SLEEP PARALYSIS

 

Sleep paralysis, recognized as a parasomnia, represents an aberrant sleep phenomenon often associated with an underlying diagnosis of narcolepsy, a neurological disorder characterized by impaired regulation of wakefulness. It manifests in two primary forms: isolated sleep paralysis and recurrent sleep paralysis. Isolated sleep paralysis denotes singular occurrences, typically not indicative of narcolepsy, while recurrent sleep paralysis involves multiple episodes over time and may coincide with narcolepsy. Recurrent isolated sleep paralysis (RISP) integrates these features, presenting ongoing instances of sleep paralysis absent narcoleptic symptoms. The hallmark symptom of sleep paralysis is atonia, manifesting as the inability to move or speak during episodes, often accompanied by sensations of chest pressure, breathing difficulty, and emotional distress such as panic. Approximately 75% of cases involve hallucinations, categorized into three types: intruder hallucinations, chest pressure hallucinations (incubus), and vestibular-motor (V-M) hallucinations. These episodes typically emerge in childhood or early adulthood, with increased frequency observed in one's 20s and 30s. Duration varies from seconds to minutes, with an average length of approximately six minutes. Predominantly distressing, sleep paralysis episodes evoke feelings of fear in about 90% of cases, though a minority may experience more pleasant hallucinations. Effective management strategies involve understanding the underlying mechanisms and addressing associated sleep disturbances and psychological distress.

 

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