Does Recurrent Isolated Sleep Paralysis Involve More than Cognitive Neurosciences? By Jean-Christophe Terrillon and Sirley Marques Bonham

 Fuseli: The Nightmare, 1781, Detroit, Institute of Arts.

RISP is experienced while drifting to sleep or upon waking from sleep, and most commonly while lying on one's back. At the beginning of an episode, one feels progressively heavier and heavier as the generalized muscle atonia sets in. This progressive heaviness can be perceived as successive "pulses" that affect the whole body. One suddenly realizes that it is impossible to move or to speak, or to cry out. A strong pressure on the chest gives the sensation that an entity is sitting on the chest. It becomes difficult to breathe. A buzzing/ringing/roaring/whistling/hissing/high-pitched screeching sound in the ears sets in and becomes louder and louder to the point of becoming unbearable. Occasionally a sensation of explosion in the head occurs [22-25] that could be compared to a seizure [26]. A presence, often perceived as malevolent, is felt and eventually seen in the room of the sleeper. It may take a variety of forms, from a shadow to animals to a humanoid form. Occasionally it is trying to pull one's legs. Voices or even music may be heard vividly. Flashes of bright light may be seen. By that time, intense fear is experienced and an attempt to move a part of the body (such as a hand or leg or the head) is made in order to liberate oneself of the atonia. If such is the case, and if one can finally move, the same phenomena as described above may occur again, repeatedly, after one tries to go back to sleep. If no attempt is made to move, that is, if the fear is overcome or if it is mild, another complex of phenomena sets in: what seems to be a "phantom body" slowly slips away from the physical body. There seems to be a dissociation from the immobile physical body and consciousness is perceived to reside within the phantom body. At that point, the immediate surroundings of the room may be "seen," sometimes vividly, by the phantom body, and a sensation of rising and/or floating, sometimes rolling, is experienced. The phantom body can "see" under itself the physical body lying motionless on the bed. It can stay inside the physical room or proceed to other locations perceived to be part of the physical world (e.g., other rooms in the house, a corridor adjacent to the room, etc…). The surroundings appear to the consciousness as they would while in the wake state, eventually with some odd modifications (a few more objects than there should be, or a change in the configuration of some objects, for example); or, in another possible scenario, the phantom body may feel accelerated inside a "tunnel" that seems to appear out of nowhere: the tunnel usually appears to be elastic and dark. The phantom body then "arrives" in what could be described as an "oniric scenery": rooms in a house, a landscape (a countryside, a garden, mountains, etc...) with vivid colors, or on streets in a city, for example. In such as state, the "consciousness" that resides within the phantom body has to a certain extent a volitional control on the scenery, the "story" and what the phantom body can do: walking, flying, floating, going through walls but still be able to have the sensation of touching and grasping objects in the scenery, etc... The phantom body may then reenter the tunnel and either proceeds to another "oniric scenery" or go back to the physical room and reenter the physical body. In both scenarios, the return to the physical body may be abrupt or slow. In the second case the phantom body may "hover" for some time above the physical body before "reentering" it. The whole process may be repeated several times in the course of one night, in what may be described as a complex of sequential or "back-to-back" episodes, or it may occur only once. Therefore a complex of episodes may last from a few minutes up to 2-3 hours in some rare cases (although the perceived time usually seems significantly shorter). Upon awaking, if such a phenomenon has not been experienced before or if it has been experienced only very infrequently, one usually is extremely puzzled or troubled and is unable to find a rational explanation let alone a name for the experience.

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