Managing Sleep Paralysis Symptoms: A Guide

Medically reviewed by Julie Dodson, MA
Updated April 25, 2024by BetterHelp Editorial Team

The reality of sleep paralysis, including conditions like recurrent sleep paralysis can feel overwhelming. However, we want to assure you that you aren’t alone in your experiences. It’s estimated that sleep paralysis can affect millions of people around the world, including those who have experienced sleep paralysis due to factors such as sleep deprivation or anxiety disorders, which is why ongoing education and support can be so important. 

Below, we’re exploring what common sleep paralysis symptoms look like, possible risk factors for sleep paralysis, and the benefits that online therapy can offer to those diagnosed with sleep paralysis and currently living with the condition. 

Experiencing sleep paralysis?

Understanding sleep paralysis symptoms

Sleep paralysis generally occurs most during the transition between wakefulness and sleep, specifically during the rapid eye movement (REM) stage of sleep. During REM sleep, your body may be paralyzed as a natural mechanism to prevent you from acting out your dreams. This is crucial for those who experience sleep paralysis as they fall asleep or upon waking. While experiences can vary based on the unique situations and experiences of each individual patient, there are common symptoms that may point to the presence of sleep paralysis. One such symptom is hallucination, which may or may not accompany muscle relaxation or muscle paralysis. Symptoms might range from mild to severe and could include intruder hallucinations and out-of-body sensations. 

Hallucinations, lucid dreaming, and vivid dreaming associated with this condition may have vivid visual, auditory, and even tactile experiences—such as sensing that there's a presence in the room or feeling pressure on your chest, known as chest pressure hallucinations. These may last from a few minutes to longer periods. You may also experience a range of motion-related disturbances, ranging from mild weakness to a complete inability to move. Some people may also have trouble breathing, sweating, nighttime leg cramps, and a sense of impending doom prior to the occurrence of paralysis. Sleep paralysis treated for specific experiences will be tailored to the individual.

We do want to note:This condition can manifest differently for those who experience it. Some people may have mild symptoms, while others may have severe symptoms. Sleep paralysis might also be associated with other sleep disorders, such as narcolepsy—which is a disorder that can be characterized by excessive daytime sleepiness, sudden loss of muscle control, and hypnogogic hallucinations. If you suspect that you have sleep paralysis, you may want to consider seeing a sleep specialist for an accurate diagnosis.

Identifying possible sleep paralysis risk factors

A variety of factors may impact the presence or occurrence rate of the condition. Some of these can include irregular sleep patterns, certain medications, and certain medical conditions, such as narcolepsy and obstructive sleep apnea. Family history may also play a role in the development of sleep paralysis. 

For many, a sleep pattern change is the most common event that may bring on paralysis. When you have irregular sleep habits, such as inconsistent bedtimes or frequent disruptions during sleep or while falling asleep or waking, it may disrupt the normal sleep-wake cycle and increase the likelihood of further disruption in the REM cycle.

This is particularly concerning for those with sleep apnea, panic disorders, or neurological disorders, who may find their symptoms exacerbating sleep paralysis. If sleep paralysis routinely stops when you maintain a consistent sleep pattern, your therapist might help you focus on how to maintain this long-term to stop sleep paralysis.

Managing sleep paralysis symptoms

For many, a large part of trying to manage sleep paralysis is identifying personal triggers. You might be able to do this through self-monitoring methods, such as keeping a sleep diary—in which you can record your sleeping patterns and any other subsequent symptoms you experienced around the time of paralysis, like feeling excessively sleepy or having emotional distress. By trying to identify your triggers, including stress, alcohol consumption, or changes in your sleep schedule, you might take steps to regulate them and reduce the likelihood of future sleep paralysis episodes.

Additionally, managing sleep paralysis diagnosed based on complex symptoms often requires a multifaceted approach that may include lifestyle changes. These changes may often revolve around strategies to help you get a better night’s sleep on a regular, consistent schedule. Basic medical research focusing on sleep research and sleep medicine reviews support these lifestyle modifications as effective methods for managing sleep-related issues.

Some positive changes you may choose to implement to support a stronger sleep schedule may include: 

  • Avoiding caffeine and alcohol close to bedtime
  • Avoiding heavy meals before bed
  • Maintaining a consistent sleep schedule
  • Going to bed earlier than usual 
  • Limiting TV and blue light (such as from a smartphone or tablet) 

Understanding and managing symptoms of sleep paralysis can be key for those who frequently experience this condition. Your physician or health professional can help you determine the most appropriate lifestyle changes for your specific condition-related experience and needs, especially if you have a history of mental health conditions or a sleep disorder like sleep apnea. Additional mental health disorders or mental conditions that arise may alter your treatment plan. 


Coping with sleep paralysis

Dealing with sleep paralysis can be a challenging experience, both physically and emotionally. One strategy that may help some to cope with sleep paralysis is to learn ways to manage the emotional and psychological effects. 

This can be particularly important for those who experience sleep paralysis routinely and may feel emotional distress or significant health effects as a result.

There are many ways to begin this specific healing process. Many may choose to talk with an online therapist or support group, creating a plan for dealing with future episodes. Online therapy may be a valuable resource when you wish to live well around the emotional and psychological effects of sleep paralysis. Therapists can help you work through any feelings of fear or nervousness that may be associated with sleep paralysis and can offer tools to help you to better manage feelings of frustration or overwhelm. 

Support groups might also be a helpful resource, as they can provide a safe and encouraging environment in which you have the ability to connect with others who may have similar experiences. 

Creating a plan for navigating future episodes of sleep paralysis may also help you live well with sleep paralysis. If possible, you might choose to educate family and friends about sleep paralysis and its symptoms—possibly allowing them to empathize with you and validate your experiences. This can help to reduce the feelings of isolation and nervousness that may accompany the condition. 

How can online therapy help those living with sleep paralysis?

If you’re living with sleep paralysis, online therapy may be a helpful tool to use. You can work through any feelings or nervousness you may have from the experiences, speaking candidly to an online therapist in the comfort of your own home.  

An additional benefit to using online therapy for support for sleep paralysis is the ability to communicate freely and comfortably. This format generally offers a safe setting for self-expression and many experience greater comfort with the potential unknownness of online counseling. This may also be a more convenient and affordable method of therapeutic support for many, especially for those who feel excessively sleepy due to sleep paralysis or have related mental health disorders.

When diagnosing sleep paralysis, healthcare professionals typically evaluate the patient’s description of the sleep paralysis and the frequency of episodes. Individuals may report experiencing multiple sleep paralysis episodes or even occasional sleep paralysis. Each episode of sleep paralysis is characterized by a temporary inability to move or speak while falling asleep or upon awakening. This condition can significantly impact sleep quality, often leading to fear of falling asleep. In some cases, sleep paralysis may be associated with other sleep disorders, such as obstructive sleep apnea, which can exacerbate the severity and frequency of episodes.

One step to treat sleep paralysis often involves addressing underlying conditions, improving sleep habits, and in certain cases, utilizing specific medications or therapy techniques to reduce the occurrence and impact of these episodes.

Experiencing sleep paralysis?

Is online therapy effective?

Online therapy can be a useful option for treating insomnia and other sleep problems that have been linked to sleep paralysis. A study by Espie suggested that adults with insomnia disorders could benefit from online cognitive behavioral therapy (CBT), as it can support some in getting better sleep and achieving a higher level of daytime functioning overall.  

The study found that online CBT was deemed possibly more effective in treating insomnia than in-person CBT. It also suggested that online CBT was more effective than other sleep medications and treatments, such as relaxation techniques or lifestyle changes per self-assessment and recorded responses from study participants. Therefore, it’s currently suggested that consistent use of online therapy might help reduce the frequency and severity of sleep paralysis episodes by assisting people in identifying the root causes of their condition—empowering them to make changes to support their needs. Online therapy can also support comorbid mental health disorders effectively.


Sleep paralysis can be overwhelming, but you aren’t alone in your experience. The condition is thought to affect millions every year. Many methods of management, such as lifestyle changes and medication, have been shown to address the condition effectively. Additionally, online therapy has been clinically suggested to be as effective (if not more so) as other interventions such as those listed above. By using online therapy, individuals can receive the support they need in a convenient way—possibly helping them to better understand and manage their symptoms. BetterHelp can connect you with a therapist in your area of need.
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