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Sleep Disorders

Atypical Sleep Paralysis

08/25/2009

Question:

This requires a bit of a story. My husband likes to hold me while sleeping. When we were first married, I would wake instantly whenever he did this. I`ve finally become used to it, but this has presented another problem. Often when I am asleep he will lay his arm over my ribs, and this for some reason causes every inhalation to become shallow and painful (I sleep on my side). I suspect he lays his arm over my floating ribs, which when combined with the relaxation of sleep cave in a bit. It is never painful when he does this and I am awake.

When this occurs I become lucid in my dream, know what is going on and realize that I have to move my physical body in order to make the pain go away. I cannot however move, as is typical in sleep paralysis. I scream, kick, try to dig my nails in, all in an effort to move my physical body. I know that I need to wake up so I can move, but I can`t actually wake up. That, I think, is the terrifying part--I cannot make myself wake up.

This sleep paralysis has also started to occur in other situations, not just when I am in pain. I was having an unpleasant dream the other night and somehow incorporated my husband`s embrace into the nightmare. The embrace became a trapping, stifling presence, almost like Old Hag phenomenon but with physical components. I apologize if this is a bit convoluted--I just haven`t been able to find an explanation anywhere else. I simply want to know if this is still normal, if disturbing.

Answer:

Hello - thank you for using NetWellness.

While distressing to you, sleep paralysis is certainly normal in a certain percentage of adults. It is a common condition with a prevalence of 5-62%. Although most affected people have single or infrequent episodes, sleep paralysis may be recurrent. It is also occurs in association with the narcoleptic syndrome (cataplexy - loss of muscle tone after an emotional stir; sleep paralysis; hallucinations either at the onset of sleep or at awakening; excessive daytime sleepiness) as well as in the setting of sleep deprivation. Studies have also found the following factors that are also associated with sleep paralysis:

- anxiolytic medication (e.g. ativan, valium)

- various psychiatric disorders (e.g. automatic behavior, bipolar disorders)

- physical disease

Sleep paralysis is usually described as the inability to perform voluntary movements either at sleep onset or upon awakening. Individuals often report an inability to speak or move the limbs, trunk or head.

While breathing is actually not affected, the sensation of not being able to breath can accompany the paralysis and can be quite scary. Most individuals will recall the events. The episodes usually only last for seconds up to a few minutes and tend to resolve on their own. Occasionally, the episode will end if the person is touched or spoken to.

Episodes of sleep paralysis can be very anxiety producing as you have described. In addition to the sensation of an inability to breathe as noted above, hallucinations, whether hearing or seeing things that are not present, can accompany the event. All-in-all, the experience can be somewhat frightening.

I recommend that you should ask your husband not to embrace you during sleep - this action alone may alleviate your symptoms. If he is unable to do this then you should sleep in another bedroom so as to see if your symptoms resolve.

You may wish to consult with a Sleep Physician so as to ascertain if you have an associated condition that can be treated. It is imperative to obtain a full history and physical examination so as to establish the exact reason as to why you have such events.

Once again thank you for using NetWellness.

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Response by:

Steven  Kadiev, MBBCh Steven Kadiev, MBBCh
Formerly:
Assistant Professor
College of Medicine
The Ohio State University