Sleep Paralysis in Adults: Causes, Symptoms, and Coping
Waking up unable to move or speak can feel like something out of a nightmare. For a few seconds (or more), you’re completely aware, but your body won’t respond. Some people describe a heavy pressure on their chest, a sense of being watched, or vivid dreamlike images that blur the line between sleeping and waking. This unsettling experience is known as sleep paralysis.
Though the experience of sleep paralysis can be alarming, it isn’t dangerous. However, when it happens frequently, it can be distressing and can impact our sleep and daily functioning. So, in this article, we’ll explore:
- What sleep paralysis is and its symptoms.
- Causes of sleep paralysis.
- Coping and sleep paralysis treatment options.
- Answering commonly asked questions about adult sleep health.
What Is Sleep Paralysis?
Sleep paralysis is a disorder that occurs when the brain wakes up before the body does. During this brief overlap between sleep and wakefulness, you become conscious but are unable to move or speak. It can happen while falling asleep (known as hypnagogic paralysis) or upon waking (hypnopompic paralysis).
This disorder is actually quite common, with around 8% of the general population and 30% of those within the psychiatric population experiencing sleep paralysis at some time in their lives.2
To understand why this happens, it helps to know a little about REM (rapid eye movement) sleep — the stage where we dream most vividly. During REM sleep, our brains send signals to temporarily “turn off” muscle activity, preventing us from physically acting out dreams.
In sleep paralysis, this natural paralysis (called atonia) lingers even as the mind becomes alert. The result is a strange in-between state with the brain being awake, but the body remaining in REM mode.1
There are two primary forms of sleep paralysis:
- Isolated sleep paralysis, which occurs occasionally and isn’t connected to another sleep disorder.3 Many people experience it once or twice in their lives, often after major stress or exhaustion.
- Recurrent sleep paralysis, which happens more frequently and may be linked to disrupted sleep patterns, anxiety, trauma, or conditions like narcolepsy.
While a single episode can feel terrifying, especially if it involves vivid dream imagery or sensations of pressure on the chest, it’s not a sign of danger or a mental health disorder. Instead, it’s the body’s natural sleep process temporarily misfiring.
Common Symptoms of Nighttime Sleep Disorders
For those people who have experienced sleep paralysis, it can begin suddenly — one moment you’re dreaming and the next you’re awake but unable to move. While everyone’s experiences differ from person to person, there are some common symptoms of sleep paralysis, such as:
- The inability to move or speak. This is the hallmark symptom, where you’re conscious but feel paralyzed from head to toes, unable to open your eyes, call out, or change position.
- Being aware of your surroundings. You might be able to see your room, feel the bed underneath you, or even be aware of your partner lying next to you, but be unable to respond to anything.
- Feeling pressure on your chest or throat. This sensation often creates the feeling of being “held down” or “suffocated,” though it’s caused by the body’s restricted muscle movement during REM.
- Having vivid hallucinations. Some people experience visual, auditory, or tactile hallucinations, such as shadows, whispers, or sensations of movement, that can feel frighteningly real.
- Feeling a strong sense that someone or something else is in the room, even when no one else might be there, which can trigger intense fear or panic.
- A lingering anxiety or fatigue. After an episode, it’s common to feel disoriented, uneasy, or hesitant to fall back asleep.
Although many people can find this experience scary and distressing, we want to reiterate: It’s not harmful. Understanding the causes of why this may be happening can reduce fear and help you regain a sense of control.
Causes of Sleep Paralysis
Basically, sleep paralysis is caused by our brains and bodies falling out of sync, though no one really understands why this happens. But experts report that our mental health, emotions, and stress levels affect sleep paralysis. Here are some of the causes of sleep paralysis:
Sleep Deprivation and Irregular Schedules
Not getting consistent, restorative sleep is one of the leading causes of sleep paralysis.4 When REM cycles are disrupted by staying up late, working long hours, or pulling all-nighters, the transition between sleep stages becomes less stable. This instability increases the likelihood of “waking up” before your muscles have regained control.
Stress and Sleep Paralysis
Stress has a powerful influence on how the body sleeps. When we’re under constant pressure, whether from work, relationships, or emotional strain, our nervous system remains in a state of alertness.5 This disrupts healthy REM sleep and can trigger or worsen episodes of sleep paralysis.
Many people notice that sleep paralysis attacks are more frequent during periods of burnout or high anxiety. Because stress and sleep paralysis feed into each other, addressing emotional regulation and relaxation before bed can significantly reduce recurrence.
Anxiety and Sleep Paralysis
Anxiety often keeps the brain alert even when the body is tired, making it difficult to reach deep, restorative sleep. During anxious periods, our minds are more prone to hypervigilance — waking suddenly during REM and becoming aware while the body remains paralyzed.
PTSD and Sleep Paralysis
Trauma survivors frequently experience changes in REM patterns due to hypervigilance and nightmares. With PTSD and sleep paralysis, the body may remain stuck in a defensive state even while sleeping. The result is heightened fear responses, more intense hallucinations, and a sense of threat during episodes.
Sleep Position
Sleeping on your back can make episodes of sleep paralysis three to four times more likely.6 This is because when we lie on our backs, we take in less oxygen, which can increase awakenings during REM.
Because our brains may “wake” before muscle control returns, we can become aware of being unable to move. Shifting to a side-sleeping position or using pillows to maintain posture often helps reduce episodes of sleep paralysis from happening.
Genetic and Medical Factors
Some studies suggest that there might be a genetic component to sleep paralysis, possibly involving genes related to REM regulation and stress response.7 Besides our genes, medical conditions like sleep apnea and narcolepsy can also contribute to causing sleep paralysis.
In most cases, sleep paralysis reflects a connection between the body’s sleep mechanisms and the mind’s emotional state.
Therapy for Sleep Paralysis
Overcoming sleep paralysis starts with understanding what’s happening both in the body and the mind. Then comes therapy and support strategies.
By combining behavioral therapy for sleep issues and simple sleep support techniques, you will likely find that episodes become less frequent, less intense, and far less frightening. Here are some of the strategies for coping with sleep paralysis:
Cognitive Behavioral Therapy (CBT) for Sleep Issues
CBT helps identify and change the thought patterns that fuel nighttime anxiety and fear of future episodes. If you have experienced frequent paralysis, you may begin to anticipate it, creating tension that keeps your body from fully relaxing.
CBT challenges these beliefs and promotes realistic, balanced thinking to prevent sleep paralysis episodes. A specialized version known as CBT-I focuses on rebuilding healthy sleep rhythms, improving consistency, and reducing rumination at night.3
Trauma-Informed Therapy
If you’re someone who lives with PTSD and experiences sleep paralysis, trauma-focused treatment, such as EMDR, Somatic Experiencing, or internal family systems (IFS), can help. These approaches help the nervous system process stored trauma and reduce hypervigilance that can trigger nighttime awakenings.
Mindfulness and Relaxation-Based Therapies
Mindfulness teaches awareness without judgment, helping you respond to fear with calm instead of panic. During an episode, focusing on breathing and body sensations can interrupt the spiral of fear and restore control. Regular mindfulness practice also reduces baseline stress and anxiety, which are common emotional triggers for sleep paralysis.
Sleep Hygiene Support
Therapy often includes education about how REM sleep, stress, and physical health intersect. Understanding the biological reasons behind sleep paralysis empowers clients to manage symptoms rather than fear them.
Learning practical sleep support techniques, like adjusting your sleep position, limiting caffeine, or keeping the bedroom at the recommended temperature between 65-68°F, helps restore a stable rhythm.8
Overcoming sleep paralysis episodes isn’t about forcing the body to behave — it’s about helping it feel safe enough to rest. With patience and the right tools, restful, peaceful sleep becomes not only possible, but sustainable.
Mission Connection: Professional Support for Mental Health and Sleep
Sleep paralysis can be one of the most unsettling experiences. At Mission Connection, we understand how connected these moments are to the mind and body.
Our team offers compassionate, evidence-based care designed to help you restore a sense of safety around rest. By combining approaches like trauma-focused care, CBT, and mindfulness therapy, we work with you to identify the underlying emotional triggers for sleep paralysis and develop tools to calm your body before bedtime.
If sleep paralysis or chronic sleep disruptions are affecting your life, you don’t have to face them alone. Reach out today to learn how our therapists can support you in overcoming sleep paralysis episodes, so you can return to restful sleep.
FAQs About Sleep Paralysis in Adults
1. How Do You Get Out Of Sleep Paralysis?
Although it can feel overwhelming, sleep paralysis passes on its own within seconds or minutes. The key is to stay calm and focus on small, controlled actions. Try to:
- Focus on breathing slow, steady breaths to help regulate panic and bring your body back into rhythm.
- Try to move a small muscle, like wiggling your toes or fingers, which can signal the brain to reestablish muscle control.
- Remind yourself it’s temporary by silently repeating “This will pass.” This can shift focus away from fear.
Practicing these techniques and addressing stress or anxiety through therapy can make it easier to regain control during an episode and reduce how often they occur.
2. Is Sleep Paralysis Dangerous?
No. Sleep paralysis may feel terrifying, but it’s not life-threatening and doesn’t cause physical harm. It’s a temporary mismatch between the brain waking up and the body remaining in REM paralysis. The main concern is how emotionally distressing it can be, particularly for people with underlying stress and sleep paralysis or trauma-related sleep disruptions.
3. Can Anxiety Cause Sleep Paralysis?
Yes. Anxiety activates the body’s stress response, keeping the nervous system in a state of alertness even while you sleep. Over time, this can fragment REM cycles and increase the likelihood of waking up before the body fully reactivates—causing paralysis. Addressing anxiety and sleep paralysis through therapy, mindfulness, and relaxation strategies can reduce these episodes.
4. When Should I Seek Professional Help for Sleep Paralysis?
If sleep paralysis happens often, disrupts your daily life, or is accompanied by panic, exhaustion, or nightmares, professional support can help. Reaching out to a therapist or sleep specialist ensures that you are addressing the potential underlying issues with compassionate care.
5. Does Mission Connection Treat Sleep Paralysis and Related Conditions?
Yes, we provide care for adults experiencing sleep disorders, like sleep paralysis. With a focus on the impact of both mental health conditions and the physical response your body has during these episodes, our goal is to help you calm the nervous system and rebuild trust in your body.
References
- Farooq, M., & Anjum, F. (2023, September 4). Sleep paralysis. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK562322/
- Sharpless, B. A., & Barber, J. P. (2011). Lifetime prevalence rates of sleep paralysis: A systematic review. Sleep Medicine Reviews, 15(5), 311–315. https://doi.org/10.1016/j.smrv.2011.01.007
- Sharpless, B. (2016). A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatric Disease and Treatment, Volume 12, 1761–1767. https://doi.org/10.2147/ndt.s100307
- Bhalerao, V., Gotarkar, S., Vishwakarma, D., & Kanchan, S. (2024). Recent Insights into Sleep Paralysis: Mechanisms and Management. Cureus. https://doi.org/10.7759/cureus.65413
- Chu, B., Marwaha, K., Sanvictores, T., Awosika, A. O., & Ayers, D. (2024, May 7). Physiology, stress reaction. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK541120/
- Cheyne, J. A. (2002). Situational factors affecting sleep paralysis and associated hallucinations: position and timing effects. Journal of Sleep Research, 11(2), 169–177. https://doi.org/10.1046/j.1365-2869.2002.00297.x
- Denis, D., French, C. C., Rowe, R., Zavos, H. M. S., Nolan, P. M., Parsons, M. J., & Gregory, A. M. (2015). A twin and molecular genetics study of sleep paralysis and associated factors. Journal of Sleep Research, 24(4), 438–446. https://doi.org/10.1111/jsr.12282
- Pacheco, D., & Pacheco, D. (2025b, July 11). Best temperature for sleep. Sleep Foundation. https://www.sleepfoundation.org/bedroom-environment/best-temperature-for-sleep