Sleep paralysis has been studied in different countries and regions, but it has rarely been investigated in mainland China. The aim of the present study was to estimate the prevalence of sleep paralysis and examine features of and factors associated with sleep paralysis (SP) among Chinese adolescents. A cross-sectional study was performed by using self-administrated questionnaires distributed to junior and senior high school students. The prevalence of sleep paralysis was determined from 11 754 completed questionnaires (overall response rate: 95.1%). The relationship of sleep paralysis to personal (age, gender), lifestyle (smoking, drinking alcohol), and community (rural or urban) characteristics and sleep status (sleep duration, nap time, bedtime, subjective sleep quality) were analyzed, and the features of sleep paralysis were investigated. We found that the prevalence of sleep paralysis in this population was 6.77%. The prevalence of sleep paralysis increased significantly from junior to senior high school regardless of sleep duration, naptime, bedtime, or mental health status. Logistic regression analysis revealed that risk factors for sleep paralysis included female sex, drinking alcohol, low subjective sleep quality, and living in a rural area. Major features of sleep paralysis included the inability to move (92%) and a sense of weight on chest/difficulty breathing (43%). The results of this study suggest that in order to reduce the incidence of SP, health education should be used to promote the importance of regular sleep habits for adolescents.
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Nishino S. Clinical and neurobiological aspects of narcolepsy. Sleep Med. 2007; 8: 373–99.
Nielsen TA, Zadra A. Nightmares and other common dream disturbances. In: Kryger MH, Roth T, Dement WC, eds. and Practice of Sleep Medicine. W.B. Saunders Company: Philadelphia, PA, 2005; 926–35.
Hishikawa Y, Shimizu T. Physiology of REM sleep, cata-plexy, and sleep paralysis. Adv. Neurol. 1995; 67: 245–71.
Munezawa T, Kaneita Y, Osaki Y et al. Nightmare and sleep paralysis among Japanese adolescents: a nationwide representative survey. Sleep Med. 2011; 12: 56–64.
Fukuda K, Miyasita A, Inugami M, Ishihara K. High prevalence of isolated sleep paralysis: Kanashibari phenomenon in Japan. Sleep 1987; 10: 279–86.
Bell CC, Shakoor B, Thompson B et al. Prevalence of isolated sleep paralysis in black subjects. J. Natl Med. Assoc. 1984; 76: 501–8.
Wing YK, Lee ST, Chen CN. Sleep paralysis in Chinese: ghost oppression phenomenon in Hong Kong. Sleep 1994; 17: 609–13.
Ohaeri JU, Odejide AO, Ikuesan BA, Adeyemi JD. The pattern of isolated sleep paralysis among Nigerian medical students. J. Natl Med. Assoc. 1989; 81: 805–8.
Téllez-López A, Guerrero-Sánchez ME, Gutierrez-Torres F et al. Sleep habits and sleep disorders among residents of Monterrey metropolitan area. Salud. Ment. 1995; 18: 14–22. (in Spanish).
Ohayon M, Zulley J, Guilleminault C, Smirne S. Prevalence and pathologic associations of sleep paralysis in the general population. Neurology 1999; 52: 1194–200.
Jiménez-Genchi A, Avila-Rodríguez VM, Sánchez-Rojas F, Terrez BE, Nenclares-Portocarrero A. Sleep paralysis in adolescents: the “a dead body climbed on top of me” phenomenon in Mexico. Psychiatry Clin. Neurosci. 2009; 63: 546–9.
Ness RC. The old hag phenomenon as sleep paralysis: a biocultural interpretation. Cult. Med. Psychiatry 1978; 2: 15–39.
Fukuda K, Ogilvie RD, Chilcott L, Vendittelli AM, Takeuchi T. The prevalence of sleep paralysis among Canadian and Japanese college students. Dreaming 1998; 8: 59–66.
Fukuda K, Ogilvie RD, Takeuchi T. Recognition of sleep paralysis among normal adults in Canada and in Japan. Psychiatry Clin. Neurosci. 2000; 54: 292–3.
Fukuda K. One explanatory basis for the discrepancy of reported prevalence of sleep paralysis among healthy respondents. Percept. Mot. Skills 1993; 77: 803–7.
Wing YK, Chiu H, Leung T, Ng J. Sleep paralysis in the elderly. J. Sleep Res. 1999; 8: 151–5.
Goldberg DP, Rickels K, Downing R et al. A comparison of two psychiatric screening tests. B r. J. Psychiatry 1976; 129: 61–7.
Doi Y, Minowa M. Factor structure of the 12-item General Health Questionnaire in the Japanese general adult population. Psychiatry Clin. Neurosci. 2003; 57: 379–83.
Ohayon M, Priest R, Zulley J, Smirne S, Paiva T. Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology 2002; 58: 1826–33.
Otto MW, Simon NM, Powers M, Hinton D, Zalta AK, Pollack MH. Rates of isolated sleep paralysis in outpatients with anxiety disorders. J. Anxiety Disord. 2006; 20: 687–93.
Oluwole OS. Lifetime prevalence and incidence of parasomnias in a population of young adult Nigerians. J. Neurol. 2010; 12: 56–64.
Johnson EO, Breslau N. Sleep problems and substance use in adolescence. Drug Alcohol Depend. 2001; 64: 1–7.
Kenney SR, LaBrie JW, Hummer JF, Pham AT. Global sleep quality as a moderator of alcohol consumption and consequences in college students. Addict. Behav. 2012; 37: 507–12.
Brower KJ, Krentzman A, Robinson EA. Persistent insomnia, abstinence, and moderate drinking in alcohol-dependent individuals. Am. J. Addict. 2011; 20: 435–40.
American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual, 2nd edn. American Academy of Sleep Medicine: Westchester, IL, 2005.
Takeuchi T, Takeuchi T, Miyasita A, Sasaki Y, Inugami M, Fukuda K. Isolated sleep paralysis elicited by sleep interruption. Sleep 1992; 15: 217–25.
Morin CM, Espie CA. Insomnia: A Clinical Guide to Assessment and Treatment. Kluwer Academic/Plenum Publishers: New York, 2003.
Nielsen TA, Laberge L, Paquet J, Tremblay RE, Vitaro F, Montplaisir J. Development of disturbing dreams during adolescence and their relation to anxiety symptoms. Sleep 2000; 23: 727–36.
Takeuchi T, Fukuda K, Yamamoto Y et al. What kind of sleep related life style affects the occurrence of sleep paralysis in normal individuals. Sleep Res. 1997; 26: 518.
Shengli Ma and Tao Wu contributed equally to this manuscript.
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Ma, S., Wu, T. & Pi, G. Sleep paralysis in Chinese adolescents: A representative survey. Sleep Biol. Rhythms 12, 46–52 (2014). https://doi.org/10.1111/sbr.12045