Sleep paralysis is when, when awake or asleep, a person is conscious but can not move or speak. During an episode, a person may hear, feel, or see things that are not there. It often results in fear. Episodes generally last less than a few minutes. This can happen as an episode or recurring.
This condition can occur in those who are healthy, those with narcolepsy, or can walk in the family as a result of certain genetic changes. This condition can be triggered by lack of sleep, psychological stress, or abnormal sleep cycles. The underlying mechanism is believed to involve dysfunction in REM sleep. The diagnosis is based on a person's description. Other conditions that may present together include narcolepsy, atonic spasms, and hypokalemic periodic paralysis.
Treatment options for sleep paralysis have been poorly studied. It is recommended that people be assured that the conditions are common and generally not serious. Other possible attempts include hygienic sleep, cognitive behavioral therapy, and antidepressants.
Between 8% and 50% of people experience sleep paralysis at a time. About 5% of people have regular episodes. Men and women are affected equally. Sleep paralysis has been described throughout history. It is believed to have played a role in the creation of stories about alien abductions and other paranormal events.
Video Sleep paralysis
Signs and symptoms
The central symptom of sleep paralysis can not move during waking.
Imagined sounds like humming, hissing, static, electric and buzzing sounds are reported during sleep paralysis. Other sounds such as voice, whisper, and roar are also experienced. These symptoms are usually accompanied by intense emotions such as fear and panic. People also have the sensation of being dragged out of bed or flying, numb, and the tingling feeling or electric vibrations that flow through their bodies.
Sleep paralysis may include hypnogogic hallucinations, such as supernatural beings who are choked or frightened individuals, accompanied by feelings of distress in the chest and difficulty in breathing. Another example of hallucinations involves a shadowy figure threatening to enter someone's room or hiding outside one's window, while the subject is paralyzed. The content and interpretation of these hallucinations is driven by fear, somatic sensation, REM-induced sexual arousal, and REM mentasi embedded in the narrative of sleep culture.
The physiology of REM sleep and somatic symptoms coupled with the awareness that a person is paralyzed can produce various psychological symptoms during sleep paralysis, including fears and worries compounded by the catastrophic cognition of the attack. This can activate a fight-flight reaction and panic-like passion. As a result, when people try to escape from paralysis, somatic symptoms and arousal are exacerbated, as the implementation of motor programs in the absence of proprioceptive feedback reductions can lead to high sensations of body stiffness and pressure, and even pain and spasms in the limbs.
Maps Sleep paralysis
Pathophysiology
The pathophysiology of sleep paralysis has not been concretely identified, although there are several theories about the cause. The first of these stems from the understanding that sleep paralysis is parasomnia due to dysfunctional overlap of REM and an awakened sleep stage. Polysomnographic studies found that individuals who experienced sleep paralysis had shorter than normal REM sleep latency along with shorter NREM and REM sleep cycles, and REM sleep fragmentation. This study supports the observation that disorders of ordinary sleep patterns can trigger episodes of sleep paralysis, because fragmentation of REM sleep generally occurs when sleep patterns are impaired and are now seen in combination with sleep paralysis.
Another major theory is the nervous function that regulates unbalanced sleep, causing different sleep status to overlap. In this case, cholinergic sleep in nervous populations is hyperactive and sleeps serotonergically from inactive nerve populations. As a result, cells capable of transmitting signals that allow the full passion of sleep state, the serotonergic nerve population, have difficulty overcoming signals sent by cells that keep the brain in sleep. During normal REM sleep, the threshold for a stimulus for passion greatly increases. Under normal conditions, the medial and vestibular nuclei, cortical, thalamic, and cerebellar coordinate such things as head and eye movement, and orientation in space.
However, in individuals with SP, there is almost no exogenous stimulus barrier, which means it is much easier for stimuli to excite individuals. There may also be a problem with the regulation of melatonin, which under normal circumstances governs the serotonergic nerve population. Melatonin is usually at its lowest point during REM sleep. Inhibition of melatonin at the wrong time will make it impossible to sleep from the nerve population to depolarize when presented with a stimulus that usually leads to a complete passion. The vestibular nuclei in particular have been identified closely related to dreaming during the REM sleep stage. According to this hypothesis, disorientation of the vestibular motor, unlike hallucinations, arises from a source of entirely endogenous stimuli.
This could explain why the REM and waking stages overlap during sleep paralysis, and clearly explain the muscle paralysis experienced when awake. If sleep effects in the neural population can not be neutralized, REM sleep characteristics are maintained at wake. The general consequences of sleep paralysis include headache, muscle aches or weakness and/or paranoia. As correlation with REM sleep indicates, paralysis is incomplete: EOG trace use suggests that eye movement is still possible during the episode; however, individuals who experience sleep paralysis can not speak.
Research has found a genetic component in sleep paralysis. Fragmentation of REM sleep characteristics, hypnopompic, and hypnagogic hallucinations have components inherited in other parasomnia, which gives confidence to the idea that sleep paralysis is also genetic. Twin studies have shown that if one of the twins of a monozygotic couple experiences sleep paralysis then another twin is very likely to experience it as well. The identification of the genetic component means there is some sort of impaired function at the physiological level. Further research should be done to determine whether there are errors in the signal path for passion as suggested by the first theory presented, or whether the regulation of melatonin or the nerve population itself has been disrupted.
Hallucinations
Several types of hallucinations have been linked to sleep paralysis: the belief that there are intruders in the room, the presence of an incubus, and a floating sensation. The neurological hypothesis is that in sleep paralysis mechanisms that normally coordinate body movement and provide information about the position of the body becomes active and, as there is no actual movement, causing a floating sensation.
Incubus destroyers and hallucinations are highly correlated with each other, and sufficiently correlated with the third hallucination, vestibular motor disorientation, also known as an out-of-body experience, which differs from the other two in the absence of a threat-activated precautionary system.
Several theories have been proposed to explain hallucinations that may accompany sleep paralysis, but currently no studies support neurological models.
Threat hyper-vigilance
Hyper-alert conditions made in the midbrain may further contribute to hallucinations. More specifically, emergency responses are activated in the brain when individuals wake up paralyzed and feel vulnerable to attack. This powerlessness can intensify the effects of a threat response far above the normal level of normal dreams, which may explain why such sightings during sleep paralysis are very clear. A threat-activated alert system is a protection mechanism that distinguishes between dangerous situations and determines whether the fear response is appropriate.
Hyper-alert responses can lead to the creation of endogenous stimuli that contribute to perceived threats. A similar process may explain hallucinations, with slight variations, in which an evil presence is perceived by the subject to try to strangle him, either by pressing on his chest or by a strain. Neurological explanations suggest that this is the result of a combination of a threat activation system and muscle paralysis associated with sleep paralysis that removes voluntary respiratory control. Some features of REM respiratory patterns worsen the feelings of suffocation. These include shallow superficial breathing, hypercapnia, and slight airway obstruction, which is a common symptom in sleep apnea patients.
According to this report, subjects sought to breathe deeply and found themselves incapable of doing so, creating a sensation of resistance, which was activated by the threat of an activated system as an unnatural sitting on their chest, threatening to suffocate. Trap sensations cause feedback loops when the fear of suffocation increases as a result of continuing helplessness, causing the subject to struggle to end the SP episode.
Diagnosis
Sleep paralysis is primarily diagnosed through clinical interviews and excludes other potential sleep disorders that may explain feelings of paralysis. The main disorder examined is narcolepsy because of the high prevalence of narcolepsy in relation to sleep paralysis. The availability of a genetic test for narcolepsy makes this an easy nuisance to get rid of. Several steps are available to reliably diagnose (eg, scary isolated sleep paralysis interview) or screen (Munich Parasomnia Screening) for recurrent isolated sleeping paralysis.
Classification
Episodes of sleep paralysis may occur in the context of some medical conditions (eg, narcolepsy, hypokalemia). When an episode occurs independently of this condition or substance use, it is called "sleep paralysis isolation" (ISP). When episodes of ISPs are more frequent and cause significant distress and/or clinical disorders, these are classified as "recurrent isolated sleeping palsy" (RISP). Episodes of sleep paralysis, regardless of classification, are generally short (1-6 minutes), but longer episodes have been documented. With an individual RISP can also suffer from sleepback paralysis episodes from back to back on the same night, which is unlikely in individuals suffering from ISPs.
It is difficult to distinguish between the cataplexy caused by narcolepsy and actual sleep paralysis, since both phenomena are physically indistinguishable. The best way to distinguish between them is to keep track of when attacks occur most often. Narcolepsy attacks are more common when someone falls asleep; ISP and RISP attacks are more common when waking up.
Prevention
Several circumstances have been identified that are associated with an increased risk of sleep paralysis. These include insomnia, lack of sleep, erratic sleep schedules, stress, and physical exhaustion. It is also believed that there may be a genetic component in the development of RISP, as there is a high incidence of paralyzed sleep paralysis in monozygotic twins. Sleeping in the supine position has been found as the main instigator of sleep paralysis.
Sleeping in a supine position is believed to make sleeping more susceptible to episodes of sleep paralysis because in this sleeping position it is possible for the soft palate to collapse and block the airway. This is a possibility regardless of whether a person has been diagnosed with sleep apnea or not. There may also be a higher level of microarousals while sleeping in the supine position because there is more pressure given to the lungs by gravity.
While many factors can increase the risk of ISP or RISP, they can be avoided with small lifestyle changes. By maintaining a regular sleep schedule and observing good sleep hygiene, one can reduce the likelihood of sleep paralysis. It helps subjects to reduce stimulant intake and stress in daily life by taking a hobby or seeing a trained psychologist who can suggest stress coping mechanisms. However, some cases of ISP and RISP involve genetic factors - which means some people may find sleep paralysis unavoidable. Practicing meditation regularly may also help in preventing sleep split, and thus the occurrence of sleep paralysis. Research has shown that long-term meditation practitioners spend more time in slow-wave sleep, and just as regular meditation practice can reduce nocturnal passion and thus may be sleep paralysis.
Treatment
Medical care begins with an education about the stage of sleep and the inability to move muscles during REM sleep. People should be evaluated for narcolepsy if symptoms persist. The safest treatment for sleep paralysis is for people to adopt healthy sleeping habits. However, in more serious cases, tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) may be used. Despite the fact that these treatments are prescribed at this time no drugs have been found to actually interfere with the episodes of sleep paralysis most of the time.
Drugs
Although there are no major trials that focus on the treatment of sleep paralysis, some drugs have promise in case studies. Two GHB trials for people with narcolepsy showed decreased episodes of sleep paralysis.
Cognitive behavioral therapy
Some of the earliest jobs in treating sleep paralysis are done using cognitive therapy-a sensitive cultural behavior called CA-CBT. The work focuses on psycho-education and modifies catastrophic cognition about sleep paralysis attacks. This approach has previously been used to treat sleep paralysis in Egypt, although clinical trials are lacking.
The first published psychosocial treatment for recurrent isolated sleeping paralysis is cognitive-behavioral therapy for isolated sleep paralysis (CBT-ISP). CBT-ISP manually, has compliance guidelines for research purposes, and is intended to prevent and disrupt an ISP episode. It begins with self-monitoring of symptoms, cognitive restructuring of the maladaptive mind that is relevant to the ISP (eg, "paralysis will become permanent"), and psychoeducation about the nature of sleep paralysis. Preventive techniques include ISP specific sleep cleansing and use of preparation of various relaxation techniques (eg diaphragmatic breathing, consciousness, progressive muscle relaxation, meditation). The episode interruption technique was first performed in a session and then applied during the actual attack. No controlled trials of CBT-ISPs have not been performed to prove their effectiveness.
Meditation-relaxation therapy
Relaxation-meditation therapy (MR) is a published direct treatment for sleep paralysis. This treatment is partly derived from the neuroscience hypothesis which suggests that movement efforts during sleep paralysis (eg, due to panic-like reactions) can cause a neurological distortion of a person's "body image", which may trigger hallucinations of shadowy human figures. This therapy is based on four steps applied during sleep paralysis: (1) reassessment of the meaning of attack (cognitive reappraisal); which requires closing one's eyes, avoid panic and reassess the meaning of the attack as benign. (2) psychological and emotional distances (emotional regulation); the sleeping person reminds himself that the event disaster (ie, fear and worry) will worsen and possibly extend it; (3) inward-focused attention meditation; focusing inward attention on positive positive objects emotionally; 4) muscle relaxation; relax one's muscles, avoid controlling breathing and avoid attempting to move. There are preliminary case reports supporting this treatment, although no randomized clinical trials have demonstrated their effectiveness.
Epidemiology
The same sleep paralysis experienced in men and women. Lifetime prevalence rates from 35 aggregate studies show that about 8% of the general population, 28% of students, and 32% of psychiatric patients experience at least one episode of sleep paralysis at some point in their life. The rate of recurrent sleep paralysis is not well known, but 15% -45% of those with a history of sleep paralysis can meet the diagnostic criteria for Recurrent Isolated Sleep Paralysis. In surveys from Canada, China, Britain, Japan and Nigeria, 20% to 60% of people report having experienced sleep paralysis at least once in their lives. In general, non-whites seem to experience sleep paralysis at a higher rate than whites, but the magnitude of the difference is rather small. About 36% of the general population who experience isolated sleep paralysis tend to develop between 25 and 44 years.
The isolated sleep paralysis is generally seen in patients who have been diagnosed with narcolepsy. About 30-50% of people who have been diagnosed with narcolepsy have experienced sleep paralysis as an additional symptom. Most individuals who experience sleep paralysis experience sporadic episodes that occur once a month to once a year. Only 3% of individuals who experience sleep paralysis that is not associated with neuromuscular disorders have night episodes.
Sleep paralysis can lead individuals to get conditioned fear from experience ("worry attack"), resulting in more wake-up time and sleep divided (due to nocturnal excitement and alertness to symptoms of paralysis), making people more likely to have paralysis sleeping in the future.
Society and culture
Etymology
The original definition of sleep paralysis was codified by Samuel Johnson in his book English Dictionary as a nightmare , a term that evolved into our modern definition. The term was first used and dubbed by the English neurologist, S.A.K. Wilson in his 1928 dissertation, The Narcolepsies. Such sleeping paralysis is widely regarded as the work of the devil, and more specifically the incubi, which is considered sitting on the sleeping chest. In Old English the names for these creatures are mare or mÃÆ'Â|re (from proto-Germanic mar 'n \/i>, see Norse Old mara ), then it appears mare in the word nightmare . The word may be etymologically similar to the Greek Mar? N (in Odyssey) and Sanskrit M? Ra . Culture and priming meaning
Although the core features of sleep paralysis (eg, atony, clear sensory, and frequent hallucinations) appear to be universal, the ways in which they are experienced vary according to time, place, and culture. More than 100 terms have been identified for this experience. Some scientists have proposed sleep paralysis as an explanation for reports of paranormal phenomena such as ghosts, parasites, foreign visits, demons or demon possessions, alien abduction experience, Night Hag, and haunting shadows.
The night hag is a generic name for the fantastic creatures of the various peoples folklore used to explain the phenomenon of sleep paralysis. The general picture is that one feels the presence of a supernatural evil creature that incapacitates the person as if sitting on his chest. Different cultures have various names for this phenomenon and/or supernatural character. For example, sleep paralysis is referred to as the Pandafeche attack in Italy.
Among the Italians, Pandafeche may refer to wicked magicians, sometimes ghostlike spirits or frightening cat-like creatures. Sleep paralysis among Cambodians is known as, "ghosts push you down," and requires confidence in the dangerous visits of deceased relatives. In Egypt, sleep paralysis is conceptualized as a frightening Jinn attack. . Jinn (that is, evil genes) can terrorize and even kill the victim. Sleep paralysis is sometimes interpreted as a kidnapping alien space in the United States.
According to some cultural scientists may be a major factor in shaping sleep paralysis. When sleep paralysis is interpreted through a particular cultural filter, a greater meaning may be required. For example, if sleep paralysis is feared in a particular culture, this fear can cause conditioned fear, and thus exacerbate the experience, in turn leading to higher levels. Consistent with this idea, high rates and long duration of immobility during sleep paralysis have been found in Egypt, where there is an elaborate belief about sleep paralysis, involving creatures such as evil spirits, Jin.
Research has found that sleep paralysis is associated with great fear and fear of impending death in 50% of patients in Egypt. A study comparing the levels and characteristics of sleep paralysis in Egypt and Denmark found that the phenomenon is three times more common in Egypt versus Denmark. In Denmark, unlike Egypt, there is no detailed magical conviction about sleep paralysis, and the experience is often interpreted as a strange physiological event, with an overall episode of shorter sleep paralysis and fewer people (17%) who fear that they can die therefore.
Literature
Various forms of magic and spiritual mastery also advanced as a cause in literature. In nineteenth-century Europe, dietary twists and turns were held responsible. For example, in Charles Dickens A Christmas Carol Ebenezer Scrooge attributes the ghost he sees with â € Å"in a bit of undigested meat, a mustard bottle, a piece of cheese, a fragment of less potatoes... "In the same vein, Household Cyclopedia (1881) offers the following suggestions about nightmares:
- "Great attention has to be paid to the regularity and the choice of diet.Key of every kind is painful, but there is nothing more productive than this disease than drinking bad wine.From the food they all prejudice is all fat and meat oily and pastry... Moderate sports contribute to higher levels to promote food digestion and prevent flatulence, but those who are confined to sedentary work, should primarily avoid applying themselves to study or physical delivery immediately after eating... Going to bed before the usual hours is the cause of frequent night mare, as either the patient's chance to sleep too long or to lie long at night. Passing overnight or part of the night without rest also gave birth to illness, because sometimes the patient, on the next night , to sleep too soundly. Actions to sleep too late in the morning, adala h method is almost certain to carry on paroxysm, and the more often it returns, the greater the power it gets; the tendency to sleep today is almost unbearable. "
J. M. Barrie, author of Peter Pan's story, may experience sleep paralysis. He said of himself "In my early childhood, it was a sheet that tried to strangle me at night." He also explained several incidents in Peter Pan's story which show that he is familiar with the awareness of temporary muscular loss in a dreamlike state. For example, Maimie is asleep but calling 'What is it.... It comes closer! It feels like your bed with its horns - it's boring to [be] you '. and when Darling's children dream of flying, Barrie says' There's nothing terrible seen in the air, but their progress is slow and difficult, just as if they were pushing their way through enemy troops. Sometimes they hang in the air until Peter strikes him with his fist. Barrie describes many parasomnia and neurological symptoms in her books and uses them to explore the nature of consciousness from an experiential point of view.
Documentary movie
The Nightmare is a 2015 documentary that discusses the causes of sleep paralysis as seen through extensive interviews with participants, and the experience is repeated by professional actors. In the synopsis, he proposes that cultural memes such as alien abduction, near-death experience and the shadow of a person can, in many cases, be associated with sleep paralysis. The "real" horror film debuted at the Sundance Film Festival on January 26, 2015 and aired in theaters on June 5, 2015.
References
External links
- Sleep information and links from Stanford University
- Sleep Paralysis and Related Hypnagogic and Hypnopompic Experience from the University of Waterloo
Source of the article : Wikipedia
0 Comments