Meditation-relaxation therapy may offer escape from the terror of sleep paralysis
August 12, 2020
Science Daily/University of Cambridge
Sleep paralysis -- a condition thought to explain a number of mysterious experiences including alleged cases of alien abduction and demonic night-time visits -- could be treated using a technique of meditation-relaxation, suggests a pilot study published today.
Sleep paralysis is a state involving paralysis of the skeletal muscles that occurs at the onset of sleep or just before waking. While temporarily immobilised, the individual is acutely aware of their surroundings. People who experience the phenomenon often report being terrorised by dangerous bedroom intruders, often reaching for supernatural explanations such as ghosts, demons and even alien abduction. Unsurprisingly, it can be a terrifying experience.
As many as one in five people experiences sleep paralysis, which may be triggered by sleep deprivation, and is more frequent in psychiatric conditions like post-traumatic stress disorder. It is also common in narcolepsy, a sleep disorder involving excessive daytime sleepiness and sudden loss of muscle control.
Despite the condition being known about for some time, to date there are no empirically-based treatments or published clinical trials for the condition.
Today, in the journal Frontiers in Neurology, a team of researchers report a pilot study of meditation-relaxation therapy involving 10 patients with narcolepsy, all of whom experience sleep paralysis.
The therapy was originally developed by Dr Baland Jalal from the Department of Psychiatry, University of Cambridge. The current study was led by Dr Jalal and conducted in collaboration with Dr Giuseppe Plazzi's group at the Department of Biomedical and Neuromotor Sciences, University of Bologna/IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy.
The therapy teaches patients to follow four steps during an episode:
Reappraisal of the meaning of the attack -- reminding themselves that the experience is common, benign, and temporary, and that the hallucinations are a typical by-product of dreaming
Psychological and emotional distancing -- reminding themselves that there is no reason to be afraid or worried and that fear and worry will only make the episode worse
Inward focused-attention meditation -- focusing their attention inward on an emotionally-involving, positive object (such as a memory of a loved one or event, a hymn/prayer, God)
Muscle relaxation -- relaxing their muscles, avoiding controlling their breathing and under no circumstances attempting to move
Participants were instructed to keep a daily journal for four weeks to assess sleep paralysis occurrence, duration and emotions. Overall, among the 10 patients, two-thirds of cases (66%) reported hallucinations, often upon awakening from sleep (51%), and less frequently upon falling asleep (14%) as rated during the first four weeks.
After the four weeks, six participants completed mood/anxiety questionnaires and were taught the therapy techniques and instructed to rehearse these during ordinary wakefulness, twice a week for 15 min. The treatment lasted eight weeks.
In the first four weeks of the study, participants in the meditation-relaxation group experienced sleep paralysis on average 14 times over 11 days. The reported disturbance caused by their sleep paralysis hallucinations was 7.3 (rated on a ten-point scale with higher scores indicating greater severity).
In the final month of the therapy, the number of days with sleep paralysis fell to 5.5 (down 50%) and the total number of episodes fell to 6.5 (down 54%). There was also a notable tendency towards reductions in the disturbance caused by hallucinations with ratings dropping from 7.3 to 4.8.
A control group of four participants followed the same procedure, except participants engaged in deep breathing instead of the therapy -- taking slow deep breaths, while repeatedly counting from one to ten.
In the control group, the number of days with sleep paralysis (4.3 per month at the start) was unchanged, as well as their total number of episodes (4.5 per month initially). The disturbance caused by hallucinations was likewise unchanged (rated 4 during the first four weeks).
"Although our study only involved a small number of patients, we can be cautiously optimistic of its success," said Dr Jalal. "Meditation-relaxation therapy led to a dramatic fall in the number of times patients experienced sleep paralysis, and when they did, they tended to find the notoriously terrorising hallucinations less disturbing. Experiencing less of something as disturbing as sleep paralysis is a step in the right direction."
If the researchers are able to replicate their findings in a larger number of people -- including those from the general population, not affected by narcolepsy -- then this could offer a relatively simple treatment that could be delivered online or via a smartphone to help patients cope with the condition.
"I know first-hand how terrifying sleep paralysis can be, having experienced it many times myself," said Dr Jalal. "But for some people, the fear that it can instil in them can be extremely unpleasant, and going to bed, which should be a relaxing experience, can become fraught with terror. This is what motivated me to devise this intervention."
https://www.sciencedaily.com/releases/2020/08/200812094900.htm
Sleep paralysis and hallucinations are prevalent in student athletes
Study also suggests sleep disorders are associated with depression symptoms
June 4, 2018
Science Daily/American Academy of Sleep Medicine
Pilot data from a recent study suggest that sleep paralysis and dream-like hallucinations as you are falling asleep or waking up are widespread in student athletes and are independently associated with symptoms of depression.
Occasional sleep paralysis was reported by 18 percent of the sample, and 7 percent reported that this happens at least once per week. Hypnogogic/hypnopompic hallucinations (which are dream-like experiences that occur while falling asleep or waking up) were reported by 24 percent of the sample, and 11 percent reported that they experience these symptoms at least once per week.
Compared to those who never experience sleep paralysis or hypnogogic/hypnopompic hallucinations, those who did experience them -- even rarely -- also reported higher depression scores. This was even the case after controlling for how much sleep or what quality of sleep the person experienced.
"These symptoms are often thought to be relatively harmless and quite rare. But they can be very distressing to those who experience them, and they may be surprisingly common among student athletes," said senior author Michael Grandner, PhD, MTR, the director of the Sleep and Health Research Program and assistant professor of psychiatry at the University of Arizona College of Medicine. "What was also surprising was that the degree to which people reported these symptoms predicted severity of depression symptoms, even after controlling for poor sleep and lack of sleep -- which can contribute to both depression and these types of sleep symptoms."
Data were collected from 189 NCAA Division-I student athletes, who were asked how often they experienced the symptoms of sleep paralysis and hypnogogic/hypnopompic hallucinations. Participants were also asked about sleep duration, and they completed the Insomnia Severity Index and the Centers for Epidemiological Studies Depression Scale. Regression analyses examined depression score as outcome and sleep symptom as predictor in models adjusted for age and sex; as well as age, sex, insomnia severity, and sleep duration.
Student athletes often struggle to find time to rest due to their busy schedules. Shorter sleep duration and poor sleep quality contribute to disordered sleep in many student athletes. In addition, sleep symptoms such as sleep paralysis and hallucinations are more common in younger adults.
The preliminary findings of this study suggest that these symptoms may be warning signs of another medical problem.
"These sleep symptoms are usually harmless on their own, but they can be a sign of more serious sleep problems," said lead author Serena Liu, a student research assistant in the Sleep and Health Research Program directed by Grander. "The fact that they are so common among student athletes suggests that this is a group with some significant sleep problems that should be evaluated and dealt with."
https://www.sciencedaily.com/releases/2018/06/180604093104.htm