Abstract

Sleep paralysis (SP) is a condition where a person is paralyzed upon waking or falling asleep. SP afflicts ~20% of people, and is also one of the typical symptoms in narcolepsy. During SP the sleeper may experience hallucinations. Unsurprisingly, SP is associated with great fear globally. To date, there are no published clinical trials or outcome data for treating this condition. However, few non-pharmacological interventions have been proposed, including cognitive behavioral approaches, and case studies showing clinical amelioration with auto-hypnosis and Meditation-Relaxation (MR) therapy. The latter for instance showed positive preliminary results; when applied for 8 weeks it reduced SP frequency and anxiety/worry symptoms. With this paper we aimed to evaluate, with a small-scale pilot study, the efficacy of MR therapy for SP in patients with narcolepsy. Ten patients with narcolepsy and SP were enrolled in the study. Notably, MR therapy (n = 6), applied for 8 weeks, resulted in a dramatic decrease in the number of days SP occurred (50% reduction); and the total number of SP episodes (54% reduction) in the last month of the study (demonstrated by large within-group effect sizes); unlike the control intervention (deep breathing) (n = 4). These findings are preliminary and exploratory given the small sample. Nonetheless, they represent the first proof of concept at providing empirically-guided insights into the possible efficacy of a novel treatment for frequently occurring SP. Although the study was conducted in patients with narcolepsy we cautiously suggest that the findings may generalize to individuals with isolated SP.

Highlights

  • Sleep paralysis (SP) is a state of atonia—skeletal muscles paralysis—occurring at sleep onset and offset

  • Disturbance caused by SP hallucinations correlated with depression (r = 0.69, p = 0.039) and worry symptoms (r = 0.69, p = 0.039) unlike anxiety

  • MR therapy resulted in a dramatic decrease in the number of days SP was experienced (50% reduction), and total number of episodes (54% reduction) in the last month of the study

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Summary

Introduction

Sleep paralysis (SP) is a state of atonia—skeletal muscles paralysis—occurring at sleep onset and offset. The person is acutely aware of his/her surroundings (i.e., semi or fully conscious) [1,2,3]. SP commonly occurs in narcolepsy; a sleep disorder involving excessive daytime sleepiness, cataplexy and other untimely manifestations of rapid-eye-movement (REM) sleep such hypnagogic hallucinations and SP [4]. SP is prevalent in the general population, afflicting ∼20% of people [1, 5, 6]. Hypnogogic or hypnopompic hallucinations may occur during SP and can involve all sensory modalities [7]. Supernatural interpretations of SP are found worldwide and often reflect the cultural background of the population in question

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