Between sleep and wakefulness: how sleep quality and stress affect isolated sleep paralysis - a cross-sectional survey.
Ahmed Ali Khan, Ammara Abid, Maheen Nawaz, Muhammad Shaheer Bin Faheem, Zahra Ali Haque, Rayyan Mohammad Makki Bakhsh, Areeba Ashfaq, Fnu Raja
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia September 1, 2025 DOI: 10.1016/j.jocn.2025.111435 (opens in new tab) via PubMed
Summary
AI-generated from the abstractIsolated sleep paralysis (ISP) is a common experience among people without narcolepsy. A survey of 336 shopping mall visitors found that 36.6% had experienced ISP at least once, with an average onset age of 17.9 years. Poor sleep quality and moderate stress were significantly linked to more frequent ISP episodes, though together they accounted for only a small portion of the variance, indicating other factors also contribute. The findings suggest that improving sleep and managing stress may help, but more research is needed to establish causal relationships and develop effective interventions.
Study at a glance
| Characteristics | Cross-sectional survey Longitudinal Peer reviewed |
|---|---|
| Sample size | 336 |
| Population | Shopping mall visitors |
| Keywords | Sleep paralysis Non-rapid eye movement Parasomnias |
| Key finding | Poor sleep quality and moderate stress are significantly associated with increased frequency of isolated sleep paralysis episodes, but their predictive value is limited. |
Abstract
Sleep paralysis (SP) is a rapid-eye movement (REM) parasomnia in which a person is alert but temporarily unable to move or speak during the transition between wakefulness and sleep. It is a cardinal feature of narcolepsy; however, it may also occur independently as isolated sleep paralysis (ISP). This study examines ISP's prevalence, sociodemographic variations, and contributing factors, particularly the impact of poor sleep quality and stress. A cross-sectional survey was conducted among shopping mall visitors using the Unusual Sleep Experiences Questionnaire (USEQ) to assess ISP episodes. Participants also provided data on sleep quality and stress levels to identify potential ISP predictors. Data from 336 participants was analyzed (mean age: 25.6 ± 9.45; 54.8 % females). 123 (36.6 %) participants reported experiencing ISP episodes at least once in their lifetime with the average age of episode onset being 17.9 ± 5.22 years. Poor sleep quality significantly influenced ISP frequency (p < 0.0001). Moderate stress levels were found to be significantly associated with the prevalence of ISP (p = 0.028). Logistic regression models showed that sleep quality and stress accounted for 11.6 % and 5.70 % of the variance in ISP prevalence. ISP is common among the non-narcoleptic population. Poor sleep quality and stress are significantly associated with increased ISP frequency; however, their limited predictive value suggests the involvement of other contributing factors. Longitudinal research is needed to confirm the causal relationship between these factors and ISP, and to develop effective interventions aimed at lowering frequency of ISP episodes.