Sleep Paralysis and Sleep Apnea

Although obstructive sleep apnea and sleep paralysis are different conditions, it is not uncommon to suffer from both at the same time. This is speculation that there may be a link between the two sleep disorders.

Obstructive sleep apnea is the better known of the two conditions and affects millions of people around the world. Although it can occur at any age, it is uncommon among teenagers and young adults -- and more likely to appear in middle age and later life.


Sleep paralysis, although far less common, does not confine itself to any particular age group -- and cases have been recorded among teenagers, adults and older people with no common underlying cause being discovered.

Big Difference

Both conditions can disrupt a night's sleep and leave the sufferer feeling drained and tired. But there is a big difference between sleep paralysis and sleep apnea.

Obstructive sleep apnea (OSA) causes breathing to pause briefly during sleep due to a blockage in the air passage. This, in turn, causes the brain to react by quickly alerting the sufferer -- which leads to a brief awakening, as the body clears the airway and restores breathing to normal. 

These short pauses in breathing can occur dozens of times during sleep and can be very debilitating for the sufferer as the quality of sleep essential for proper functioning and good health proves very difficult to achieve.

Sleep paralysis, as the name suggests, is an inability to speak or move -- and which occurs immediately upon falling asleep or at the moment of awakening. 

The inability to move or speak during sleep is a natural process called muscle atonia – and prevents the body from acting out nocturnal dreams or nightmares which may lead to injury

Ordinarily, muscle atonia goes unnoticed by the sleeper -- and only becomes evident when we fall asleep or awaken, and the paralysis becomes an issue. 

Sleep paralysis can also lead to hallucinations or a sense of suffocation, but you may be unable to react as the body remains unresponsive.

While OSA is a recognized medical condition, sleep paralysis is considered an irregular sleeping behavior. 

Sleep paralysis is associated with the REM (rapid eye movement) cycle of sleep, the cycle that involves the most vivid dreams. Atonia kicks in during this cycle and ends upon waking in normal sleep. However, sometimes the atonia continues beyond waking leaving the sufferer awake and alert but temporarily unable to move. This state of paralysis can last anywhere from a few seconds to several minutes and can be quite worrying for the sufferer.

Onset and Cause

Research into sleep paralysis is still in its infancy and opinions are divided into how prevalent the condition is and which age groups are affected most. 

It is generally accepted that sleep paralysis will affect approximately 20% of people at some point in life. Similarly, experts agree that the condition can appear from childhood to old age and that episodes are somewhat more frequent among patients in their twenties and thirties.

No precise cause for sleep paralysis has, as yet, been discovered -- but research seems to indicate that several factors may come into play. The condition tends to be more common among those with:

Sleeping Disorders including insomnia and sleep apnea

Narcolepsy (which affects neurotransmitters in the brain)

Mental health problems including PTSD (post traumatic stress disorder), anxiety issues and panic attacks

There is also some evidence to show that imaginative people and those prone to daydream also tend to experience sleep paralysis at above-average levels. 

Whatever the cause, there is no definitive way to prevent sleep paralysis from occurring.

Obstructive Sleep Apnea Connection

There is no clear link between obstructive sleep apnea and sleep paralysis. However, it is not unusual for OSA sufferers to also experience sleep paralysis occasionally.

Sleep apnea is at its worst during REM sleep.  The body becomes atonic and apneas and hypopneas are most severe due to the lack of tone to keep the airway open and unobstructed.  Because of this oxygen saturation is normally at its lowest levels during REM sleep.

This may be more due to the same factors influencing sleep apnea also affect the neurotransmitters controlling movement. The main culprits which can trigger or exacerbate sleep apnea are caffeine, alcohol, tobacco and medications.

Reducing the intake will help control OSA which also reduces the likelihood of sleep paralysis -- although there can be no guarantees as the precise nature of the condition is still in the early investigative stages.

As is the case with OSA, a good sleep routine will significantly reduce the chances of suffering attacks of sleep paralysis. In general this means:

Establishing a set bedtime routine

Avoiding caffeine and alcohol before retiring

Using sleeping aids such as background music, white noise etc. if preferred

Sleeping in a cool, well-ventilated room

Many sleep apnea sufferers find that the use of a positive airway pressure (PAP) device can greatly relieve, or even eliminate, the effects of OSA and provide the correct environment for quality sleep. 

This PAP therapy uses pressurized air to keep the air passage open which eliminates the need to gasp for air during sleep. 

Quality sleep alone cannot guarantee that sleep paralysis will never occur, but it will certainly reduce the disruptions and breaks associated with obstructive sleep apnea which should reduce the likelihood of sleep paralysis to a large degree.

Sleep paralysis can happen to anyone at any time and for no apparent reason. An occasional bout is nothing to be alarmed about but if the attacks become regular and recurrent it is advisable to consult a doctor or sleep specialist. 

In all likelihood the cause can be quickly identified and the problem nipped in the bud. Ignoring the problem, on the other hand, will only allow the situation to deteriorate and adversely impact overall health and well-being -- as well as cause unnecessary worry and concern.