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A study conducted by Sedaghat F. et al. has investigated the prevalence of sleep paralysis among Iranian medical students. 24.1% of students reported experiencing sleep paralysis at least once in their lifetime. The same result was reported among Japanese, Nigerian, Kuwaiti, Sudanese and American students.<ref>Sedaghat-Hamedani F.,Kayvanpour E.,Rezai A.:" Prevalence of sleep paralysis and other symptoms of narcolepsy in Iranian medical students "</ref>
A study conducted by Sedaghat F. et al. has investigated the prevalence of sleep paralysis among Iranian medical students. 24.1% of students reported experiencing sleep paralysis at least once in their lifetime. The same result was reported among Japanese, Nigerian, Kuwaiti, Sudanese and American students.<ref>Sedaghat-Hamedani F.,Kayvanpour E.,Rezai A.:" Prevalence of sleep paralysis and other symptoms of narcolepsy in Iranian medical students "</ref>


Many people who commonly enter sleep paralysis also suffer from [[narcolepsy]]. In non-Nigerian Africans, [[panic disorder]] occurs with sleep paralysis more frequently than in Caucasians.<ref>
Many people who commonly enter sleep paralysis also suffer from [[narcolepsy]].
Friedman, S. & Paradis, C. (2002). Panic disorder in Blacks: Symptomatology and isolated sleep paralysis. Cult Med Psychiatry. 2002 Jun;26(2):179-98 PMID 12211324 </ref>
Some reports read that various factors increase the likelihood of both paralysis and hallucinations. These include:<ref>{{cite web| author= J. A. Cheyne | url=http://watarts.uwaterloo.ca/~acheyne/prevent.html | title= Preventing and Coping with Sleep Paralysis | dateformat=mdy | accessdate=17 July 2006}}</ref>
Some reports read that various factors increase the likelihood of both paralysis and hallucinations. These include:<ref>{{cite web| author= J. A. Cheyne | url=http://watarts.uwaterloo.ca/~acheyne/prevent.html | title= Preventing and Coping with Sleep Paralysis | dateformat=mdy | accessdate=17 July 2006}}</ref>
* Sleeping in a face upwards or [[supine position]]
* Sleeping in a face upwards or [[supine position]]

Revision as of 11:10, 16 August 2009

The Nightmare, by Henry Fuseli (1781) is thought to be one of the classic depictions of sleep paralysis perceived as a demonic visitation.

Sleep paralysis is a condition that may occur in normal subjects or be associated with narcolepsy, cataplexy, and hypnagogic hallucinations. The pathophysiology of this condition is closely related to the normal hypotonia that occur during REM sleep.[1] When considered to be a disease, isolated sleep paralysis is classified as MeSH D020188.[2] Some evidence suggests that it can also, in some cases, be a symptom of migraine.[3][4]

Symptoms and characteristics

Physiologically, sleep paralysis is closely related to the paralysis that occurs as a natural part of REM (rapid eye movement) sleep, which is known as REM atonia. Sleep paralysis occurs when the brain awakes from a REM state, but the body paralysis persists. This leaves the person fully conscious, but unable to move. The paralysis can last from several seconds to several minutes "after which the individual may experience panic symptoms and the realization that the distorted perceptions were false".[5] As the correlation with REM sleep suggests, the paralysis is not entirely complete; use of EOG traces shows that eye movement can be instigated during such episodes.[6] When there is an absence of narcolepsy, sleep paralysis is referred to as isolated sleep paralysis (ISP).[7]

In addition, the paralysis state may be accompanied by terrifying hallucinations (hypnopompic or hypnagogic) and an acute sense of danger.[8] Sleep paralysis is particularly frightening to the individual due to the vividness of such hallucinations.[9] The hallucinatory element to sleep paralysis makes it even more likely that someone will interpret the experience as a dream, since completely fanciful, or dream-like, objects may appear in the room alongside one's normal vision. Some scientists have proposed this condition as an explanation for alien abductions and ghostly encounters.[10] A study by Susan Blackmore and Marcus Cox of the University of the West of England supports the suggestion that reports of alien abductions are related to sleep paralysis rather than to temporal lobe lability.[11]

Possible causes

Sleep paralysis occurs during REM sleep, thus preventing the body from manifesting movements made in the subject's dreams. Very little is known about the physiology of sleep paralysis.[citation needed] However, some have suggested that it may be linked to post-synaptic inhibition of motor neurons in the pons region of the brain.[citation needed] In particular, low levels of melatonin may stop the depolarization current in the nerves, preventing the stimulation of the muscles and any consequent enactment of the dream activity by the body (e.g. preventing a sleeper from flailing his legs when dreaming about running).[citation needed]

Several studies have concluded that many or most people will experience sleep paralysis at least once or twice in their lives.[citation needed] A study conducted by Sedaghat F. et al. has investigated the prevalence of sleep paralysis among Iranian medical students. 24.1% of students reported experiencing sleep paralysis at least once in their lifetime. The same result was reported among Japanese, Nigerian, Kuwaiti, Sudanese and American students.[12]

Many people who commonly enter sleep paralysis also suffer from narcolepsy. Some reports read that various factors increase the likelihood of both paralysis and hallucinations. These include:[13]

  • Sleeping in a face upwards or supine position
  • Irregular sleeping schedules; naps, sleeping in, sleep deprivation
  • Increased stress
  • Sudden environmental/lifestyle changes
  • A lucid dream that immediately precedes the episode.

Treatment

Treatment starts with patient education about sleep stages and about the muscle atonia that is typically associated with REM sleep. For most healthy individuals, avoiding chronic sleep deprivation is enough to relieve symptoms. It is recommended that patients be evaluated for narcolepsy if symptoms persist.[14]

Many perceptions associated with sleep paralysis (visceral buzzing, loud sounds, adrenal mental state, presences, and the paralysis itself) also constitute a common phase in the early progression of episodes referred to as out of body experiences.[15][16] Mental focus varies between the two conditions; paralysis sufferers tend to fixate on reestablishing operation of the body, whereas subjects of out-of-body episodes are more occupied by perceived non-equivalence with the body.

Folklore

Complete references to many cultures are given in the References section

  • In African culture, isolated sleep paralysis is commonly referred to as "the witch riding your back".[17][18]
  • In Cambodian, Laotian, and Thai culture, sleep paralysis is called pee umm and khmout sukkhot. It is described as an event in which the person is sleeping and dreams that one or more ghostly figures are nearby or even holding him or her down. The sufferer usually thinks that he or she is awake but unable to move or make any noises. This is not to be confused with pee khao and khmout jool, ghost possession.
  • In Hmong culture, sleep paralysis describes an experience called "dab tsog" or "crushing demon." Often the sufferer claims to be able to see a tiny figure, no larger than a child, sitting on his or her chest. What is alarming is that a vast number of American Hmong have died in their sleep, prompting the Centers for Disease Control to create the term "Sudden Unexpected Nocturnal Death Syndrome" (see Sudden unexplained death syndrome) or "SUNDS" for short; this is now theorized to be a form of Brugada syndrome.
  • In Vietnamese culture, sleep paralysis is referred to as "ma đè", meaning "held down by a ghost" or "bóng đè", meaning "held down by a shadow". Many people in this culture believe that a ghost has entered one's body, causing the paralyzed state.
  • In Chinese culture, sleep paralysis is widely known as "鬼壓身/鬼压身" (pinyin: guǐ yā shēn) or "鬼壓床/鬼压床" (pinyin: guǐ yā chuáng), which literally translate into "ghost pressing on body" or "ghost pressing on bed." A more modern term is "夢魘/梦魇" (pinyin: mèng yǎn); notice that the character "魘/魇" (pinyin: yǎn) is composed of "厭/厌" (pinyin: yàn), "to detest", and "鬼" (pinyin: guǐ), "ghost, demon".
  • In Japanese culture, sleep paralysis is referred to as kanashibari (金縛り, literally "bound or fastened in metal," from kane "metal" and shibaru" to bind, to tie, to fasten"). This term is occasionally used by English speaking authors to refer to the phenomenon both in academic papers and in pop psych literature.[19]
  • In Philippine culture, "bangungut", or sudden unexplained death syndrome, has traditionally been attributed to nightmares.[20] People who have claimed to survive such nightmares have reported experiencing the symptoms of sleep paralysis.[citation needed]
  • In Hungarian folk culture sleep paralysis is called "lidércnyomás" ("lidérc pressing") and can be attributed to a number of supernatural entities like "lidérc" (wraith), "boszorkány" (witch), "tündér" (fairy) or "ördögszerető" (demon lover).[21] The word "boszorkány" itself stems from the Turkish root "bas-", meaning "to press".[22]
  • In Iceland folk culture sleep paralysis is generally called having a "Mara". A goblin or a succubus (since it is generally female) believed to cause nightmares (the origin of the word 'Nightmare' itself is derived from her name). Other European cultures share variants of the same folklore, calling her under different names; Proto-Germanic: marōn; Old English: mære; German: Mahr; Dutch: nachtmerrie; Icelandic, Old Norse, Faroese, and Swedish: mara; Danish: mare; Norwegian: mare; Old Irish: morrigain; Slovene: môra; Bulgarian, Serbian, Polish: mora; French: cauchemar; Romanian: moroi; Czech: můra. The origin of the belief itself is much older and goes back to the reconstructed Proto Indo-European root mora-, an incubus, from the root mer- "to rub away" or "to harm".
  • In Malta, folk culture attributes a sleep paralysis incident to an attack by the "Haddiela" who is the wife of the "Hares", the entity in Maltese folk culture which haunts the individual in similar ways as to those of a poltergeist. As believed in folk culture, to rid oneself of the Haddiela, one must place a piece of silverware or a knife under the pillow prior to sleep.
  • Kurdish people call this phenomenon a "mottaka", they believe that some one, in a form of a ghost or perhaps an evil spirit, turns up on top the of the person in the middle of the night and suffocates him/her. Apparently this happens usually when some one has done something bad.
  • In New Guinea, people refer to this phenomenon as "Suk Ninmyo", believed to originate from sacred trees that use human essence to sustain its life. The trees are said to feed on human essence during night as to not disturb the human's daily life, but sometimes people wake unnaturally during the feeding, resulting in the paralysis.
  • In Turkish culture, sleep paralysis is often referred to as "karabasan" ("The dark presser/assailer"). It is believed to be a creature which attacks people in their sleep, pressing on their chest and stealing their breath.
  • In Mexico, it's believed that sleep paralysis is in fact the spirit of a dead person getting on the person and impeding movement, calling this "se me subió el muerto" (the dead person got on me).
  • In many parts of the Southern United States, the phenomenon is known as a "hag", and the event is said to often be a sign of an approaching tragedy or accident.
  • Ogun Oru is a traditional explanation for nocturnal disturbances among the Yoruba of Southwest Nigeria; ogun oru (nocturnal warfare) involves an acute night-time disturbance that is culturally attributed to demonic infiltration of the body and psyche during dreaming. Ogun oru is characterized by its occurrence, a female preponderance, the perception of an underlying feud between the sufferer's earthly spouse and a 'spiritual' spouse, and the event of bewitchment through eating while dreaming. The condition is believed to be treatable through Christian prayers or elaborate traditional rituals designed to exorcise the imbibed demonic elements.[23]
  • In Greece and Cyprus, it is believed that sleep paralysis occurs when a ghost-like creature or Demon named Mora, Vrahnas or Varypnas (Greek: Μόρα, Βραχνάς, Βαρυπνάς) tries to steal the victim's speech or sits on the victim's chest causing asphyxiation.
  • In Zimbabwean Shona culture the word Madzikirira is used to refer something really pressing one down. This mostly refers to the spiritual world in which some spirit—especially an evil one—tries to use its victim for some evil purpose. The people believe that witches can only be people of close relations to be effective, and hence a witches often try to use one's spirit to bewitch one's relatives.
  • In Ethiopian culture the word Dukak is used. Dukak is believed to be some form of evil spirit that possesses people during their sleep. This experience is also believed to be related to use of Khat. Most Khat users experience sleep paralysis when quitting after a long time of use.
  • Several studies have shown that African-Americans may be predisposed to isolated sleep paralysis also known as "the witch is riding you" or "the haint is riding you".[24] In addition, other studies have shown that African-Americans who have frequent episodes of isolated sleep paralysis, i.e., reporting having one or more sleep paralysis episodes per month coined as "sleep paralysis disorder," were predisposed to having panic attacks.[25] This finding has been replicated by other independent researchers[26][27]
  • In the Muslim culture of South Asia (Pakistani, Bangladeshi, Indian Muslims), sleep paralysis is considered an encounter with evil jinns and demons. It is also assumed that it is caused by the black magic performed by enemies and jealous persons. Spells and Curses could also result in a ghoul haunting a person. Some homes and locations are also alleged to be haunted by these satanic beings.
  • In Tamil and Sri Lankan Culture, this particular phenomenon is referred to as 'Amuku Be" or 'Amuku Pei' meaning "the ghost that forces one down".
  • In Malay of Malay Peninsula, sleep paralysis is known as 'kena tindih' (or 'ketindihan' in Indonesia), which means "being pressed".[28] Incidents are commonly considered to be the work of a malign agency; occurring in what are explained as blind spots in the field of vision, they are reported as demonic figures.
  • In Newfoundland and Labrador, it is known as the 'Old Hag'.[29] In island folklore, the Hag can be summoned to attack a third party, like a curse. In his 1982 book, The Terror that Comes in the Night, David J. Hufford writes that in local culture the way to call the Hag is to recite the Lord's Prayer backwards. It is also common for believers to claim that those who are not wakened from this paralysis will die.
  • In Persian culture it is known as 'bakhtak' (Persian: بختک) which is a ghost-like creature who does this.

Notes

  1. ^ (From Adv Neurol 1995;67:245-271)
  2. ^ D020188
  3. ^ http://www.dreaminglucid.com/articlejc.html
  4. ^ http://www.migraine-aura.org/content/e27891/e27265/e42285/e42290/e55289/e58636/index_en.html
  5. ^ Hersen, Turner & Beidel. (2007) Adult Psychopathology and Diagnosis. p. 380
  6. ^ Hearne, K. (1990) The Dream Machine: Lucid dreams and how to control them, p18. ISBN 0-85030-906-9
  7. ^ Hersen, Turner & Beidel. (2007) Adult Psychopathology and Diagnosis
  8. ^ Hersen Turner & Beidel. (2007) Adult Psychopathology and Diagnosis
  9. ^ Hersen, Turner & Beidel. (2007) Adult Psychopathology and Diagnosis
  10. ^ McNally RJ, Clancy SA. (2005). "Sleep Paralysis, Sexual Abuse, and Space Alien Abduction". Transcultural Psychiatry. 42 (1): 113–122. doi:10.1177/1363461505050715. PMID 15881271.
  11. ^ Blackmore, Susan. "Alien Abductions, Sleep Paralysis and the Temporal Lobe". European Journal of UFO and Abduction Studies (1): pp. 113–118. Retrieved 2008-07-26. {{cite journal}}: |pages= has extra text (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  12. ^ Sedaghat-Hamedani F.,Kayvanpour E.,Rezai A.:" Prevalence of sleep paralysis and other symptoms of narcolepsy in Iranian medical students "
  13. ^ J. A. Cheyne. "Preventing and Coping with Sleep Paralysis". Retrieved 17 July 2006. {{cite web}}: Unknown parameter |dateformat= ignored (help)
  14. ^ Wills L, Garcia J. Parasomnias: Epidemiology and Management. CNS Drugs [serial online]. December 2002;16(12):803-810.
  15. ^ http://www.susanblackmore.co.uk/Conferences/SPR99.html "OBEs and Sleep Paralysis", Susan Blackmore
  16. ^ "The Projection of the Astral Body", 1968, Sylvan Muldoon and Hereward Carrington: chapter II, "Sensation and emotion at different stages of exteriorization" subsection
  17. ^ Mattek, (2005) Memoirs p. 34
  18. ^ Katherine Roberts. "Contemporary Cauchemar: Experience, Belief, Prevention". Folklife in Louisiana. The Louisiana Folklife Program.
  19. ^ Fukuda K, Miyasita A, Inugami M, Ishihara K. (1987), "High prevalence of isolated sleep paralysis: kanashibari phenomenon in Japan", Sleep, p. 279-286 {{citation}}: |chapter= ignored (help)CS1 maint: multiple names: authors list (link)
  20. ^ Munger, Ronald G. (1998). "Bangungut in Manila: sudden and unexplained death in sleep of adult Filipinos" (PDF). International Journal of Epidemiology. 27 (4). Logan, UT: International Epidemiological Association: 677–684. Retrieved May 28, 2009. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  21. ^ lidérc, Magyar Néprajzi Lexikon, Akadémiai Kiadó, Budapest 1977, ISBN
  22. ^ boszorkány, Magyar Néprajzi Lexikon, Akadémiai Kiadó, Budapest 1977, ISBN
  23. ^ Aina OF, Famuyiwa OO (2007). "Ogun Oru: a traditional explanation for nocturnal neuropsychiatric disturbances among the Yoruba of Southwest Nigeria". Transcultural psychiatry. 44 (1): 44–54. doi:10.1177/1363461507074968. PMID 17379609.
  24. ^ Bell CC, Shakoor B, Thompson B, Dew D, Hughley E, Mays R, Shorter-Gooden K (1984). "Prevalence of isolated sleep paralysis in black subjects". Journal of the National Medical Association. 76 (5): 501–508. PMID 6737506.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. ^ Bell CC, Dixie-Bell DD, Thompson B (1986). "Further studies on the prevalence of isolated sleep paralysis in black subjects". Journal of the National Medical Association. 78 (7): 649–659. PMID 3746934.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. ^ Paradis CM, Friedman S (2006). "Sleep Paralysis in African Americans with Panic Disorder". Transcultural psychiatry. 43 (4): 692–694. doi:10.1177/1363461505050720. ISBN 3461505050720. PMID 15881272. {{cite journal}}: Check |isbn= value: invalid prefix (help)
  27. ^ Friedman S, Paradis CM, Hatch M (1994). "Characteristics of African-Americans and white patients with panic disorder and agoraphobia". Hospital and Community Psychiatry. 45 (8): 798–803. PMID 7982696.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ http://sleepclinicjakarta.tblog.com/post/1969898557
  29. ^ Firestone, M. (1985), "The "Old Hag": sleep paralysis in Newfoundland", The Journal of Psychoanalytic Anthropology, pp. 47–66 {{citation}}: |chapter= ignored (help)

References

  • Culhane-Pera, Kathie (2003). Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers. Vanderbilt University Press.
  • Bower, Bruce (July 9, 2005). "Night of the Crusher." Science News.
  • Conesa, J. (2000). Geomagnetic, cross-cultural and occupational faces of sleep paralysis: An ecological perspective. Sleep and Hypnosis, 2, (3), 105-111.
  • Conesa, J. (2002). Isolated Sleep Paralysis and Lucid Dreaming: Ten-year longitudinal case study and related dream frequencies, types, and categories. Sleep and Hypnosis, 4, (4), 132-143.
  • Conesa, J. (2003). Sleep Paralysis Signaling (SPS) As A Natural Cueing Method for the Generation and Maintenance of Lucid Dreaming. Presented at The 83rd Annual Convention of the Western Psychological Association, May 1 - 4, 2003 in Vancouver, BC, Canada.
  • Conesa-Sevilla, Jorge (2004). Wrestling With Ghosts: A Personal and Scientific Account of Sleep Paralysis. Pennsylvania: Xlibris/Randomhouse.
  • Firestone M. The “Old Hag”: sleep paralysis in Newfoundland. The Journal of Psychoanalytic Anthropology 1985; 8:47-66.
  • Fukuda K, Miyasita A, Inugami M, Ishihara K. High prevalence of isolated sleep paralysis: kanashibari phenomenon in Japan. Sleep 1987; 10:279-286.
  • Hartmann E. The nightmare: the psychology and biology of terrifying dreams. New York:Basic,1984.
  • Hufford D.J. The terror that comes in the night: an experience-centered study of supernatural assault traditions. Philadelphia:University of Pennsylvania Press, 1982
  • Kettlewell, N; Lipscomb, S; Evans, E. (June, 1993). "Differences in neuropsychological correlates between normals and those experiencing "Old Hag Attacks'." Perceptual and Motor Skills. 76 (3 Pt 1): 839-45; discussion 846. PMID 8321596
  • Ness RC. “The Old Hag” phenomenon as sleep paralysis: a bicultural interpretation. Culture, Medicine and Psychiatry 1978; 2:15-39.
  • Ohayon MM, Zulley J, Guilleminault C, Smirne, S. Prevalence and pathologic associations of sleep paralysis in the general population. Neurology, 1999; 52:1194-1200.
  • Sagan, Carl (1997). The Demon-Haunted World: Science as a Candle in the Dark.
  • Schneck JM. Sleep paralysis and microsomatognosia with special reference to hypnotherapy. The International Journal of Clinical and Experimental Hypnosis 1977; XXV:72-77.
  • Takeuchi T, Miyasita A, Sasaki Y, Inugami M, Fukuda K. Isolated sleep paralysis elicited by sleep interruption. American Sleep Disorders Association and Sleep Research Society, 1992; 15: 217-225.
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