Health
PT Health Watch: Why sleep paralysis feels like a spiritual attack — Expert
Many Nigerians who wake up unable to move, speak or call for help often describe the experience as a spiritual attack, saying “something pressed me” or “a witch held me down.”
However, health experts say the frightening phenomenon, known as sleep paralysis, has a medical explanation rooted in the brain’s sleep cycle and is often linked to stress, sleep deprivation and irregular sleeping patterns.
Speaking with PT Health Watch, Joshua Nnatus, a senior manager at Lagos MiND and a public health professional, explained that while the experience can feel terrifyingly real, it is a recognised sleep condition with a well-understood neurological basis.
When the brain wakes before the body
Mr Nnatus described sleep paralysis as a temporary inability to move or speak that occurs either while falling asleep or, more commonly, while waking up.
“It is classified as a parasomnia, one of the sleep-related experiences recognised in the American Psychiatric Association’s DSM-5 and the International Classification of Sleep Disorders,” he said.
He explained that the condition is closely tied to rapid eye movement (REM) sleep, the stage of sleep associated with vivid dreaming, which typically accounts for about 20 to 25 per cent of an adult’s sleep cycle.
During REM sleep, the brain activates a protective mechanism called REM atonia, which temporarily switches off voluntary muscles to prevent people from physically acting out their dreams.
Normally, this muscle “off-switch” ends immediately upon waking. However, in sleep paralysis, the transition between sleep and wakefulness becomes misaligned.
“The mind becomes awake and aware before the muscle switch has been turned back on,” Mr Nnatus said.
As a result, the person is conscious, aware of their environment, but unable to move or speak. Breathing and eye movements remain unaffected, which is why people can still look around and breathe normally despite feeling completely “frozen”.
Episodes typically last from a few seconds to a couple of minutes and resolve on their own.
A common but misunderstood experience
Although many people are reluctant to discuss it, sleep paralysis is relatively common.
Research suggests that a significant proportion of people experience at least one episode during their lifetime, particularly adolescents, university students and young adults who are exposed to high levels of stress, sleep deprivation or irregular sleeping schedules.
Because the experience is often sudden and frightening, it is frequently misunderstood and interpreted through cultural or spiritual beliefs.
Why it feels like a spiritual attack
Mr Nnatus said the experience is often interpreted as supernatural because several frightening sensations occur at the same time.
The first is the sudden loss of control, which triggers intense fear. Second is the persistence of dream-like activity in the brain, which produces vivid hallucinations.
These may include sensing a presence in the room, seeing a figure, feeling pressure on the chest, or believing something is sitting on or holding the body down.
He added that the brain’s fear-processing centres remain highly active during REM sleep, which amplifies panic and makes the experience feel extremely real.
“The result feels absolutely real because, in a neurological sense, it is real to the person experiencing it. It is not imagination, and it is not a sign of madness,” he said.
Across cultures, similar experiences have been explained through spiritual beliefs.
In parts of Europe, it has been described as the “Old Hag” phenomenon. In some Middle Eastern traditions, it is linked to Jinn. In parts of China, it is associated with ghost oppression.
In south-west Nigeria, it is widely referred to as ogun oru, interpreted by many as nocturnal spiritual attack, while others describe it as a witch “pressing” the body during sleep.
Mr Nnatus said these interpretations reflect cultural frameworks, but the underlying process remains the same across populations.
Stress, disrupted sleep and lifestyle factors
According to Mr Nnatus, the strongest trigger for sleep paralysis is disrupted sleep.
Common risk factors include sleep deprivation, irregular sleep schedules, late-night studying, shift work, and constantly changing sleep routines.
He noted that stress and anxiety, particularly among students and young professionals, significantly increase vulnerability.
Other triggers include sleeping on the back, caffeine or alcohol close to bedtime, jet lag, and prolonged screen use at night, which delays sleep onset.
Mental health conditions such as anxiety, depression and post-traumatic stress disorder may also increase the likelihood of episodes.
In some cases, sleep paralysis occurs alongside narcolepsy, a neurological sleep disorder characterised by excessive daytime sleepiness and sudden sleep attacks.
He added that research suggests a possible genetic component in some individuals.
When it becomes a concern
Mr Nnatus stressed that sleep paralysis is not physically dangerous.
He, however, said repeated episodes can lead to significant distress, including fear of sleeping, anxiety and poor-quality rest.
He advised medical attention if episodes become frequent or are accompanied by excessive daytime sleepiness, or sudden uncontrollable sleep episodes during the day, symptoms that may suggest narcolepsy.
“That pattern is a core warning sign and should be properly evaluated,” he said.
Managing and reducing episodes
Mr Nnatus recommended maintaining consistent sleep and wake times, ensuring adequate sleep duration, and reducing stress levels.
Limiting caffeine and alcohol intake in the evening, reducing screen exposure before bedtime, and improving sleep environment can also help.
According to sleep health guidance from the US Centres for Disease Control and Prevention (CDC), adults require at least seven hours of sleep per night for optimal health.
He also noted that sleeping on one’s side may reduce the likelihood of episodes in people who are prone to them.
For people experiencing frequent or distressing episodes, Mr Nnatus said support and referral services are available through Lagos MiND’s Lagos Lifeline on 070 0000 6463, 020 1410 6463, or via WhatsApp on 090 9000 6463.
Health experts have advised that all candidate treatments and vaccines for Ebola disease caused by the Bundibugyo virus should be used exclusively within clinical trials to ensure safe, ethical, and effective research.
A statement made available on Thursday said that the experts were convened by the World Health Organisation (WHO).
According to it, the recommendation comes in response to the current outbreak in the Democratic Republic of the Congo, with additional cases reported in Uganda, and follows assessments by multiple WHO experts and advisory groups.
“WHO convened meetings with its Research and Development (R&D) Blueprint technical advisory groups on candidate vaccines and therapeutics for Bundibugyo Virus Disease (BVD) to evaluate options for both prevention and treatment.
“In parallel, the Strategic Advisory Group of Experts on Immunisation and its Ebola vaccine working group reviewed the potential role of licensed Ebola vaccines during BVD outbreaks,” it said.
The statement said that there are currently no licensed therapeutics or vaccines specifically approved for the prevention and treatment of BVD, though several candidate products were identified as promising enough to prioritise for clinical trial evaluation.
It noted that for treatment of confirmed BVD cases, independent experts recommended prioritising three candidates: the monoclonal antibodies MBP134 and Maftivimab®, and the antiviral remdesivir.
“Combination therapy using a monoclonal antibody and remdesivir was also recommended for evaluation in research settings.
“For prevention, the oral antiviral obeldesivir was identified as a priority candidate for post-exposure prophylaxis among contacts of confirmed and probable cases,” it said.
According to it, experts noted that post-exposure prophylaxis with obeldesivir depends on effective contact tracing, which remains operationally challenging in some affected areas of the DRC.
It said the most promising vaccine candidate is the single-dose rVSV Bundibugyo vaccine being developed by the International AIDS Vaccine Initiative, though it is expected to require 7–9 months before it is ready for clinical trial assessment.
It said that another candidate, ChAdOx1 Bundibugyo from Oxford University and the Serum Institute of India, could potentially be available within two to three months for efficacy testing, pending additional animal data.
“Experts suggested a single-dose approach for contacts of cases, while a two-dose strategy might be considered for high-risk but unexposed populations such as health-care workers and frontline responders.
READ ALSO: Ebola: WHO says conflict, mistrust hindering response as suspected cases top 900 in DRC
“The groups also reviewed Ervebo, the only licensed Ebola vaccine, which is approved for outbreaks caused by the most common Ebola virus in Africa but is not licensed for BVD and lacks conclusive evidence of cross-protection,” it said.
The statement said that the WHO recommended that Ervebo should not be used outside carefully designed research settings to allow its performance against BVD to be properly assessed.
“WHO, the governments of the DRC and Uganda, Africa CDC, ANRS Emerging Infectious Diseases, and other partners are now working to develop protocols for clinical field trials.
“While continuing to rely on established Ebola response measures like surveillance, contact tracing, isolation, testing, community engagement, and safe burials to stop transmission,” it said. (NAN)
The Nigeria Centre for Disease Control and Prevention (NCDC) has warned healthcare workers nationwide to heighten surveillance and preparedness for Ebola Virus Disease (EVD), citing a “high” risk of importation into Nigeria due to ongoing outbreaks in the Democratic Republic of the Congo (DRC) and Uganda.
The agency, however, said Nigeria has not recorded any confirmed Ebola case linked to the current regional outbreak as of 28 May.
In a public health advisory issued on Thursday, the NCDC said the World Health Organisation’s (WHO) declaration of the outbreak as a Public Health Emergency of International Concern (PHEIC), rising infections in neighbouring African countries, and increased cross-border movement have raised concerns about Nigeria’s vulnerability.
The advisory highlights concerns over delayed detection, healthcare-associated transmission, and the vulnerability of frontline health workers if the virus enters Nigeria.
“This assessment estimated the risk of Ebola importation into Nigeria as high due to the ongoing transmission in the DRC and Uganda, international travel and population movement, uncertainty regarding the full magnitude of the outbreak, and the potential for delayed recognition because symptoms may overlap with endemic diseases such as malaria and Lassa fever,” the agency stated.
It said high-risk states, border communities, major transport hubs and points of entry had already been identified through its national risk assessment.
Existing outbreak response systems
The NCDC said Nigeria still retains important outbreak response structures developed after previous viral haemorrhagic fever outbreaks, including the 2014 Ebola outbreak, which was successfully contained in Lagos.
According to the agency, the country currently maintains laboratory capability, trained rapid response teams, Emergency Operations Centres (EOCs), established Viral Haemorrhagic Fever preparedness systems, and prior outbreak response experience.
However, it admitted that existing systems require constant review and strengthening.
It also warned healthcare workers that Ebola patients or suspected cases could present at health facilities anywhere in Nigeria.
“The key operational question is therefore how healthcare workers should recognise, respond to, and safely manage such situations,” it said.
The agency stressed that healthcare workers remain one of the most vulnerable groups during Ebola outbreaks because of direct exposure during patient care.
Symptoms
The agency warned that Ebola symptoms may initially resemble several common illnesses frequently seen in Nigerian hospitals, increasing the risk of delayed recognition.
It listed malaria, typhoid fever, Lassa fever, gastroenteritis, COVID-19, influenza, sepsis and other severe bacterial infections among illnesses with symptoms similar to Ebola.
According to the advisory, Ebola has an incubation period of two to 21 days.
Early symptoms may include fever, weakness, headache, muscle pain, sore throat, vomiting and diarrhoea. While severe illness may involve unexplained bleeding, organ dysfunction, confusion, shock and collapse
Patients with non-specific febrile illness could initially appear similar to people suffering from more common diseases, “potentially delaying recognition and increasing exposure risk within healthcare settings.”
No approved vaccine
The current outbreak involves the Bundibugyo strain of the Ebola virus, which differs from the Zaire strain responsible for the 2014 West African epidemic.
The Bundibugyo virus is a Risk Group 4 pathogen and one of the less common Ebola virus strains.
“Unlike the Zaire strain, there are currently no approved vaccines or specific antiviral therapies for Bundibugyo virus disease,” the agency said.
The absence of approved vaccines or targeted therapies could complicate response efforts if infections are detected in Nigeria.
Ebola not airborne
The agency clarified that Ebola is not considered an airborne disease under normal circumstances.
Transmission occurs through direct contact with infected blood, body fluids, secretions, organs, contaminated materials, or infected animals.
The advisory listed vomit, diarrhoea, urine, saliva, sweat, breast milk and semen among infectious body fluids capable of transmitting the virus.
The agency warned that transmission risk is highest when infected patients become symptomatic and actively produce infectious body fluids.
It added that healthcare-associated transmission remained a major concern during Ebola outbreaks, citing reports by the WHO of infections and deaths among healthcare workers linked to gaps in infection prevention and control measures.
READ ALSO: FG releases names of 21 states, FCT at high risk of Ebola infection – FULL LIST
Hospital surveillance
The NCDC directed healthcare facilities to strengthen triage systems for early identification and isolation of suspected cases.
It urged workers to maintain “a high index of suspicion,” especially among persons with recent travel history to affected countries or epidemiological links to confirmed or suspected cases.
It also asked them to carefully assess patients’ travel history, exposure history, contact with sick persons, and attendance at burial or funeral activities where relevant.
It advised hospitals to minimise unnecessary exposure while ensuring safe clinical care.
It also asked the healthcare workers to strictly implement infection prevention and control measures at all times, including hand hygiene before and after patient contact, appropriate use of personal protective equipment (PPE) and safe injection practices.
Others are environmental cleaning and disinfection, safe waste segregation and disposal and safe handling of laboratory specimens.
It further asked to avoid direct contact with blood or body fluids without PPE, prevent needle-stick injuries, follow safe burial guidance, and ensure proper decontamination of equipment and surfaces.
In addition, the health workers are instructed to promptly report occupational exposure incidents and participate in refresher infection prevention and preparedness training programmes.
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