How to Stop Sleep Paralysis and Prevent It

Sleep paralysis always ends by itself, usually within a few minutes, and it can't hurt you. That's hard to believe while you're lying awake and can't move a finger, though, and three people in four who have had it say their fear during an episode was moderate or worse.^[1] Most of the advice on how to stop sleep paralysis comes from forums. And some of it (fight your way out, scream for help) is what the people who get it rate as least likely to work. Here's what to do while it's happening, what makes the next episode less likely, and when it's worth seeing a doctor.

How to stop sleep paralysis in 5 steps#

No single trick ends every episode, and most people find that out the hard way. In one study, seven in ten people with sleep paralysis had tried to break out of an episode at some point, and only about half of them said it had worked.^[2] The steps below are the ones that people who get sleep paralysis rate highest, in the order you'd use them during an episode.

1. Tell yourself it's sleep paralysis#

The first thing to do is name it, silently and as plainly as you can (this is sleep paralysis, it's harmless and it will end). During REM sleep, the stage of the night when most vivid dreams happen, our brains switch off almost every muscle so that we don't act out our dreams, and sleep paralysis is your mind waking up before that switch has flipped back. Episodes last anywhere from a few seconds to about 20 minutes, six minutes on average. The paralysis always lifts.^[3] Is there a figure in the room, or a voice? That's a piece of the dream running on in your real bedroom, from the same family as the hypnagogic hallucinations many of us get at the edge of sleep.

Naming it sounds too simple to help, but the worst thoughts during an episode tend to be about what it means ("I'm going crazy", "this will be permanent"). Answering those thoughts is one of the things the therapy built for sleep paralysis teaches. In one large survey, people who explained to themselves that they were still asleep said it worked about half the time, which already beats most of what people try by instinct.

2. Stop fighting the paralysis#

Your first instinct will be to struggle. Most of us try to sit up or shout, and it's the instinct that works least. Of everything people said they do to get out of an episode, desperately trying to move was rated as working about 30% of the time, screaming 27% and calling out for help 20%. And the struggle can make things worse. Pushing against muscles that won't answer can bring on a stronger feeling of tightness and pressure, sometimes even pain or cramps in your arms and legs. Fear and worry can also make the episode last longer.^[4]

So let your arms and legs go heavy, even if every part of you wants to fight, because the next two steps only work once you've stopped pushing.

3. Slow down your breathing#

The weight on your chest is one of the most frightening parts, because it feels as if you can't breathe, but you can. During sleep paralysis you keep some control over your breathing, even while it feels like suffocating, and your eyes are never paralysed at all. People who focused on their breathing rated it as working a little more than half the time (58%), and those who breathed slowly and deeply put it at 60%.

Don't try to gulp big breaths against the pressure, though. The only method for sleep paralysis that has been tested in a trial tells you not to control your breathing at all. A deep breath that won't come only adds to the panic, so just watch your breath, slow and steady, and let it run by itself.

4. Put all your effort into one toe#

Once you're calmer, pick one small part of your body, a big toe or the tip of one finger, and put all your attention into moving it, a millimetre at a time. This is the way out that people who get sleep paralysis rate best. Focusing on moving the toes or feet was said to work about two times in three, against less than one time in three for trying to move the whole body.

Does the toe trick really work, or do people just remember the nights it did? Nobody has tested it in a sleep lab, so these are people's own ratings (and we all tend to keep using a trick that once worked). But earlier, smaller studies had found the same thing, with small movements of the fingers and toes and calming down near the top of the list. If even a toe won't answer, try your eyes, which some people move from side to side or blink hard to wake themselves. There's no study on that one either, but it can't do any harm.

5. Get up once it's over#

When the paralysis lets go, it's tempting to roll over and go straight back to sleep. But a common complaint on sleep paralysis forums is that this is how one episode turns into two or three in the same night. Sit up, turn on a light and give yourself a few minutes before you lie down again, on your side if you can. People rated not falling straight back asleep as keeping the next episode away about two times in three, and turning on a light about 60% of the time.

What about MR therapy?#

All of the steps above come from what people with sleep paralysis say they do, because there are almost no trials to go on. As of 2016, not a single randomized trial of any treatment for recurring sleep paralysis had been run. The closest thing is MR therapy (short for meditation-relaxation), a four-step method the neuroscientist Baland Jalal designed for the moment itself. You tell yourself what's happening, let the fear pass, turn your attention to someone you love and relax every muscle. The four steps are set out one by one in how to make a sleep paralysis demon go away.

Annie Spratt, Unsplash

In a small pilot with six people who had narcolepsy, eight weeks of MR therapy halved the number of days with sleep paralysis, and the number of episodes fell by 54%.^[5] Four people who practised deep breathing instead saw no change in how often they came. It's a tiny study, and the fear during the episodes that remained didn't drop by much, so it's a good reason to try MR therapy rather than proof that it works for everyone.

So which should you follow, MR therapy or the toe? MR therapy tells you not to try to move at all, not even a finger, while the people in the big survey rated small movements as their best way out. Both agree on the part that matters most, which is to stop struggling, so pick whichever feels more natural to you. And practise it a few times while you're awake, lying on your back with your eyes closed, because panic makes it hard to remember anything new.

How to help someone with sleep paralysis#

From the outside, sleep paralysis is easy to miss, because the person looks asleep or seems to be lying still with their eyes open. If you share a bed with someone who gets it, agree on what you'll do while you're both awake. Talking to them or a gentle touch often brings an episode to an end, which is one way sleep paralysis differs from night terrors, where comforting a person usually changes nothing. Afterwards, help them sit up and stay awake for a few minutes before they go back to sleep.

How to prevent sleep paralysis#

Stopping an episode is the part everyone asks about, but preventing the next one works better, at least by the ratings of the people who get it, and it's the part we can actually plan for during the day. Each of the five most common prevention habits in the large survey was rated as working more than 60% of the time. The ways out of an episode ranged from about 30% to 60%. Fewer people bother, though, and in the smaller study only one person in five had ever tried to prevent their sleep paralysis (four in five of those thought it had worked).

Sleep on your side#

The most common prevention habit is to avoid sleeping on your back, and there's good reason for it. In a study of 6,730 people, lying on the back was three to four times more common during sleep paralysis than when people normally fell asleep.^[6] People who never slept on their back said it kept episodes away almost four times in five (78%).

Shane, Unsplash

Falling asleep on your side isn't always enough, because we roll onto our backs during the night without knowing it. And the episodes that came in the middle and at the end of the night were even more likely to happen on the back. The researcher behind that study suggested borrowing an old trick for sleep apnea, a tennis ball sewn into the back of a T-shirt, so that lying on your back becomes uncomfortable. It hasn't been tried on sleep paralysis, but it costs a tennis ball.

Keep regular hours and skip naps#

The next most common habit is regular sleep, and it was rated even higher. People who went to bed and got up at the same times said it worked about 80% of the time, and those who made sure they weren't overtired put it at 75%. Skipping naps came out top of the whole list at 88%, although only 40 people mentioned it. People who get sleep paralysis also take longer to fall asleep and have more insomnia symptoms than people who don't. So the sleep hygiene habits that matter most are worth a look too.

Keep a log of your episodes#

Writing each episode down for a few weeks shows you your own pattern, which is more use than any list of tips. Note the time, the position you woke up in, how much you'd slept the night before and what ended it. The researchers behind the smaller study suggested exactly this, keeping a closer eye on your own episodes, as a way to manage sleep paralysis that keeps coming back. If you already keep a dream journal, add your episodes there, next to the dreams from the same nights.

When to see a doctor about sleep paralysis#

For most people, sleep paralysis is a few frightening minutes now and then, and it never needs a doctor. In the smaller study, only about one person in seven had episodes that caused real distress or got in the way of their life. It's worth seeing one in three cases, though.

The first is when episodes come often enough that you dread going to bed, or you're tired all the time because of them. The second is when sleep paralysis comes with heavy sleepiness during the day (sleep "attacks" that come on quickly) or with muscles that suddenly go weak when you laugh, get angry or feel excited. Those are signs of narcolepsy, a sleep disorder that has sleep paralysis among its usual symptoms.^[7] And the third is loud snoring or waking up gasping, since sleep apnea is one of the conditions linked to sleep paralysis.

A doctor can rule those out, and if the episodes themselves are the problem, there are options. There's a short course of cognitive behavioural therapy for sleep paralysis, five sessions covering sleep habits, relaxation and ways to end an episode, but it hasn't been tested in a trial yet. Some doctors prescribe antidepressants that suppress REM sleep. If you're ever on one, don't stop it suddenly on your own, because stopping abruptly can cause a rebound of REM sleep. If frequent nightmares come along with your episodes, what causes nightmares explains where they come from and what helps.

For everyone else, the most useful thing you can do takes a minute, and you can do it tonight. Lie on your back, close your eyes and move only your right big toe, slowly, while the rest of you stays heavy. Then if the paralysis does come, the one thing you need to remember is already in your foot.