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Suffering from sleep paralysis. What treatment should be done?

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Since a young age (approx 12 years ol) I have suffered from what I believe is sleep paralysis, ie being frozen whilst I'm entering sleep, it usually ends in horrific nightmares, although on the very odd occasion they can by brilliant and sureal dreams or out of body experiences. I can feel myself entering this state and am fully aware of my surroundings and often can see my room quite clearly. I've managed to control them to a certain extent over time by fighting my way back to a fully awake state. Now Im 33 and have huge problems sleeping, I get huge shocks and jumps as Im trying to sleep and often start to shake. I often see images when my eyes are closed which often turn in dreams when I finally sleep. During and after the event I see images of people in my room, whom usually aren't 'friendly', often pulling at me or trying to stab me or the likes. When I come through my heart is pounding very heavily. I've done much research online and it sounds very much like sleep paralyisis but most people only suffer this very rarely, I've had it thousands of times and I'm sick of it and its really starting to affect my life. I spoke to a GP about it many years ago but he didnt seem to have a clue what I was talking bout. Do you know a way I can better control this or stop it? Any help on this would be greatly appreciated. Thank you.
Posted Mon, 3 Dec 2012 in Sleep Disorders
Answered by Dr. Jonas Sundarakumar 10 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

From your clinical history, it appears that you are having a REM Sleep disorder, predominantly sleep paralysis. The other symptoms which you describe such as disturbing nightmares and seeing non-existent people as you come out of sleep (hypnopompic hallucinations) are also indicators of an REM sleep abnormality.

Such disorders occur when there is an alteration in the sequence or proportion of the different stages of sleep. Normally sleep proceeds through various stages in a particular patten and sequence; there should also be a correct proportion of REM / NREM cycles in order to have a normal refreshing sleep. When this sequence or proportion gets erratic, then such kind of sleep disorders may occur.

I would suggest the following:
1) To have a Sleep study (Polysomnography) done to confirm the diagnosis.

2) Certain antidepressant medication (like tricyclic antidepressants) have been found effective in treating this disorder. Please consult a psychiatrist to discuss treatment options.

3) Ofen, repeated terrifying experiences of sleep paralysis or nightmares or hallucinations can result in a subconscious anxiety / fear about sleeping. This anxiety itself then keeps worsening / propogating the sleep abnormalities. So, this becomes a viscious cycle. Following strict sleep hygiene, trying relaxation techniques like XXXXXXX breathing, progressive muscle relaxation, yoga, etc. prior to going to sleep can help a lot. There are also certain behavioural therapies which can help break this viscious cycle and thereby reduce symptoms.

So, please consult a psychiatrist for further evaluation and treatment. With appropriate treatment, I'm sure you'll be able to overcome your problem soon.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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