Indian researcher Amalesh Honnekeri conducted a review of scientific articles on the topic of sleep paralysis. This condition has a rich history in various cultures’ folklores, which have explained it as having supernatural causes, such as evil spirits and witches. It’s also often associated with medical and psychological problems, including hypertension, alcohol abuse, apnea, narcolepsy, PTSD, panic, and anxiety disorders.
The author describes three main types of hallucinations associated with sleep paralysis:
1. “Intruder”—the sensation that a hostile figure is nearby. This is accompanied by fear, various images, and sounds.
2. “Incubus”—the chest is constricted, breathing is difficult, and an image of a figure sitting on the chest often appears.
3. Vestibular-motor hallucinations—levitation, spinning, or out-of-body experiences occur.
Sleep paralysis happens when a person wakes up during the REM sleep phase but remains in a state of muscle atonia—paralysis. It’s assumed that the parietal lobe of the brain, which is responsible for perception, and the amygdala, which is involved in processing fear, play a role in the occurrence of hallucinations and feelings of fear. Evidence suggests that the causes of sleep paralysis are genetic. Also, it’s believed that women, young people, and non-white people are at an increased risk.
The author also emphasizes the importance of sleep hygiene. In some cases, cognitive-behavioral therapy may help reduce fear and anxiety, and medication is usually not required. But the role of the doctor is important—they should show sensitivity and understanding to such patients, and they should dispel myths and prejudices.
Have you experienced sleep paralysis? What kind of hallucinations did you have?
The article was published in July 2025 in the Journal of Family Medicine and Primary Care.
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