Sleep Paralysis

Is Sleep Paralysis a Symptom of a Serious Problem?

Sleep researchers conclude that, in most cases, sleep paralysis is simply a sign that your
body is not moving smoothly through the stages of sleep. Rarely is sleep paralysis linked to
deep underlying psychiatric problems.

Over the centuries, symptoms of sleep paralysis have been described in many ways and
often attributed to an "evil" presence: unseen night demons in ancient times, the old hag in
Shakespeare's Romeo and Juliet, and alien abductors. Almost every culture throughout
history has had stories of shadowy evil creatures that terrify helpless humans at night.
People have long sought explanations for this mysterious sleep-time paralysis and the
accompanying feelings of terror.

What Is Sleep Paralysis?

Sleep paralysis is a feeling of being conscious but unable to move. It occurs when a person
passes between stages of wakefulness and sleep. During these transitions, you may be
unable to move or speak for a few seconds up to a few minutes. Some people may also feel
pressure or a sense of choking. Sleep paralysis may accompany other sleep disorders such
as narcolepsy. Narcolepsy is an overpowering need to sleep caused by a problem with the
brain's ability to regulate sleep.

When Does Sleep Paralysis Usually Occur?

Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep,
it's called hypnagogic or predormital sleep paralysis. If it happens as you are waking up, it's
called hypnopompic or postdormital sleep paralysis.

Who Develops Sleep Paralysis?

Up to as many as four out of every 10 people may have sleep paralysis. This common
condition is often first noticed in the teen years. But men and women of any age can have it.
Sleep paralysis may run in families. Other factors that may be linked to sleep paralysis
include:

 Lack of sleep
 Sleep schedule that changes
 Mental conditions such as stress or bipolar disorder
 Sleeping on the back
 Other sleep problems such as narcolepsy or nighttime legcramps
 Use of certain medications, such as those for ADHD
 Substance abuse

How Is Sleep Paralysis Treated?

Most people need no treatment for sleep paralysis. Treating any underlying conditions such
as narcolepsy may help if you are anxious or unable to sleep well. These treatments may
include the following:

 Improving sleep habits -- such as making sure you get six to eight hours of sleep each
night
 Using antidepressant medication if it is prescribed to help regulate sleep cycles
 Treating any mental health problems that may contribute to sleep paralysis
 Treating any other sleep disorders, such as narcolepsy or leg cramps

What Can I Do About Sleep Paralysis?

There's no need to fear nighttime demons or alien abductors. If you have occasional sleep
paralysis, you can take steps at home to control this disorder. Start by making sure you
get enough sleep. Do what you can to relieve stress in your life -- especially just
before bedtime. Try new sleeping positions if you sleep on your back. And be sure to see
your doctor if sleep paralysis routinely prevents you from getting a good night's sleep.
6 Steps to Controlling Your Emotions
Emotions are the most present, pressing and sometimes painful force in our lives. We are
driven day by day by our emotions. We take chances because we're excited for new prospects. We cry
because we've been hurt and we make sacrifices because we love. Without a doubt, our emotions
dictate our thoughts, intentions and actions with superior authority to our rational minds. But when we
act on our emotions too quickly, or we act on the wrong kinds of emotions, we often make decisions
that we later lament.

Our feelings can alter between dangerous extremes. Veer too far to the left and you're
bordering on rage. Steer too much to the right and you're in a state of euphoria. As with many other
aspects of life, emotions are best met with a sense of moderation and logical perspective. This is not
to say that we should stop ourselves from falling in love or jumping for joy after great news. These
truly are the finer things in life. It is negative emotions that must be handled with extreme care.

Negative emotions, like rage, envy or bitterness, tend to spiral out of control, especially
immediately after they've been triggered. In time, these sorts of emotions can grow like weeds, slowly
conditioning the mind to function on detrimental feelings and dominating daily life. Ever met a person
who's consistently angry or hostile? They weren't born that way. But they allowed certain emotions to
stir within them for so long that they became inbred feelings arising all too frequently.

So how can we avoid operating on the wrong types of feelings and master our emotions under
the harshest of circumstances?

Follow my six steps to control your emotions and regain rationality in any challenging
situation:

 Don't react right away.

Reacting immediately to emotional triggers can be an immense mistake. It is guaranteed that you'll
say or do something you'll later regret. Before refuting the trigger with your emotional argument, take
a deep breath and stabilize the overwhelming impulse. Continue to breathe deeply for five minutes,
feeling as your muscles untense and your heart rate returns to normal. As you become calmer, affirm
to yourself that this is only temporary.
 Ask for divine guidance.
Faith is our saving grace in our darkest moments. No matter your creed, developing a healthy
relationship with the divine world will help you surmount your obstacles more easily. This is because
when you believe in a higher force, you also believe in the power of divine intervention to show you
what you must do, teach you why something is happening or even save you from a certain unwanted
situation. When burdened with emotion, close your eyes, envision a positive solution to your problem,
and ask the universe to illuminate the best path forward.
 Find a healthy outlet.
Now that you've managed your emotion, you'll need to release it in a healthy way. Emotions should
never be bottled up. Call or go see someone you trust and recount to them what happened. Hearing an
opinion other than your own broadens your awareness. Keep a journal and transfer your emotions
from your inner self onto the paper. Many people find it helpful to engage in aggressive exercises,
such as kickboxing or martial arts, to discharge their feelings. Others meditate and chant to return to a
tranquil state of being. Perform whatever activity is best-suited to you in order to liberate your being
from pent-up sentiments.
 See the bigger picture.
Every happening of our lives, whether good or bad, serves a higher purpose. Wisdom means being
able to see past the moment and discern the greater meaning of any given situation. You may not
understand it in the beginning, but as time goes by, you'll begin to see the bigger picture falling into
perfect order. Even in the midst of an emotionally upsetting moment, trust that there exists an ultimate
purpose which you will come to comprehend soon.
 Replace your thoughts.
Negative emotions bind us to recurring negative thoughts, creating cycles of downright negative
patterns. Whenever you are confronted with an emotion which is making you feel or think something
bad, force it out of your mind and replace it with a different thought. Imagine the ideal resolution to
your problem playing out, think about someone who makes you happy or remember an event that
makes you smile.
 Forgive your emotional triggers.
Your emotional triggers may be your best friend, your family members, yourself or all of the above.
You may feel a sudden wave of anger when your friend "does that thing she does," or a stab of self-
loathing when you remember something you could have done differently. But when you forgive, you
detach. You detach from the resentment, the jealousy or the fury lingering within you. You allow
people to be who they are without the need for escalating emotions. As you forgive, you will find
yourself disassociating from the harsh feelings attached to your being.
A constant reminder of our ardent nature, emotions surge through us at every second of the
day. But we often take wrong actions when wrong feelings filter through our mind without restraint.
To avoid the burn of acting out during an emotional upsurge, take a few simple steps to calm your
heightened spirit and quiet your uneasy mind. When the moment has passed (in hindsight), you'll be
grateful you were able to be the master of your emotions.
Sleeping Positions To Stay Healthy: The Best And Worst
Ways To Sleep During The Night
Getting a good night’s sleep is pivotal for our health, body, mind, and our mood, especially
since we spend one-third of our lives asleep. While it is recommended every adult get seven to eight
hours of sleep per night, according to the National Sleep Foundation, for many of us this is easier said
than done. Sleep difficulty can be caused by a number of things, ranging from eating or drinking the
wrong things before bed to our sleep position.
“Eighty percent of the population will have back problems at some point in [their] lives
oftentimes caused or aggravated by the way they sleep,” Dr. Hooman Melamed, an orthopedic spine
surgeon at the DISC Sports & Spine Center in Los Angeles, Calif., featured on The Doctors,Dr. Oz,
and The Steve Harvey Show, told Medical Daily in an email. This suggests our p.m. pose could be the
cause of our back and neck pain, stomach troubles, and even premature aging. To discover the best
sleep positions for our body and the ones we may want to avoid, Medical Dailyhas put together a list
so you can optimize your hours of sleep and stay healthy.

Best Position: On Your Back

Sleeping on our back makes it easier for our head, neck, and spine to align and keep it in a
neutral position. No extra pressure or curves are being added to the back. “You are in the best position
as your spine stays in natural alignment all night long,” Melamed said.

Dr. Michael Breus, known as “The Sleep Doctor,” is a clinical psychologist and both a
diplomat of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep
Medicine, who also sides with Melamed’s recommendation of lying on your back during sleep. In Dr.
Mehmet Oz’s sleep clinic last Thursday, Oz and sleep specialists answered questions and provided
sleep tips for Twitter users using #DrOzSleepClinic, and via phone toll-free at 844-223-006. I asked
the most common question most people have in mind: What#sleep position is best for our body in
order to get a good night's sleep?”
How Positive Emotions Improve Our Health

We all know that physical health depends on a good diet and exercise. But recent
research suggests that it also comes from a regular dose of positive emotions.
Now a new study goes one step further, not only showing that positive emotions improve
health but identifying precisely how they have this effect: by making people feel more socially
connected.
In the study, published online inPsychological Science, researchers divided 65 people into
two groups. One received training in the ancient practice of loving-kindness meditation; the other was
put on a waiting list for the meditation training. All of the participants were faculty or staff at the
University of North Carolina at Chapel Hill. None had any prior meditation experience.
The researchers chose loving-kindness meditation because, they write, “it teaches individuals
how to cultivate feelings of love, compassion, and goodwill toward themselves and others.” The
participants in the meditation group attended one hour-long class per week for six weeks, which they
were asked to supplement with daily practice at home.
Each day during the training period, and for two weeks beforehand and one week afterward,
participants in both groups were asked to report on the amount of time they’d meditated, the emotions
they’d felt most strongly that day, and the quality of their social interactions.
The researchers also assessed participants’ health before the training started and after it
ended. To do that, they took readings of participants’ heart rate and breathing patterns—a way of
measuring their “vagal tone,” or the activity of their vagus nerve, which regulates heart rate. Vagal
tone has been linked to cardiovascular health, and the researchers viewed it as a good objective
measure of physical well-being.
Compared with people on the waiting list, people in the loving-kindness meditation group
showed greater increases in positive emotions like amusement, awe, and gratitude over the course of
the training. And the people who showed greater increases in positive emotions were also more likely
to feel more socially connected over time, saying they felt closer and more “in tune” with the people
around them. Those feelings of social connection, in turn, were linked to improvements in vagal tone.
These results offer some of the strongest evidence to date that positive emotions can enhance physical
health, but they suggest that simply experiencing positive emotions on their own isn’t necessarily
enough. Instead, the key factor is the effect positive emotions have on our sense of connection to
others. This study is the first to show how social connectedness provides the important link between
positive emotions and better health.
According to the authors, who were led by Bethany Kok and included Barbara Fredrickson,
the study is also the first to show that vagal tone isn’t simply a fixed characteristic; instead, “although
vagal tone is largely stable,” they write, “it can also be improved through sustained enhancements in
an individual’s emotions and social perceptions.” In fact, they found that even a modest amount of
practice cultivating positive emotions could drive significant changes in vagal tone—and, in effect,
physical health.
All of these findings are important because they suggest that we can take relatively simple
and practical steps to improve our own health. The results should encourage people to “prioritize how
and how often we connect with other people,” says study co-author (and former GGSC fellow) Tanya
Vacharkulksemsuk, even by doing things as simple as “picking up the phone or sending a text.”
And if we can’t connect with other people at the moment, we may be able to achieve a similar
effect by cultivating positive emotions on our own. As we experience more positive emotions over
time—whether through loving-kindness meditation or dwelling on positive memories or doing
activities we enjoy—we may be taking care of our bodies as well as our minds.
The authors describe this whole process as an “upward spiral,” whereby positive emotions
bring us better health—and good health, according to prior research, generates more positive
emotions.
“Recurrent momentary experiences of positive emotions appear to serve as nutrients for the
human body,” they write, “increasing feelings of social belonging and giving a needed boost to
parasympathetic health, which in turn opens people up to more rewarding positive emotional and
social experiences.”
The association of sleep-disordered breathing and sleep symptoms
with quality of life in the Sleep Heart Health Study.

This study assessed the extent to which sleep-disordered breathing (SDB), difficulty initiating
and maintaining sleep (DIMS), and excessive daytime sleepiness (EDS) were associated with
impairment of quality of life (QoL) using the SF-36. Participants (n=5,816; mean age=63 years;
52.5% women) were enrolled in the nation-wide population-based Sleep Heart Health Study (SHHS)
implemented to investigate sleep-disordered breathing as a risk factor in the development of
cardiovascular disease. Each transformed SF-36 scale was analyzed independently using multiple
logistic regression analysis with sleep and other potential confounding variables (e.g., age, ethnicity)
included as independent variables. Men (11.6%) were significantly more likely to have SDB
compared to women (5.6%), while women (42.4%) were significantly more likely to report DIMS
than men (32.5%). Vitality was the sole SF-36 scale to have a linear association with the clinical
categories of SDB (mild, moderate, severe SDB). However, individuals with severe SDB indicated
significantly poorer QoL on several SF-36 scales. Both DIMS and EDS were strongly associated with
reduced QoL even after adjusting for confounding variables for both sexes. Findings suggest 1) mild
to moderate SDB is associated with reduced vitality, while severe SDB is more broadly associated
with poorer QoL, 2) subjective sleepsymptoms are comprehensively associated with poorer QoL, and
3) SF-36 mean score profiles for SDB and sleep symptoms are equivalent to other chronic diseases in
the U.S. general population.
5 Steps to Improve Sleep &
Emotional Vulnerability
Most of us don’t need science to tell us that sleep and emotion are closely linked. Spend a couple
nights with interrupted sleep or talk to any parent of a newborn and the connection is quite clear.

The connection appears not just in everyday life. In certain physical and mental disorders sleep
disturbance and emotion dysregulation are hallmark symptoms. Symptoms of one rare disorder,
cataplexy, which often co-occurs with the sleep disorder, narcolepsy for example, include sudden
muscle weakness when a person experiences strong emotion, such as anger or fear, or exhilaration.

Lack of adequate sleep also is commonly linked with emotional or psychological problems. Examples
include depression and PTSD, while sleep disturbances combined with emotional reactivity are key
dimensions of bipolar disorder.

And even when lack of sleep isn’t connected to rare disorders or affective psychological problems, it
is linked to increased emotionality.

Yelling at traffic more often, bursting into tears over minor grievances, anxious about perceived
slights that your rational mind tells you are only part of the picture. These are some examples of the
type of intense and overwhelming emotion that we tend to experience when we’re not getting enough
sleep.

This relationship between sleep and emotion is not one-way. Lack of sleep may make you feel more
intensely, while at the same time, intense feelings, particularly painful emotions, can affect the quality
of your sleep. Dreams are linked to emotional experience and emotions during waking hours. Fear,
anxiety, sadness, and anger can have a particular impact on dreams. Restless sleep also increases
during times of intense emotion. Emotion, then, is causing sleep disturbance, which in turn, causes
more intense emotion.

Sleep deprivation can have serious implications for your health. And health problems, such as sleep
problems, increase emotional vulnerability. Poor sleep can result in health problems such as
increased resting blood pressure, obesity and diabetes (likely connected to hormone imbalances that
cause people who are sleep deprived to prefer eating foods that are high in calories and
carbohydrates).

So what can you do to improve sleep and decrease emotional vulnerability?

Certain key activities can help to improve the quality of your sleep. These are often referred to as
“sleep hygiene.” You can think of them like brushing your teeth or taking a shower. If you want to
avoid cavities and gum disease, you need to perform certain daily activities to clean your teeth —
dental hygiene. The same is true of sleep. If you want to sleep well, you need to perform certain
activities daily to set your body up for restful sleep.

1. Commit to a sleep schedule.

It’s important to go to bed and wake up at the same time each day, even on the weekends.

2. Get exercise.
But be aware that exercise timing is crucial to the quality of your sleep. Exercise within 5 to
6 hours of bedtime can contribute to wakefulness and sleep difficulties, so try to exercise
early in the day.

3. Get sun exposure.

Sunshine is essential to regulating our circadian rhythms — our daily cycles of activity and
sleep. Try to get natural sunlight for at least 30 minutes each day.

4. Create a relaxing routine before bed.

When you take time to slow down and repeat the same relaxing actions each day, you are
signaling your body to wind down. Creating a ritual of reading, listening to music or gently
stretching before allows your body to get into a state of relaxation before you climb into
bed. Be aware that time in front of a screen — watching TV or surfing the Internet — tends
to stimulate rather than relax the mind.

5. If you’re in bed, but can’t sleep, don’t lie in bed awake.

Spinning your mind, anxiously stewing about problems in your life or worrying about the
sleep you’re losing can make it harder to get back to sleep. If you’ve been awake for more
than 20 minutes, get up and do some relaxing activity until you feel sleepy. One strategy is to
simply stand next to your bed, allowing your limbs and body to feel heavy. Once your body
has that sleepy, groggy feeling, try climbing back in bed and see if you drift off.

If sleep problems persist, or if they are extreme, see a doctor. Sleep disturbance can be a sign of
physical problems. Breaking the cycle between sleep disturbance and intense emotion can help you to
improve all areas of your life.
 Sleep and Mood

People who have problems with sleep are at increased risk for developing emotional disorders,
depression, and anxiety.Dr . Lawrence J. Epstein

The Takeaway
 Sleep and mood are closely connected; poor or inadequate sleep can cause irritability and
stress, while healthy sleep can enhance well-being.
 Chronic insomnia may increase the risk of developing a mood disorder, such as anxiety or
depression.
 Poor sleep and feelings of depression or anxiety can be helped through a variety of
treatments, starting with improved sleep habits, and, if needed, extending to behavioral
interventions and an assessment for a sleep or mood disorder.

The Link Between Sleep and Mood

You probably know firsthand that sleep affects mood. After a sleepless night, you may be
more irritable, short-tempered, and vulnerable to stress. Once you sleep well, your mood often returns
to normal.

Studies have shown that even partial sleep deprivation has a significant effect on mood.
University of Pennsylvania researchers found that subjects who were limited to only 4.5 hours of
sleep a night for one week reported feeling more stressed, angry, sad, and mentally exhausted. When
the subjects resumed normal sleep, they reported a dramatic improvement in mood.1

Not only does sleep affect mood, but mood and mental states can also affect sleep. Anxiety
increases agitation and arousal, which make it hard to sleep. Stress also affects sleep by making the
body aroused, awake, and alert. People who are under constant stress or who have abnormally
exaggerated responses to stress tend to have sleep problems.

Insomnia and Psychological Problems

"There's a big relationship between psychiatric and psychological problems and sleep. So
people who are depressed or have anxiety often have trouble with sleep as part of those disorders,"
says Dr. Lawrence Epstein, Medical Director of Sleep Health Centers and an instructor at Harvard
Medical School.
Difficulty sleeping is sometimes the first symptom of depression. Studies have found that 15
to 20 percent of people diagnosed with insomnia will develop major depression.2 While sleep research
is still exploring the relationship between depression and sleep, studies have shown that depressed
people may have abnormal sleep patterns.
 Sleep problems may, in turn, contribute to psychological problems. For example, chronic
insomnia may increase an individual's risk of developing a mood disorder, such as depression or
anxiety. In one major study of 10,000 adults, people with insomnia were five times more likely to
develop depression.4 Lack of sleep can be an even greater risk factor for anxiety. In the same study,
people with insomnia were 20 times more likely to develop panic disorder (a type of anxiety
disorder).5 Another study showed that insomnia is a reliable predictor of depression and many other
psychiatric disorders, including all types of anxiety disorders.

Addressing Sleep Problems Makes a Difference

If you sleep poorly and feel depressed, anxious, or less emotionally responsive, there are
many treatments that can help. First, look at your sleep habits and see if there are steps that you can
take on your own to improve the quantity and quality of your sleep. See Adopt Good Sleep Habits for
tips on how to improve your sleep. If problems persist, you may wish to see a medical provider and
ask about an evaluation for sleep problems and mental health concerns. After an evaluation and
diagnosis, your provider can advise you on the best course of treatment. Options may include
behavioral or other forms of therapy and/or medications. You can read about and watch a video of a
behavioral sleep consultation in the Healthy Sleep module.
Even if you do not have underlying sleep problems, taking steps to ensure adequate sleep will
lead to improved mood and well-being. Sheila, a Boston district attorney and mother, became sleep
deprived due to the conflicting demands of a full-time job and caring for her young children. She
began to feel cranky, irritable, and uncharacteristically depressed. When she got both of her children
on a consistent sleep schedule, she herself started sleeping an average of seven to eight hours a night
and her mood improved considerably.