Sleep paralysis: A brain glitch or an evil spirit?

On a typical humid Wednesday afternoon in the suburbs of Karachi, sixteen-year-old Imaan took a break from her gruesome study schedule for a quick power nap. 

“It turned into a nightmare,” she remembers. 

Barely an hour after dozing off, she was wide awake and unable to move. “It felt like I was glued to the bed. My mother and brother were in the same room, but I couldn’t even lift a finger let alone call for help.”

Some 6,600 kilometres away, Anita jolted awake in the wee hours of the night at her home in Nairobi. “I sensed someone in my room and panicked. I tried to get out of my bed but couldn’t move.” Anita tried to call for help but no words came out. “I snapped out of it after what seemed like an eternity.” 

About one in five people across the globe have experienced being awake but unable to move, sensing an evil presence, feeling a crushing weight on their chest and gasping for breath, or an out-of-body experience. This experience is known as “sleep paralysis” – a term coined by Wilson in 1928.

Scientists today explain it as a basic brain glitch that occurs at the intersection between wakefulness and rapid eye movement (REM) sleep. When we fall asleep, our body alternates between Non-REM and REM sleep. “This transition is controlled by chemicals pushing us between sleep and wakefulness,” says neuroscientist Dr. Baland Jalal. 

We have our most life-like dreams during REM sleep and to prevent us from acting them out, the brain temporarily paralyses the body. Occasionally, we wake up while under the “spell” of 

REM paralysis. The timing and duration of sleep paralysis vary but three classic elements include sensing an evil presence (an intruder), feelings of suffocation (incubus), and an out-of-body experience – which is what Imaan experienced. 

She vividly recollects sliding into the next room. “When I reached the storage room, I saw a dark figure lurking. It had a very evil vibe.” She remembers the fear but doesn’t recall how she made it back into her room. 

Dr. Jalal and his colleague VS Ramachandran theorise that when realised you’re paralysed, the brain tells the body to move and carbon copies (cc) the message to the parietal lobes – a region that creates a sense of body image. 

“Parietal lobes can “see” neurons sending commands but don’t detect any movements in your limbs. This affects how your brain creates your sense of self,” says Jalal, the Cambridge University professor. “Brain tries to clear the confusion by building a body image – fill in the blank, sort of like Google or auto-correct.”

This results in strange bodily hallucinations. “It may also affect your ability to distinguish between self and other,” continues Dr. Jalal. “As the barrier between self and other dissolves, you mistake your projected body for a separate entity with agency and intentions.”

A witch attack?

Sleep paralysis is terrifying because it cannot be explained away as merely a “bad dream” as it is experienced in wakefulness. Even after recurrent occurrences, the conviction of wakefulness cannot be denied.

Despite its prevalence, sleep paralysis remains a mystery with cultures across the world attributing it to paranormal activity, black magic, and mythical creatures. 

Before the 15th century, a “nightmare” was synonymous with a spiritual attack believed to be orchestrated by a witch. The definition was later extended to “bad dreams”. 

Henry Fuseli’s 1781 painting “The Nightmare” has been interpreted as the most “classical” pictorial representation of sleep paralysis for depicting a small creature sitting upon the chest of a sleeper. 

In Mexico, this experience is known as “Se me subió el Muerto” roughly translated as “a dead body climbed on top of me”. In Catalonia, a black animal invades houses at night and steps over the sleeper’s chest.  

Brazilian anthropologist Luís da Câmara Cascudo describes folklore character “Pisadeira” as a nightmare personified in an old man or woman who takes advantage of the sleeper. “[It] would sit upon their stomach and pressure their thorax, disturbing one’s breathing,” he writes. 

Canadian Eskimos believe the experience, “uqumangirniq”, is angakkuit [shamans] casting ilisiiqsijuq [spells] – attacking the enemies as they sleep. 

In Japanese traditions, “kanashibari” is a “state of being totally bound, as if constrained by metal chains” that manifests through the spell of a summoner who uses a vengeful spirit to suffocate their enemies. In Thailand, “phi am” is a ghost that haunts people when half-asleep and unable to move while Chinese traditions define it as a type of “ghost oppression”. 

A popular belief in Muslim folk traditions attributes the event to Djinns – malevolent spirit-like creatures. “Frightened by the experience, people look around for explanations and settle on cultural beliefs,” says Assistant Professor of Psychiatry at Jinnah Postgraduate Medical Centre Dr. Jawed Akbar Dars. “They link sleep paralysis to Djinn possession.”

Ibn Sina's remedy 

In Arabic literature, “al Jathoom” is a “kaboos” [an evil spirit] that descends upon a person’s chest at night. “Kaboos serves the jinn king Maymun and brings night terrors to the unsuspecting,” explains Assistant Professor at Penn State Ali A. Olomi. “Appearing as a winged shadow, he slips into the cracks of the house and into your bedroom. His legions perch on the chests causing sleep paralysis.”

But Ibn Sina [Avicenna], in his medical book “al Qanoon”, describes “Kabous” as a disease where a person feels something heavy pressing down upon them, squeezing and restricting their breathing when falling asleep. He linked to epilepsy, apoplexy, or mania. 

Dr. Jawed says people rarely seek professional help for sleep paralysis. “Culture plays a huge part in shaping people’s thoughts. When you’ve been taught that the experience is caused by a Djinn, then you tend to not question it.”

“Cultural explanations can have a big impact on how people experience sleep paralysis,” reflects Dr. Jalal. “Those who have striking supernatural beliefs about it tend to have it much more; they also have longer paralysis and greater fear.”

The Harvard fellow explains that once the episode is interpreted through the lens of fear, it leads to more anxiety and unwanted night-time awakenings. “This vicious cycle, ‘I call the panic-hallucination mode’, continues to feed into itself until sleep paralysis becomes chronic, prolonged and potentially traumatizing. It is an astonishing form of mind-body interaction.”

Imaan found solace in reciting “Ayat-ul-Kursi”, Quranic verses believed to protect one from evil spirits. “I stopped napping,” she adds. “But I still have questions: was it sleep paralysis or a supernatural event?”

There is no known cause of sleep paralysis but scientists have linked it to hypertension, anxiety, and sleep disorders and stressed on sleep hygiene. 

Ibn-e-Sina and Sayyed Mohammad Hossein Aghili Khorasani-e-Shirazi recommended consumption of Paeonia officinalis seeds with honey mixed with water, Cuscutaepithymum with fresh milk and sugar, Artemisia absinthium with honey, and Euphorbia resinifera with honey.

Recent studies endorsed Ibn-e-Sina’s suggestion to avoid sleeping on one’s back while the use of antidepressants and other psychopharmacological options are also used. 

Dr. Jalal developed an exclusive four-step “Meditation-Relaxation” therapy which entails:1) Cognitive reappraisal -- the sleeper carries on closing one’s eyes, avoids panicking and reaffirms the attack to be benign. (2) Emotional regulation: reminds oneself that that fear and worry will worsen and prolong it. (3) Inward focused-attention meditation and (4) Muscle relaxation: avoid controlling breathing and not force the body to move. 

"In a pilot study in Italy, we recently showed more than 50 percent reduction in sleep paralysis after using this therapy for only 8 weeks. This is promising - but more large-scale research is needed of course,” says the world’s leading expert on sleep paralysis.