My two oldest daughters (in their teens) and I have a problem that we jokingly call “Stuck in the Position.” We are sleeping, or just dozing off and we suddenly find ourselves in a very uncomfortable position. We struggle to move anything on our bodies, a finger or even an eyelid, but we can’t. I start to panic and breath hard; I am not sure if the girls experience this. If we can move anything, the paralysis is broken and we can move again. We are able to laugh when we talk about it later, but it certainly isn’t funny at the time. Sometimes we are fearful of falling asleep again, knowing it may recur. This has been happening to me since my late teens. I am now 45. I think I can associate it with too much caffeine during the day and so do my daughters. I was recently diagnosed with Obsessive Compulsive Disorder and have been taking Luvox. I have had very few occurrences while on this medication. Luvox is a serotonin re-uptake inhibitor, could there be a connection?

—Maria, Age 45, Wenatchee, WA, USA

Hi Maria—

I’m glad to hear from someone with Sleep Paralysis who is able to laugh about it afterwards. It just goes to show that there really is comfort in numbers. :-)

Sleep paralysis is what happens when our minds wake up prior to our bodies. During sleep, muscle tone is very relaxed. During REM sleep (dreaming sleep) muscle tone is completely absent; we actually are temporarily paralyzed during each of our REM sleep periods so that we don’t act out our dreams. If our brain wakes up before our body from either stage of sleep—then we experience these moments of paralysis—and like you say—they can be quite frightening.

One of the most terrifying aspects of sleep paralysis is that our breathing is affected. This is because the muscles that support the chest—which help us to breathe—also are paralysed. We can breathe normally—as if we were still asleep—but if we go to draw a deep breath we find that our chest muscles don’t respond. This often causes us to jump to the conclusion that we can’t breathe at all, which in turn can cause us to panic.

For the same reasons, it is also difficult (or impossible) to scream or call for help during an event. The tongue, mouth and vocal cords are paralysed. This is especially unfortunate, as typically the touch of another person is all that is required to break the “spell” of the paralysis.

Occasions of sleep paralysis typically are infrequent enough—and of short enough duration when they do occur—that sleep doctors do not prescribe medication to prevent them. Sleep paralysis can be annoying and frightening, but most physicians prescribe relaxation during the event, coupled with a patient will to awaken oneself. Most periods of sleep paralysis do not last more than one minute.

The medication that you currently take, which is a member of the SSRI medications—used most commonly to treat depression—dramatically reduces the overall amount of REM sleep you experience. You are correct in drawing a link between your use of this medication and the decrease in frequency of your sleep paralysis. Most cases of sleep paralysis arise from REM sleep.