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Sleep Med Rev. 2018 Apr;38:141-157. doi: 10.1016/j.smrv.2017.05.005. Epub 2017 Jun 8.

A systematic review of variables associated with sleep paralysis.

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Center for Sleep and Cognition, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; King's College London, MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, UK; Department of Psychology, University of Sheffield, UK. Electronic address:
Department of Psychology, Goldsmiths, University of London, UK.


Sleep paralysis is a relatively common but under-researched phenomenon. While the causes are unknown, a number of studies have investigated potential risk factors. In this article, we conducted a systematic review on the available literature regarding variables associated with both the frequency and intensity of sleep paralysis episodes. A total of 42 studies met the inclusion criteria. For each study, sample size, study site, sex and age of participants, sleep paralysis measure, and results of analyses looking at the relationship(s) between sleep paralysis and associated variable(s) were extracted. A large number of variables were associated with sleep paralysis and a number of themes emerged. These were: substance use, stress and trauma, genetic influences, physical illness, personality, intelligence, anomalous beliefs, sleep problems and disorders (both in terms of subjective sleep quality and objective sleep disruption), symptoms of psychiatric illness in non-clinical samples (particularly anxiety symptoms), and psychiatric disorders. Sleep paralysis appears to be particularly prevalent in post-traumatic stress disorder, and to a less degree, panic disorder. Limitations of the current literature, directions for future research, and implications for clinical practice are discussed.


Felt presence; Incubus; Intruder; Isolated sleep paralysis; Parasomnia; REM sleep; Sleep disruption; Sleep paralysis

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