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Colombo C, Cellini N. Lifetime prevalence and characteristics of sleep paralysis in Italian university students population. Sleep Med 2024; 122:106-112. [PMID: 39154571 DOI: 10.1016/j.sleep.2024.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Sleep paralysis (SP) is a REM-related parasomnia, characterized by the inability to perform voluntary movements. It is a relatively widespread phenomenon in the general population and, although usually not dangerous, it is experienced with intense fear. The current study aims to evaluate the lifetime prevalence and characteristics of SP in the Italian student population. The study was conducted online, through an online battery of questionnaires. We used the Unusual Sleep Experience Questionnaire to investigate the prevalence of the disorder and the typical characteristics, metacognitive beliefs on the episodes, and previous distress factors. We also collected information about anxiety and depression symptomatology, sleep quality, and circadian preferences. Four hundred and thirty-two participants (333 F, 22.8 ± 2.57 y) took part in the study and 37.5 % of them reported having experienced at least one SP episode in their lifetime. On a physiological level, the most common features were the inability to speak followed by a tingling sensation and the inability to open the eyes, consistent with REM muscle atonia. Cognitive features during episodes include the perception of a presence in the room, followed by the fear of dying. Participants who reported SP had higher anxiety and worse sleep quality, and were more associated with evening chronotypes compared to non-SP responders. Our results show that SP is generally widespread in Italian students, in line with the prevalence reported in previous studies. Further studies could investigate the effects of suggested therapies to decrease the number of episodes of the disorder, especially in those who experience it recurrently.
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Affiliation(s)
- Costanza Colombo
- Department of General Psychology, University of Padova, Padova, Italy.
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy.
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Bhalerao V, Gotarkar S, Vishwakarma D, Kanchan S. Recent Insights Into Sleep Paralysis: Mechanisms and Management. Cureus 2024; 16:e65413. [PMID: 39184697 PMCID: PMC11344621 DOI: 10.7759/cureus.65413] [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: 07/02/2024] [Accepted: 07/26/2024] [Indexed: 08/27/2024] Open
Abstract
Sleep paralysis (SP) is a phenomenon wherein individuals awaken from deep sleep but are unable to move or speak, often experiencing vivid hallucinations. This condition, attributed to the persistence of muscle atonia from rapid eye movement (REM) sleep into wakefulness, is associated with factors like sleep deprivation and irregular sleep patterns. While isolated episodes of SP are generally benign, recurrent episodes may warrant clinical attention, particularly when accompanied by distressing symptoms. Despite its prevalence across cultures and its documented association with various medical conditions, SP remains poorly understood by many. This review explores the clinical characteristics, epidemiology, and associated risk factors of SP, drawing from a comprehensive analysis of the existing literature. Additionally, the review discusses potential treatment modalities, including pharmacological interventions and cognitive-behavioral therapy, highlighting the need for further research to enhance our understanding and management of this intriguing phenomenon.
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Affiliation(s)
- Vijay Bhalerao
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shashank Gotarkar
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Deepak Vishwakarma
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sushim Kanchan
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Hefnawy MT, Amer BE, Amer SA, Moghib K, Khlidj Y, Elfakharany B, Mouffokes A, Alazzeh ZJ, Soni NP, Wael M, Elsayed ME. Prevalence and Clinical Characteristics of Sleeping Paralysis: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e53212. [PMID: 38425633 PMCID: PMC10902800 DOI: 10.7759/cureus.53212] [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: 01/08/2024] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Sleep paralysis (SP) is a mixed state of consciousness and sleep, combining features of rapid eye movement (REM) sleep with those of wakefulness. The exact cause of SP is unknown, and its prevalence varies among the studies. We aim to identify SP's global prevalence, the affected population's characteristics, and the SP's clinical picture. We searched three databases (PubMed, Scopus, and Web of Science (WoS)) using a unique search strategy to identify eligible studies. All observational studies identifying the prevalence or frequency of sleeping paralysis were included. No exclusions are made based on country, race, or questionnaire. The analysis was performed using the latest version of R software (R Core Team, Vienna, Austria). The analysis included 76 studies from 25 countries with 167,133 participants. The global prevalence of SP was 30% (95% CI (22%, 39%)). There were similar frequencies of isolated SP and SP (33%, 95% CI (26%, 42%), I2 = 97%, P <0.01; 31%, 95% CI (21%, 43%), I2 = 100%, P = 0, respectively). A subgroup analysis showed that the majority of those who experienced SP were psychiatric patients (35%, 95% CI (20%, 55%), I2 = 96%, P <0.01). The prevalence among non-psychiatric patients was among students (34%, 95% CI (23%, 47%), I2 = 100%, P = 0). Auditory and visual hallucinations were reported in 24.25% of patients. Around 4% had only visual hallucinations. Meta-regression showed no association between the frequency of SP and sex. Publication bias was detected among the included studies through visual inspection of funnel plot asymmetry. Our findings revealed that 30% of the population suffered from SP, especially psychiatric patients and students. The majority of SP cases lacked associated hallucinations, while a noteworthy proportion experienced combined visual and auditory hallucinations.
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Affiliation(s)
- Mahmoud T Hefnawy
- Faculty of Medicine, Zagazig University, Zagazig, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Basma E Amer
- Faculty of Medicine, Banha University, Banha, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Samar A Amer
- Family Medicine, Royal College of General Practice, London, GBR
- Faculty of Public Health and Community Medicine, Zagazig University, Zagazig, EGY
| | | | - Yehya Khlidj
- Faculty of Medicine, University of Algiers Benyoucef Benkhedda, Algiers, DZA
| | - Bahaa Elfakharany
- Faculty of Allied Medical Sciences, Pharos University, Alexandria, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Adel Mouffokes
- Internal Medicine, Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, DZA
| | - Zainab J Alazzeh
- Faculty of Medicine, Jordanian University of Science and Technology, Ar-Ramtha, JOR
| | - Nishant P Soni
- Medicine, Gujarat Medical Education and Research Society Medical College and Hospital, Ahmedabad, IND
| | - Muhannad Wael
- Urology, Saint Joseph Hospital, Jerusalem, PSE
- Faculty of Medicine, An-Najah National University, Nablus, PSE
| | - Mohamed E Elsayed
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, DEU
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