violently shaken.
I have to work tomorrow, but the symptoms suddenly occurred again, this time so severe that I am completely afraid to go back to sleep.
I want to see a doctor, but I don't know which specialty to consult.
I feel like they would just prescribe me vitamins or think I'm being superstitious; it's really exhausting.

Lenard, 20~29 year old female. Ask Date: 2023/04/10

Dr. Peng Shiwei reply Neurology

Hello, based on your description, it seems that the symptoms occur during sleep.
I recommend that you visit a hospital with a "sleep center" for consultation and examination.
Before your appointment, you can keep a sleep diary.
During the sleep study, you will be asked to spend a night at the hospital, where they will record video, monitor your heart rate, brain waves, and limb movements.
This should help in diagnosing your issue.
Thank you for your question.

Reply Date: 2023/04/10

More Info

Your symptoms suggest a complex interplay of sleep disorders, particularly sleep paralysis and possibly other sleep-related issues. Sleep paralysis is a phenomenon that occurs when a person is either falling asleep or waking up and experiences an inability to move or speak. This can be accompanied by vivid hallucinations, a feeling of pressure on the chest, and a sense of impending doom. The shaking sensations you describe, along with the severe head movements and auditory disturbances, may indicate a more intricate condition that could involve aspects of parasomnia or even anxiety-related disorders.

Understanding Your Symptoms
1. Sleep Paralysis: This occurs during transitions between sleep and wakefulness. It is often associated with REM sleep, where the body is typically paralyzed to prevent acting out dreams. When someone wakes up during this phase, they may find themselves unable to move or speak, which can be terrifying. The hallucinations you experience, such as seeing figures near your bed or feeling pressure, are common.

2. Severe Shaking Sensations: The intense shaking you describe, akin to a massage gun's vibration, could be related to a phenomenon known as "hypnic jerks" or myoclonic jerks, which are involuntary muscle contractions that can occur as one is falling asleep. However, the severity and the specific sensations you describe may warrant further investigation.

3. Auditory Hallucinations and Visual Disturbances: The white light and the auditory sensations you experience could be linked to heightened anxiety or stress levels, which often exacerbate sleep disturbances. The brain can misinterpret sensory signals during these transitional states, leading to vivid experiences that feel very real.

4. Nightmares and Anxiety: The recurring nightmares and feelings of being watched or threatened during sleep can be indicative of underlying anxiety or stress. These experiences can create a cycle of fear around sleep, leading to insomnia and further exacerbating the problem.

Recommendations for Management
1. Consult a Sleep Specialist: Given the complexity and duration of your symptoms, it would be beneficial to see a sleep specialist. They can conduct a polysomnography (sleep study) to monitor your sleep patterns, brain activity, and other physiological responses during sleep. This can help identify any underlying sleep disorders.

2. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a structured program that helps individuals address the thoughts and behaviors that contribute to sleep problems. It can be particularly effective for those with anxiety and sleep disturbances.

3. Sleep Hygiene Practices: Establishing a regular sleep schedule, creating a calming bedtime routine, and ensuring a comfortable sleep environment can help improve sleep quality. Avoiding stimulants like caffeine and electronics before bed is also crucial.

4. Stress Management Techniques: Incorporating relaxation techniques such as mindfulness, meditation, or yoga can help reduce anxiety and improve overall sleep quality. These practices can help calm the mind and body, making it easier to transition into sleep.

5. Medication: If your symptoms are significantly impacting your daily life, discussing medication options with a healthcare provider may be appropriate. This could include medications to help with sleep or anxiety, but these should be considered carefully and monitored by a professional.

6. Avoid Self-Diagnosis: While it’s tempting to attribute your symptoms to specific conditions based on online research, it’s essential to seek professional evaluation. A healthcare provider can help differentiate between various conditions and recommend appropriate treatment.

Conclusion
Your experiences are valid and deserve attention from a healthcare professional who understands sleep disorders. It’s crucial to address both the physical and psychological aspects of your symptoms to find effective relief. Don’t hesitate to seek help; you deserve restful sleep and peace of mind.

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