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WHEN SLEEP BECOMES NIGHTMARISH.

Many suffer from adisorder known as sleep paralysis but often mistake the experience to be asupernatural encounter

MANISH DEY remembers waking up late on sultry summer night and being frightened out of his wits. His eyes were wide open, and the tiny clock on his side table told him it was 4 am. Something felt very wrong.

A great force seemed to be pressing down on him, making it hard to breathe. Consumed by panic, he tried to call out for his parents who were asleep in the next room but couldn't. Though it felt like he was having a nightmare, he was wide awake. After a few minutes the enormous pressure on his body lifted and he regained movement of his limbs.

A terrified Manish was convinced he had been gripped by some supernatural force. " I had never experienced anything like this before. I went to bed as usual, and the next thing I remember is waking up feeling completely immobilised," says Manish.

The worst part was that this was not an isolated episode. A few months after this incident, Manish had yet another similar experience.

This time he was even more frightened because aside from being unable to move, he also sensed and saw a hideous figure at the foot of his bed. " Though I knew what was happening, this didn't reduce my terror. I saw a black demonic figure with a twisted ugly face at the foot of my bed, but I could not move away from it," says Manish. Speaking to his friends about these incidents, Manish learned that his experience was not unique; another of his friends had also experienced something similar and many of them had heard of such incidents. In fact, such experiences are actually common and oft related; it's just that they are mistaken to be encounters with ghosts.

FEELS SUPERNATURAL

WHAT happened to Manish might sound like its straight out of a horror movie, but is in fact a real health problem called sleep paralysis (SP). This is actually a common problem that is almost never reported since people brush it off as a supernatural experience or forget about it if there are no repeat incidences.

Although the reasons are unclear, SP typically starts in adolescence or young adulthood. And while many people just grow out of it, it can also last a lifetime. Unfortunately, a lot of the public and many health professionals have never heard of or don't understand the condition, which explains why it is under-diagnosed.

"Probably four out of ten people have had such an experience, but have not realised it is an actual sleep disorder," says Dr Manoj Goyal, director of respiratory and sleep medicine, Delhi Heart and Lung Institute. "During an SP episode -- which can last for anything between a few seconds and several minutes -- a person is in a state where they are half awake and half asleep; sometimes they are able to open their eyes, but are unable to move," says Dr RK Mani, Director, department of sleep medicine, Artemis Health Institute.

An unlucky few can have repeated attacks in one night or several times a week. In extreme cases, people can find their lives heavily disrupted by SP and they keep their terrifying experiences to themselves for fear of being shunned or ridiculed.

TERRIFYING EXPERIENCE

SLEEP paralysis is a condition that strikes a person who is most often in a supine position and is about to drop off to sleep, or has just woken up, and realises that he or she is unable to move, speak, or cry out. This may last a few seconds or minutes or even longer on occasion. There are five stages of sleep: During the first four, your brain and heart rates slow down. The fifth stage is the period of rapid eye movement ( REM) sleep, during which your brain is active and you experience vivid dreams. " During this time the muscles are temporarily ' paralysed', probably as a protective mechanism to stop the sleeper acting out their dreams," says Dr Mani. " But in those with SP, something goes awry and the sleeper becomes consciously aware of that temporary paralysis," he adds. Five per cent of those with this disorder say they visualise non- existent objects like shadows or have horrific hallucinations during the episode. Monstrous figures may be seen or a presence that is often described as evil and threatening, can be sensed in the room. This may attack, strangle or exert a crushing pressure on the chest. Other people report movement such as being dragged from the bed, or being touched. Sleep paralysis may accompany other sleep disorders such as narcolepsy which is an overpowering need to sleep caused by a problem with the brain's ability to regulate sleep.

BLAME IT ON LIFESTYLE

THERE are various possible causes behind sleep paralysis.

" Anything that disrupts the sleep cycle may result in SP, for example shift work, jet lag and stress," says Dr Goyal. Those in graveyard shifts are most prone to this problem as their natural sleep cycle is completely destroyed.

Alcohol and caffeine can also disrupt the sleep cycle, as can certain medications and drugs.

Another risk factor is sleeping on one's back, because this is associated with sleep apnoea ( a condition which causes interruptions in breathing during sleep), which may be linked to SP. Other related issues are stress and psychological problems such as schizophrenia." But people should know that if they experience this they're not going crazy, nor are they being attacked by spirits or abducted by aliens," says Dr Goyal. Doctors usually advise anyone suffering from SP to keep a sleep diary so that they can determine any treatment based on sleep history.

KEEPING CALM IS KEY

AN EPISODE of SP can be a frightening experience. Though some may know what's going on, others may not. Those experiencing this are advised to be calm and breathe deeply while trying to move the smallest parts of their bodies such as a toe, finger or eye lid. Some people prefer to just let it pass naturally without panicking. " You could request your partner to wake you if they hear you make strange noises at night as this will jolt you out of the episode," says Dr Goyal. Whereas there is no cure yet for the disorder, lifestyle changes and sleep management are the key ways to solve this problem. Go to sleep and wake up at the same time every day, including weekends. " Schedule short naps at regular intervals during the day to overcome any sleep debt and avoid using drugs, nicotine and alcohol as they can aggravate this problem," says Dr Goyal. Sleeping in different positions instead of on your back, and treating other sleep disorders like narcolepsy can be helpful in treating SP.

rituparna. mukherjee @ mailtoday. in

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Publication:Mail Today (New Delhi, India)
Date:Dec 29, 2009
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