Abstract
Sleep paralysis (SP) is a common state of involuntary immobility occurring at sleep onset or offset. It can include terrifying hypnogogic or hypnopompic hallucinations of menacing bedroom intruders. Unsurprisingly, the experience is associated with great fear and horror worldwide. To date, there exist no direct treatment intervention for SP. In this article, I propose for the first time a type of focused inward-attention meditation combined with muscle relaxation as a direct intervention to be applied during the attack, to ameliorate and possibly eliminate it (what could be called, meditation-relaxation or MR therapy for SP). The intervention includes four steps: (1) reappraisal of the meaning of the attack; (2) psychological and emotional distancing; (3) inward focused-attention meditation; (4) muscle relaxation. The intervention promotes attentional shift away from unpleasant external and internal stimuli (i.e., terrifying hallucinations and bodily paralysis sensations) unto an emotionally pleasant internal object (e.g., a positive memory). It may facilitate a relaxed meditative state characterized by a shift from sympathetic to parasympathetic dominance, associated with greater levels of alpha activity (which may lead to drowsiness and potentially sleep). The procedure may also reduce the initial panic and arousal that occur when realizing one is paralyzed. In addition, I present a novel Panic-Hallucination (PH) Model of Sleep Paralysis; describing how through escalating cycles of fear and panic-like autonomic arousal, a positive feedback loop is created that worsens the attack (e.g., leading to longer and more fearful episodes), drives content of hallucinations, and causes future episodes of SP. Case examples are presented to illustrate the feasibility of MR therapy for SP.
Highlights
Sleep paralysis refers to a state of involuntary immobility occurring at sleep onset or offset (Hobson, 1995)
Based on sleep paralysis (SP) research experience in the United States, Europe and the Middle East (e.g., Jalal and Hinton, 2013, 2015, Jalal et al, 2014a,b, 2015), I have found that SP sufferers sometimes mention that relaxing during SP helps thwart the attack
SP sufferers report that engaging in prayer or religious recitation during the attack may eliminate the episode, and even cause the hallucinations of ominous “creatures” to vanish (e.g., Jalal et al, 2014a)
Summary
Sleep paralysis refers to a state of involuntary immobility occurring at sleep onset or offset (Hobson, 1995). The individual may lay down in the supine position [i.e., sleeping in the supine position predisposes to having SP (see, Dahmen and Kasten, 2001)], and go through each step, simulating an actual attack This would make it easier for the individual to apply the treatment once SP occurs, and not become too overwhelmed by subjective fear (e.g., due to amygdala activation), and the unpleasant features of REM atonia and respiration. As focused attention and emotion centeredness demand cognitive resources, attention directed away from threatening stimuli (e.g., hallucinations and paralysis sensations) may prevent worrying about the attack Such focused meditation may in turn facilitate a relaxed meditative state and, possibly, a shift from sympathetic to parasympathetic dominance (e.g., Wu and Lo, 2008) (which might lead to drowsiness and potentially sleep). His symptoms of anxiety, pathological worry and PTSD dropped significantly from pre to post treatment: STAI-T from 58 to 49, the PSWQ from 58 to 40, and the PCL from 48 to 42; suggesting that his SP attacks might in part drive these symptoms
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