Cognitive-Behavioral Therapy in the Treatment of Recurrent Isolated Sleep Paralysis

In Russia, approximately every fifth person has experienced a state of sleep paralysis, which can be Isolated Sleep Paralysis or in the structure of post-traumatic stress disorder (for example, the loss of a significant person, a serious illness of a child), a large episode of depression and a reaction of grief (for example, in the process of separation) [1,2]. Patients describe this condition as a feeling that “the body is asleep, and the brain is working.” It is as if they are seeing a “dream in a dream”. When they wake up, they can’t move their arms or legs, they feel that they are being held by their arms/legs, they are being pressed on their chest, they are holding their mouth. They can only open their eyes and observe the difference of vision: animals, “a person without a face”, close people, dead people, “strange silhouettes”. What they saw is interpreted as a paranormal, religious experience, supernatural attack, near-death experience, “feeling that they are going crazy”, abduction/contact with someone and something. Patients begin to move the body by force, and as soon as they manage to move, push on something, the condition abruptly passes. They get up, walk and go back to bed and fall asleep. In the morning, patients forget a lot or everything, during the day there may be residual memories of the episode with a tendency to “symbolic interpretation” (dramatic mythical scenarios), the search for causes. There is somatization in the form of headache, irritable bowel, pain syndrome, fatigue. The anxious expectation increases (fear of the night, a repeat episode) [1]. The intense sensory and perceptual experiences suffered cause postepisodic distress from sleep paralysis (=SP postepisode distress), which leads to the development of a spectrum of avoidant and reinsurance behavior in the patient [2].