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Miletínová E, Kliková M, Dostalíková A, Bušková J. Morphological characteristics of cerebellum, pons and thalamus in Reccurent isolated sleep paralysis - A pilot study. Front Neuroanat 2024; 18:1396829. [PMID: 38962392 PMCID: PMC11219576 DOI: 10.3389/fnana.2024.1396829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Recurrent isolated sleep paralysis (RISP) is a rapid eye movement sleep (REM) parasomnia, characterized by the loss of voluntary movements upon sleep onset and/or awakening with preserved consciousness. Evidence suggests microstructural changes of sleep in RISP, although the mechanism of this difference has not been clarified yet. Our research aims to identify potential morphological changes in the brain that can reflect these regulations. Materials and methods We recruited 10 participants with RISP (8 women; mean age 24.7 years; SD 2.4) and 10 healthy control subjects (w/o RISP; 3 women; mean age 26.3 years; SD 3.7). They underwent video-polysomnography (vPSG) and sleep macrostructure was analyzed. After that participants underwent magnetic resonance imaging (MRI) of the brain. We focused on 2-dimensional measurements of cerebellum, pons and thalamus. Statistical analysis was done in SPSS program. After analysis for normality we performed Mann-Whitney U test to compare our data. Results We did not find any statistically significant difference in sleep macrostructure between patients with and w/o RISP. No evidence of other sleep disturbances was found. 2-dimensional MRI measurements revealed statistically significant increase in cerebellar vermis height (p = 0.044) and antero-posterior diameter of midbrain-pons junction (p = 0.018) in RISP compared to w/o RISP. Discussion Our results suggest increase in size of cerebellum and midbrain-pons junction in RISP. This enlargement could be a sign of an over-compensatory mechanism to otherwise dysfunctional regulatory pathways. Further research should be done to measure these differences in time and with closer respect to the frequency of RISP episodes.
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Affiliation(s)
- Eva Miletínová
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Praha, Czechia
| | | | | | - Jitka Bušková
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Praha, Czechia
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Rauf B, Sharpless BA, Denis D, Perach R, Madrid-Valero JJ, French CC, Gregory AM. Isolated sleep paralysis: Clinical features, perception of aetiology, prevention and disruption strategies in a large international sample. Sleep Med 2023; 104:105-112. [PMID: 36934464 DOI: 10.1016/j.sleep.2023.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/17/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023]
Abstract
STUDY OBJECTIVES Isolated sleep paralysis is a benign but frightening condition characterised by a temporary inability to move at sleep onset or upon awakening. Despite the prevalence of this condition, little is known concerning its clinical features, associated demographic characteristics, and prevention as well as disruption strategies. METHODS An online cross-sectional study was conducted. The sample comprised 3523 participants who had reported at least one lifetime episode of ISP and 3288 participants without a lifetime episode. Participants answered a survey including questions about sleep quality, sleep paralysis, and sleep paralysis prevention/disruption techniques. RESULTS A total of 6811 participants were investigated (mean age = 46.9, SD = 15.4, age range = 18-89, 66.1% female). Those who reported experiencing ISP at least once during their lives reported longer sleep onset latencies, shorter sleep duration, and greater insomnia symptoms. Females (vs. male) and younger (vs. older) participants were more likely to experience ISP. Significant fear during episodes was reported by 76.0% of the participants. Most people (63.3%) who experienced ISP believed it to be caused by 'something in the brain'. A minority endorsed supernatural causes (7.1%). Five prevention strategies (e.g., changing sleep position, adjusting sleep patterns) with at least 60.0% effectiveness, and five disruption strategies (e.g., physical/bodily action, making noise) with varying degrees of effectiveness (ranging from 29.5 to 61.8) were identified through open-ended responses. CONCLUSIONS ISP is associated with shorter sleep duration, longer sleep onset latency, and greater insomnia symptoms. The multiple prevention and disruption techniques identified in this study support existing treatment approaches and may inform subsequent treatment development. Implications for current diagnostic criteria are discussed.
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Affiliation(s)
- Betul Rauf
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom.
| | - Brian A Sharpless
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom; Department of Psychology, Pennsylvania State University, State College, PA, USA
| | - Dan Denis
- Department of Psychology, University of York, United Kingdom
| | - Rotem Perach
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom; School of Social Sciences, University of Westminster, United Kingdom
| | - Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Spain
| | - Christopher C French
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom.
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Cha EJ, Jeon HJ. The effect of COVID-19 pandemic on sleep-related problems in adults and elderly citizens: An infodemiology study using relative search volume data. PLoS One 2022; 17:e0271059. [PMID: 35819941 PMCID: PMC9275680 DOI: 10.1371/journal.pone.0271059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/22/2022] [Indexed: 11/19/2022] Open
Abstract
COVID-19 has had a substantial national impact in South Korea, causing negative psychological responses including sleep-related problems. Literature indicates sleep problems among the general population have been reported to be as high as around 35.7% during the first 8 months of COVID-19. Therefore, the aim of this study was to investigate the impact of COVID-19 pandemic on sleep problems among the general population using relative search volume (RSV) data, and whether there are any differences by age and time periods spanning before and during the pandemic. RSV data was collected from the most commonly used search engine in South Korea, NAVER. Search terms were grouped into 4 categories: insomnia, other sleep disorders, sleeping pills, and sleeping pill side effects. Time points were divided into 4 periods, each 7 months long: 7 months before COVID-19 (T0), first confirmed COVID-19 case to 7 months after (T1), 7 to 14 months (T2), and 14 to 21 months (T3). A 2x4 factorial Analysis of Variance was conducted to investigate main effects and interactions between age and time periods. Main effects and interaction effects of age and time periods were significant for all search term groups. For all search terms, both age groups showed dramatic increase from T0 to T1. In age group 60 or above, RSV continued to increase for other sleep disorders and sleeping pill. Insomnia and sleeping pill side effects showed decreasing trend at T3. In general, sudden increase in RSV after occurrence of COVID-19 followed by slow decline were observed. However, for age group 60 or above, RSV values of other sleep disorders and sleeping pills continued to increase, suggesting slower recovery of psychological impact with increasing age. Overall, the results underscore the importance of implementing preventive measures for monitoring sleep problems during the pandemic, especially in the elderly.
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Affiliation(s)
- Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, Seoul, Korea
| | - Hong Jun Jeon
- Department of Psychiatry, School of Medicine, Konkuk University, Seoul, Korea
- * E-mail:
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Benham G. Sleep paralysis in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1286-1291. [PMID: 32813623 DOI: 10.1080/07448481.2020.1799807] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/22/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
Objective: We examined the prevalence of sleep paralysis (SP), its association with stress and sleep, and associated subjective experiences and beliefs. Participants: 1,115 college students from a large university in the southwestern United States. The sample was predominantly Hispanic (94%) and female (70%). Methods: Validated measures of life-events stress, self-perceived stress, sleep quality and insomnia were administered to participants online. Results: 35% of students had previously experienced SP and reported greater stress and poorer sleep than those who had never experienced it. Effect sizes were larger when comparing those who had/had not experienced SP within the prior year. Conclusions: Based on our predominantly Hispanic and majority female sample, we found that SP is experienced by approximately one-third of undergraduate students and associated with both higher stress and poorer sleep. We therefore recommend that college health practitioners seek ways to integrate relevant assessment and education into campus health practices.
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Affiliation(s)
- Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
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Wróbel-Knybel P, Flis M, Rog J, Jalal B, Karakuła-Juchnowicz H. Risk factors of sleep paralysis in a population of Polish students. BMC Psychiatry 2022; 22:383. [PMID: 35672736 PMCID: PMC9171979 DOI: 10.1186/s12888-022-04003-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Sleep paralysis (SP) is a transitional dissociative state associated with the REM sleep phase that affects approximately 28.3% of the student population during their lifetime. The reasons for the high prevalence of SP in the student population are not entirely clear. Research indicates possible influencing factors such as the intensification of anxiety symptoms, a tendency to worry, the presence of PTSD symptoms, and behavioral factors such as the consumption of psychoactive substances (caffeine, alcohol, nicotine), sleep deprivations and poor sleep hygiene. The study aimed to assess the prevalence of SP and determine the risk factors for the occurrence of SP in the population of Polish students. METHODS The study used a battery online consisting of a set of questionnaires 1) a personal questionnaire, 2) the SP-EPQ, 3) the PCL -5, 4) the STAI-T, 5) the PSWQ. The questionnaire was sent via Facebook to 4500 randomly selected students from different universities in Poland. The questionnaire was completed by 2598 students. To unify the participant sample, people over 35 were excluded from the study (45 students). Ultimately, data from 2553 students were analyzed. RESULTS A total of 33.14% of individuals experienced at least one episode of SP in their lives. The highest odds ratio for SP was associated with: the presence of three or more health problems (OR: 2.3; p = 0.002), the presence of any mental disorder (OR: 1.77; p = 0.002), including mood disorders (OR: 2.07; p = 0.002), suffering from at least one somatic disease (OR: 1.34; p = 0.002), a high level of anxiety as a constant personality trait (OR: 1.20; p = 0.035) and smoking (OR: 1.48; p = 0.0002), alcohol consumption (OR: 1.52; p < 0.0001), physical activity (OR: 1.31; p = 0.001). CONCLUSIONS The results of our research indicate that a large proportion of students experienced isolated sleep paralysis. Mental and somatic health problems and lifestyle factors were found to predispose individuals to this disorder. Due to the numerous risk factors for SP, it is necessary to conduct additional research to confirm the impact of these factors and to investigate the mechanisms of their influence on SP.
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Affiliation(s)
- Paulina Wróbel-Knybel
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Street, 20-439, Lublin, Poland.
| | - Michał Flis
- grid.411484.c0000 0001 1033 7158I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Street, 20-439 Lublin, Poland
| | - Joanna Rog
- grid.411484.c0000 0001 1033 7158I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Street, 20-439 Lublin, Poland
| | - Baland Jalal
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138 USA ,grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Downing Street, Cambridge, CB2 3EB UK
| | - Hanna Karakuła-Juchnowicz
- grid.411484.c0000 0001 1033 7158I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 Street, 20-439 Lublin, Poland
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Kliková M, Piorecký M, Miletínová E, Janků K, Dudysová DU, Bušková J. Objective REM sleep characteristics of recurrent isolated sleep paralysis: a case-control study. Sleep 2021; 44:6305144. [PMID: 34145456 DOI: 10.1093/sleep/zsab153] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/05/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Recurrent isolated sleep paralysis (RISP) is a rapid eye movement (REM) parasomnia characterized by a dissociative state with characteristics of REM sleep and wakefulness. Pathophysiology has not yet been clarified and very little research has been performed using objective polysomnographic measures with inconsistent results. The main aim of our study was to find whether higher REM sleep fragmentation is consistent with the theory of state dissociation or whether signs of dissociation can be detected by spectral analysis. METHODS Nineteen participants in the RISP group and 19 age- and gender-matched participants in the control group underwent two consecutive full-night video-polysomnography recordings with 19-channel electroencephalography. Apart from sleep macrostructure, other REM sleep characteristics such as REM arousal index, percentage of wakefulness and stage shifts within REM sleep period were analyzed, as well as power spectral analysis during REM sleep. RESULTS No difference was found in the macrostructural parameters of REM sleep (percentage of REM sleep and REM latency). Similarly, no significant difference was detected in REM sleep fragmentation (assessed by REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep). Power spectral analysis showed higher bifrontal beta activity in the RISP group during REM sleep. CONCLUSIONS The results showed an underlying persistent trait of higher cortical activity that may predispose patients with SP to be more likely to experience recurrent episodes, without any apparent macrostructural features including higher REM sleep fragmentation.
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Affiliation(s)
- Monika Kliková
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marek Piorecký
- National Institute of Mental Health, Klecany, Czech Republic.,Faculty of Biomedical Engineering, Czech Technical University, Prague, Czech Republic
| | - Eva Miletínová
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Daniela Urbaczka Dudysová
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jitka Bušková
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Wróbel-Knybel P, Karakuła-Juchnowicz H, Flis M, Rog J, Hinton DE, Boguta P, Jalal B. Prevalence and Clinical Picture of Sleep Paralysis in a Polish Student Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103529. [PMID: 32443518 PMCID: PMC7277803 DOI: 10.3390/ijerph17103529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022]
Abstract
Sleep paralysis (SP) is a psychobiological phenomenon caused by temporary desynchrony in the architecture of rapid eye movement (REM) sleep. It affects approximately 7.6% of the general population during their lifetime. The aim of this study was to assess (1) the prevalence of SP among Polish students in Lublin (n = 439) using self-reported online surveys, (2) the frequency of SP-related somatic and psychopathologic symptoms, and (3) the factors potentially affecting the occurrence of symptoms among people experiencing SP. We found that the incidence of SP in the Polish student population was slightly higher (32%) than the average prevalence found in other student populations (28.3%). The SP clinical picture was dominated by somatic symptomatology: 94% of respondents reported somatic symptoms (most commonly tachycardia, 76%), 93% reported fear (most commonly fear of death, 46%), and 66% reported hallucinations (most commonly visual hallucinations, 37%). The number of SP episodes was related to sleep duration and supine position during sleep. The severity of somatic symptoms correlated with lifestyle variables and anxiety symptomatology. Our study shows that a significant proportion of students experience recurrent SP and that this phenomenon is associated with fear and physical discomfort. The scale of the phenomenon requires a deeper analysis.
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Affiliation(s)
- Paulina Wróbel-Knybel
- Ist Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland; (H.K.-J.); (M.F.); (J.R.)
- Correspondence:
| | - Hanna Karakuła-Juchnowicz
- Ist Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland; (H.K.-J.); (M.F.); (J.R.)
- Department of Clinical Neuropsychiatry, Medical University of Lublin, 20-059 Lublin, Poland
| | - Michał Flis
- Ist Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland; (H.K.-J.); (M.F.); (J.R.)
| | - Joanna Rog
- Ist Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland; (H.K.-J.); (M.F.); (J.R.)
| | - Devon E. Hinton
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Piotr Boguta
- Locum Pharmacy for Well and Lloyds in Berkshire, Devon, Dorset, Hampshire, Oxfordshire, West Sussex, Wilthshire RG30 2BT, UK;
| | - Baland Jalal
- Behavioural and Clinical Neuroscience Institute and Department of Psychiatry, University of Cambridge, Cambridge CB2 0QQ, UK;
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Abstract
Sleep paralysis is the unusual experience of waking up in the night without the ability to move. Currently little is known about the experience, despite the fact that the vast majority of episodes are associated with extreme fear and in a minority of cases can lead to clinically significant levels of distress. The aim of this work was to review the existing literature pertaining to the relationship sleep paralysis has to sleep more generally, measured both with subjective questionnaires and objective laboratory recordings. In terms of subjective sleep variables, worse sleep quality has been found in multiple studies to be associated with increased odds of sleep paralysis occurrence. In addition, insomnia symptoms (but not a diagnosed insomnia disorder) have also been found to predict sleep paralysis. Associations between sleep paralysis and other unusual and/or threatening sleep experiences such as nightmares, exploding head syndrome, and lucid dreaming have been reported. In terms of objective measurements, the limited literature to date shows sleep paralysis to be a "mixed" state of consciousness, combining elements of rapid eye movement sleep with elements of wakefulness. Future research needs to focus on longitudinal designs to disentangle the direction of effects and more typically employ a broader assessment of sleep paralysis that better captures associated features such as hallucinations, fear, and distress.
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Affiliation(s)
- Dan Denis
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA, .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,
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