Causes of Sleep Paralysis (2025)

Sleep paralysis is the phenomenon of being unable to move upon waking from sleep. Episodes generally last for a few minutes. These episodes are often described as scary, and sometimes they’re associated with a sense of a presence or intruder in the room or a general unexplained frightening feeling.

An individual episode can be triggered by stress, alcohol or drug use, or disrupted sleep. Some risk factors that make it more likely to experience recurrent sleep paralysis include narcolepsy, post-traumatic stress disorder (PTSD), or a family history of recurrent paralysis.

When you dream, your body releases hormones that temporarily prevent you from moving your voluntary muscles, such as those in your arms and legs. If you wake up a few minutes before the muscle paralysis of your dream state wears off, you will be awake but unable to move.

1. Narcolepsy

Narcolepsy is a sleep disorder that causes sudden episodes of sleep during the day and extreme daytime sleepiness that’s not relieved by getting enough sleep at night or by napping. There’s a strong association between narcolepsy and sleep paralysis.

2. Post-Traumatic Stress Disorder

With PTSD, people experience intrusive flashbacks and feelings of stress related to a previous traumatic event. This condition causes emotional and psychological distress and many other effects, including nightmares and an increased risk of sleep paralysis.

3. Heredity

Several aspects of your sleep are hereditary, and recurrent sleep paralysis runs in some families. Additionally, a few different genes have been identified as being associated with an increased risk of recurrent sleep paralysis. You may have inherited a predisposition for sleep paralysis even if you don’t carry one of the specific genes so far associated with familial forms of the condition.

4. Substances

Substances such as alcohol, drugs, and medications can affect sleep cycles and may disrupt hormones associated with different stages of sleep. This can lead to a mismatch of the dreaming and waking phases, potentially causing one or more episodes of sleep paralysis.

5. Anxiety and Stress

A bout of significant anxiety or stress can trigger one or more episodes of sleep paralysis in some people. Emotional strain can disrupt your sleep, and stress hormones can contribute to feelings of fear. Sometimes people who are prone to sleep paralysis experience episodes during times of stress or increasing anxiety.

6. Sleep Disruption

Sleep disruptions such as staying up all night to study or socialize, jet lag, chronic pain, a major illness that prevents you from sleeping, or shift work (working overnight or at other times outside the typical daytime work hours) can cause irregular sleep cycles. This could increase your risk of sleep paralysis.

Is Sleep Paralysis Dangerous?

Sleep paralysis is not dangerous. Once the episode resolves, you will be able to move as you normally do, and you may experience a sense of relief. But if you felt very disturbed by it, you might continue to have uneasy feelings about the experience or fear it recurring

Up to 40% of the general population has experienced sleep paralysis at least once. Recurrent sleep paralysis is much less common, affecting about 7% of the population.

If you’ve only experienced sleep paralysis a few times in your lifetime, it’s unlikely to cause any harm beyond making you feel uneasy. Some people who experience sleep paralysis feel so distressed by the event that they develop anxiety about sleeping. This can lead to a cycle of anxiety, insomnia, fatigue, and even further anxiety.

Sleep paralysis can contribute to:

• Insomnia (trouble falling asleep or staying asleep, even when you are tired)
• Lack of sleep
• Nightmares
• Preoccupation with the feeling that you had during the episode
• A general sense of anxiety

If you’re experiencing any of these effects, talk to a healthcare professional. They can diagnose an underlying condition and recommend further steps to improve sleep.

How to Prevent Sleep Paralysis

You can take some steps that may help reduce the occurrence of sleep paralysis. Additionally, a healthcare professional may be able to prescribe therapy or medication, depending on the underlying cause of your sleep paralysis.

Some ways to prevent sleep paralysis include:

• Avoid alcohol, caffeine, tobacco, and a large meal shortly before sleep.
• Try to develop a sleep routine so that your sleep schedule is consistent.
• Implement a relaxing bedtime routine.

How to Get Out of Sleep Paralysis When It's Happening

No strategy will help you come out of sleep paralysis during an episode. It will pass naturally. But you may consider these tactics to reduce the distress:

• Try to stay calm and take a deep breath.
• Try to move a small part of your body, such as an eyebrow, your tongue, or a finger.
• Spend a moment getting oriented to the date, time, and your location.
• Consider the recent routine events in your life and try to reassure yourself that the episode will resolve within a few minutes.

Treatment for Recurrent Sleep Paralysis

The underlying cause, such as anxiety, PTSD, narcolepsy, or medication side effects, may guide treatment for recurrent sleep paralysis.

Some treatments include:

• Antidepressants at a low dose
• Cognitive behavioral therapy (a type of talk therapy conducted by a mental health professional)
• Talking with a therapist about anxiety or stress if that is contributing to your sleep problems
• Getting treatment for PTSD
• Reviewing your list of medications with a healthcare provider or pharmacist to determine if any could disrupt sleep
• Getting treatment for narcolepsy or discussing treatment adjustments with your healthcare provider

When to Contact a Provider

Recurrent episodes of sleep paralysis can indicate an underlying medical or mental health condition. The experience of sleep paralysis can cause significant distress and anxiety for some people.

It's important to get medical attention if you’re experiencing recurring episodes of sleep paralysis or are distressed by it or other sleep disturbances.

Summary

Several risk factors can increase the likelihood of sleep paralysis. Stress, sleep disruption, alcohol, and medications can trigger one or more episodes. Recurrent sleep paralysis has a strong association with narcolepsy and post-traumatic stress disorder.

Episodes of sleep paralysis are often frightening, and you can get treatment if you have recurrent episodes or if they’re causing you to feel distress.

During an episode, you can take a deep breath, try to stay calm and grounded, and reflect that this episode will likely resolve within a few minutes as you regain your ability to move your muscles.