Reconsidering "Sleep Paralysis" in Narcolepsy: Non-Identity of Hypnagogic REM Intrusion and Typical Isolated Sleep Paralysis
Zenodo (CERN European Organization for Nuclear Research) December 22, 2025 DOI: 10.5281/zenodo.18018911 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Keywords | Sleep paralysis Narcolepsy Sleep system call Cataplexy Sleep disorder Intrusion K-complex Anesthesia Neurological disorder Periodic paralysis Slow-wave sleep |
| Key points | Argues that many reports of "sleep paralysis" in narcolepsy may represent a composite experience of REM intrusion at sleep onset rather than a direct increase in typical isolated sleep paralysis, and that the term should be used with explicit distinction regarding timing and mode of muscle atonia. |
Abstract
This conceptual paper re-examines the commonly used term “sleep paralysis” in narcolepsy.Although narcolepsy is often described as being associated with frequent sleep paralysis,it remains unclear whether patient-reported experiences correspond to the sameneurophysiological state as typical isolated sleep paralysis observed in healthy individuals. This paper conceptually distinguishes two phenomena:(1) typical isolated sleep paralysis in healthy individuals, which predominantly occurs upon awakeningand can be interpreted as residual REM-related muscle atonia without emotional triggering, and(2) narcolepsy-related experiences labeled as “sleep paralysis,” which more often occur at sleep onsetand are closely associated with hypnagogic hallucinations and cataplexy-like muscle atonia. The analysis suggests that many reports of “sleep paralysis” in narcolepsy may represent a compositeexperience of REM intrusion at sleep onset rather than a direct increase in typical isolated sleep paralysis.Accordingly, the paper argues that the term “sleep paralysis” should be used with explicit distinctionregarding timing (sleep onset vs. awakening) and the mode of muscle atonia (emotion-triggered vs. residual).