Locals will warn you never to sleep on your back in Newfoundland, or risk a visit from the Old Hag. She steals in on the night fog just as you are falling asleep. She is an apparition that crawls up from the foot of your bed and sits on your chest so heavily you can’t breathe or move. Sometimes she may try to seduce you, other times, to kill you. These terrifying experiences are so common in Newfoundland, they have become the subject of a tv series aptly called Hag. They are also the subject of research into the relationship between sleep paralysis and folklore.
There is a physiological explanation for sleep paralysis. And there are good reasons these peculiar events feel like visitations by the Old Hag or some other kind of apparition. Sleep paralysis episodes are not limited to Newfoundland and in fact, are fairly common worldwide and throughout human history: roughly 8 percent of us will experience one in our lifetime, and some will have recurrent episodes. Students and psychiatric patients have a much higher prevalence of about 30 percent, likely because it is more common in people who are sleep-deprived and stressed. Sleep paralysis is not a nightmare, but rather a form of sleep disturbance, a parasomnia.
Sleep Paralysis is normal: terrifying but harmless
The most important thing to know is that sleep paralysis is normal. Having an episode doesn’t mean you are losing touch with reality or being visited by the ghost of an old sea witch. These legends, in various guises, have been around since Sumerian times as a way to make sense of those frightening occasions when we wake up paralyzed, unable to move from the neck down. What you may not realize is that we all experience sleep paralysis every night, but for the most part we dream our way right through it.
During the REM sleep cycle most rich in dreaming, our body releases a chemical that makes our voluntary muscles go limp. It’s our body’s way of protecting us from thrashing around as we fight our dream dragons. In fact, it’s more of a problem if the paralysis doesn’t happen – this leads to REM sleep behaviour disorder, the dangerous propensity to physically act out one’s dreams, and it can be a precursor to Parkinson’s disease.
If you suffer from sleep paralysis, it helps to know that this is just your mind waking up from the state of dreaming before your body, when it should be the other way around. Or your body drifting right into REM sleep, and your muscles going lax before your mind has truly shut down for the night. This can happen for various reasons, mostly to do with insufficient or irregular sleep, and most often it is a benign physiological event. Terrifying but harmless.
It also helps to know that sleep paralysis episodes are short, typically lasting about 20 seconds. It may feel like much longer if you are frozen in fear as the Old Hag bears down on your chest. If something like this happens again, try to take some long deep breaths and wait for the images and sensations to subside. Remind yourself that it won’t take long. If you also experience banging noises or flashes of light, this is another parasomnia with the colorful name of exploding head syndrome. This is equally harmless and tends to last just a few seconds, so wait it out and try not to be alarmed!
Not everyone experiences sleep paralysis as an evil old hag. There are many variations of experience, and these fall into three main categories. First is the experience of an intruder, a malevolent felt presence that is sometimes visible and/or audible, but not always. The second type is called incubus, and this is experienced as a supernatural assault, a sense of being smothered, or of a great weight on the chest. These two types are well-known and often combined.
A third kind of sleep paralysis involves unusual bodily experiences (or vestibulo-motor phenomena) such as flying, out-of-body experiences or false awakenings, and some of these can be experienced as blissful. However, the vast majority of reported episodes of all three types of sleep paralysis are terrifying. Understandably, most people who wake up unable to move, and with a sensation of being trapped in their own body, react with fear. The fear itself may exacerbate the sensations of shortness of breath and chest pressure, as these are common features of panic.
What can you do about sleep paralysis
This is an area that has not been studied very well; there have been no formal clinical trials testing treatment. However, since sleep paralysis is correlated with disrupted or insufficient sleep, an obvious step is to observe good sleep hygiene: go to sleep and wake up at consistent times, no caffeine before bed, and avoid sleeping on your back. Sleep paralysis is also associated with hypertension, hypersomnia, sleep apnea and alcohol use. Not surprisingly, it is common in shift workers and others with disrupted sleep schedules.
Therapeutic interventions may be warranted if sleep paralysis is frequent and distressing enough to warrant the diagnosis of recurrent isolated sleep paralysis (RISP). Some anti-depressant medications can help, as can psychotherapy and psychoeducation, especially if it is underlying anxiety or depression that is contributing to the condition. Having a basic understanding of sleep paralysis can help; the knowledge that such episodes are normal and will end soon can make the event itself less scary.
Taking control
During an episode, you might be able to take charge of the dream state as one would in lucid dreaming. It is possible to realize that while you may not be in control of your body at the moment, you do have some control over your subjective experience. Try to remain calm and as curious as you can – this is a chance to observe yourself in the dream state. After an episode, or as a way to lessen the intensity of a future episode, you can try a version of imagery rescripting. This can set you up for a better experience should the Old Hag revisit. The idea is simply to re-imagine the experience, letting it become a different story, possibly with a different character or ending, and this may seed a more benign future encounter.
A caveat: much of the above is based on clinical literature. There are many other ways that people make sense of ‘Old Hag’ experiences that differ from this view. Some are culturally determined, and others are based on the beliefs formed through direct experience. There are those who welcome this altered state of consciousness. My desire in writing this is simply to help and inform, so use what you find valuable and leave the rest.
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References
Cheyne, J.A. (2005), Sleep paralysis episode frequency and number, types, and structure of associated hallucinations. Journal of Sleep Research, 14: 319-324. doi:10.1111/j.1365-2869.2005.00477.x
Cox A. M. (2015). Sleep paralysis and folklore. JRSM open, 6(7), 2054270415598091. https://doi.org/10.1177/2054270415598091
Sharpless B. A. (2016). A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatric disease and treatment, 12, 1761–1767. https://doi.org/10.2147/NDT.S100307
Solomonova, E. (2018). Sleep Paralysis: phenomenology, neurophysiology and treatment. In: Fox, K & Christoff, K. (Eds). The Oxford Handbook of Spontaneous Thought: Mind-Wandering, Creativity, Dreaming, and Clinical Conditions. New York: Oxford University Press.
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