How Does Sleep Paralysis Differ Around the World?

This post is written by Netra Kothari, Human Resource Intern, Monk Prayogshala, Mumbai, India.

You’re asleep — at least, you thought you were. You’re in the dark in your bedroom and unexpectedly feel the presence of something hidden. Thump, thump. Were those footsteps? Suddenly, you feel a weight on your chest and find that you cannot move your limbs. The figure reaches out to you… what does it look like? The answer may lie in the stories you were told growing up.

If you’re African American, Italian, Brazilian, Southern American, or from Newfoundland, chances are that this seemingly evil figure that accosts you in your sleep looks like an old, wrinkly witch. If you’re from China, Mexico, or Thailand, maybe it looks like some sort of ghost or spectre.

Be it a demon, a visitation from an ancestor, or simply an eerie, shadowy figure; these are all manifestations of Sleep Paralysis (SP). This is classified as a parasomnia that is marked by anxiety, fear, an accurate account of one’s overall surroundings, and an inability to perform voluntary movement in the limb, head, and trunk areas of the body.

One of the earliest appearances of SP in art is Der Nachtmahr, a painting made in 1781 by Swiss Heinrich Füssli, showcasing a demon atop a sleeping woman’s chest. Commonly, this creature was called an “incubus,” a devil that seeks sexual relations with sleeping women. This and other gendered occurrences of the famed "sleep paralysis" demon originated in the context of Puritanism in dominantly Christian cultures.

Source: The Nightmare by Johann Heinrich Füssli/Wikimedia Commons

A 2020 study on undergraduate students at an American university found that 1 in 3 respondents had experienced at least one episode of SP in their lives, however, the lifetime prevalence rate is evasive to define. It ranges from 5% to 62%, as found in a small suburban community in Newfoundland. However, more recent studies on undergraduates set the number somewhere between 30-40% of the general population. These large ranges seem to be a product of the differences in the manifestation of SP in population demographics, sizes, and culture.

A few explanations attempt to solve the problem of how culture can affect SP manifestation. The first explanation is the Panic-Hallucination hypothesis. It postulates that the state of being unable to move when half-asleep causes the sleeper to panic and try to regain control of their body desperately, which may create more distress when the attempt is futile. This may cause hallucinations surrounding the fearful emotion, causing a vicious, self-feeding cycle that escalates until the sleeper is fully awake and can move voluntarily again.

The salience hypothesis is where cultural framing kicks in. When one hears stories of Karabasta (an evil spirit in Turkish folklore that causes nightmares and drinks blood from the sleeping) or the Pandafeche (a ghost-like spirit in Italian Abruzzo mythology) in day-to-day life, it works as a primer for the immediate association of a vague, sensed presence with the creature they have heard about. The anticipatory fear may cause the event to be even more impactful and terrifying and may increase the frequency of SP episodes.

An investigation on the frequency and intensity of SP attacks in Italy found that more than 33% of SP experiencers in the Abruzzo region of Italy believed that their sleep paralysis was possibly caused by the Pandafeche, and many even called the whole experience by the same name. The hypothesis was that Italians, with such a distinct and persevering narrative culture around SP, would have a more intense experience than groups that did not have such folklore.

This was proven correct: In Denmark, where there are fewer cultural traditions regarding sleep SP, people seem to experience lower lifetime rates, shorter immobility durations, and very few experience a fear of death during the episode in comparison to Italy. In contrast, in Egypt, where SP is often linked to Jinn (genie) attacks, 41% of the population discusses SP in supernatural terms, and many seek traditional remedies. Egyptian students reported a high number of SP episodes, averaging 19.4 over a lifetime, with longer immobility durations. Additionally, 50% of Egyptians feared dying from SP. The belief in supernatural causes is strongly associated with increased fear and longer episodes of immobility among Egyptians.

Cambodians, too, have significant cultural associations with SP, and seem to have similarly elevated rates of prevalence and anxiety during the attack. However, one factor we must not overlook is the correlation with PTSD and other anxious disorders, as well as mood disorders. This pattern is also seen in Khmer refugee groups, suggesting that SP may be triggered by an existing hypervigilant and anxious state. As Cambodian and Khmer SP demons are usually ghosts or ghost-like, thoughts of their own or others’ mortality may also be a factor, as the refugees’ trauma was often related to life-or-death situations.

Cross-Cultural Psychology Essential Reads

Maximum Happiness as Life’s Ultimate Goal? Not for Everyone

The Model Minority Myth Is Also a Money Story

This brings us to another problem with one-dimensionally interpreting this multi-layered phenomenon. A study on 10 people who believed they had been abducted by aliens interpreted their narration and emotions during the event from the lens of an SP episode by default. The researchers concluded that cultural narratives give people a way to fill in blank spaces and fit odd experiences into existing schemas. However, there is one argument against the idea that cultural priming is wholly responsible for what we see during sleep paralysis attacks. There exist reports of SP that share specific cultural traits from one area or distinct local folklore, even though the sufferer is not part of any cultural webs where these stories proliferate. Dismissing direct spiritual experiences has also historically been a sad feature of the Western canon of research. One must caution against brushing off what we cannot explain as of now. Lastly, SP may also be reported often as a convenient catch-all for a variety of complex phenomena by highlighting commonalities and diminishing their unique characteristics.

All in all, science does not seem to nullify native tales of spirituality; it only seems to add to our understanding of the neurophysiological mechanisms involved in how we process these events. It is striking how we not only have diverse things we see during SP, but also how equally diverse ways to combat it exist. Kanashibari (“the state of being totally bound, as if constrained by metal chains”), the Japanese take on SP, involves a demon sent by an ill-wisher to suffocate people in their sleep. This is similar to what the Eskimo in some parts of Canada think, where shamans trying to cut the connection between one’s soul and body causes SP. One solution, naturally, can be to root out the person causing it and deter them from doing so. Chinese people might call a spiritualist, and Cambodians ensure timely funeral rites to avoid angry ghosts. Italians sleep in a prone position and place a broom by the door to deny entry to the Pandafeche.

All of these beliefs come together to form a thoroughly interesting set of information that highlights how inextricably tied our psychological experiences are to how our culture states the world works.