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.
The Bundibugyo Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda presents an urgent public health and development challenge for the Great Lakes region. Although smaller so far than the 2014-2016 West Africa Ebola epidemic, history shows how quickly localised outbreaks can escalate when containment is delayed, and health systems are strained.
The immediate policy priority is containment. Failure to control transmission would not only increase mortality but also impose high economic costs through reduced productivity, heightened fiscal burdens and disruptions to trade, investment and development.
As of 7 July, the DRC had reported 1 759 confirmed cases and 600 confirmed Ebolarelated deaths, while Uganda reported 20 confirmed cases and two deaths.
Mortality figures should be interpreted cautiously due to possible under-reporting in remote areas.
No confirmed cases have been reported in neighbouring Rwanda or Burundi. Both countries have, nevertheless, heightened surveillance and preparedness given the extended connections with eastern DRC, especially through the Goma-Rubavu border crossing.
Ebola outbreaks can disrupt healthcare services and weaken health systems’ capacity. As resources are redirected towards emergency responses, the handling of other communicable diseases may suffer, leading to higher overall incidence and mortality rates. This can reverse hard-won gains and strain already struggling health systems, underscoring the importance of swift containment.
In June, the Institute for Security Studies African Futures and Innovation (AFI) programme modelled the impact of a ‘Containment’ scenario against the ‘Current
Path’ (business-as-usual) forecast. The International Futures modelling platform’s ‘other communicable diseases’ category includes Ebola and was used to model the associated effect.
AFI analysis indicates that on the Current Path, fatalities could reach 3,360 in the DRC and 520 in Uganda by the end of 2026, compared to 490 in DRC and 30 in
Uganda under the Containment forecast. (Actual Ebola deaths are already higher than the Containment forecast, indicating the gravity of the situation.) The outcome may worsen in 2027, rising to about 4,340 additional deaths in the DRC and 750 in Uganda.
These figures are well below the 2014-2016 West Africa Ebola epidemic, which resulted in about 11,325 deaths, but they underscore the risks of delayed
intervention.
Containing the outbreak will require a significant increase in public health expenditure to enable better disease surveillance, laboratory testing, treatment
facilities, community outreach and emergency response systems. These interventions would not only limit transmission but restore public confidence and maintain economic activity.
AFI’s Containment scenario indicates that government health expenditure in 2026 would need to rise to at least US$1.82 billion in the DRC and US$1.17 billion in Uganda. This represents an increase of over US$540 million above the Current Path forecast in the DRC and US$170 million in Uganda. Taken together, at least US$710 million in additional health financing would be required to effectively contain the outbreak.
The benefits of early intervention would be substantial in terms of lives saved. Rapid containment is also significantly less costly than responding to a larger, more entrenched epidemic later.
The estimated financing requirement is broadly consistent with the US$518 million emergency appeal the United Nations and humanitarian partners launched on 5 June. Several governments and development partners have already pledged support, but crisis financing is often reactive and temporary.
The current outbreak highlights the need for more systematic investment in epidemic preparedness, surveillance systems, laboratory infrastructure, community
health workers and rapid-response capacity.
However, additional health spending should not come at the expense of other development priorities. African governments are often forced to divert resources
from education, social protection, food security and infrastructure during crises. This risks undermining long-term development outcomes and shifting the burden of the emergency onto vulnerable populations.
The challenge is not only to mobilise emergency financing, but to secure additional, flexible resources that allow governments to respond without compromising broader development objectives.
Ebola can also discourage market participation due to uncertainty and fear of infection. Border restrictions, reduced travel and disruptions to transport networks constrain trade, services and agricultural activity. These effects are particularly significant in the Great Lakes region, where communities rely on cross-border economic and social ties. If containment is further delayed, the region could face rising communicable disease fatalities alongside slower economic growth.
Often, economic activity does not disappear entirely but shifts into informal, unmonitored channels as households try to preserve their incomes and livelihoods.
As informality increases, governments collect less revenue from customs duties, corporate taxes and other domestic sources.
AFI modelling shows that in 2026, the DRC and Uganda could lose around US$70 million and US$60 million in government revenue, respectively, due to reduced formal economic activity, increased informality and the fiscal strain of financing the outbreak response. Both governments are already under pressure to finance emergency health interventions while sustaining critical development spending.
Four key policy implications emerge from these findings.
First, early containment would be far less costly than the burden of uncontrolled escalation. Rapid intervention saves lives, reduces economic disruption and lowers long-term fiscal costs. Second, emergency health financing must be mobilised quickly and should be additional to existing development resources.
Third, responses should protect livelihoods and formal economic activity wherever possible, particularly in border communities relying on trade and mobility.
Finally, the outbreak reinforces the importance of investing in resilient health systems before crises occur. Strong surveillance networks, laboratory systems, community health workers and cross-border preparedness mechanisms are the most effective safeguards against future epidemics.
The African Development Bank and other development partners can mobilise rapidresponse financing, support health-system resilience and strengthen regional preparedness. Epidemic preparedness must be recognised not just as a health priority, but as a development, fiscal stability and regional resilience imperative.
Marvellous Ngundu is a Research Consultant, Blessing Chipanda is a Senior Research Consultant, and Jakkie Cilliers is Head of African Futures and Innovation at the Institute for Security Studies (ISS) Pretoria.
(This article was first published by ISS Today, a Premium Times syndication partner. We have their permission to republish).
The Nigeria Centre for Disease Control and Prevention (NCDC) has said the country’s Lassa fever outbreak has become deadlier this year, with 221 deaths recorded and the case fatality rate rising to 24 per cent, compared with 18.7 per cent during the corresponding period in 2025.
The agency disclosed this in its Lassa fever situation report for epidemiological week 26, released on Friday.
The report also showed that confirmed infections increased during the week, with 31 new cases recorded, up from 22 in the previous reporting week.
A total of 23 states have recorded at least one confirmed case across 111 local government areas this year, highlighting the continued spread of the disease across the country.
Five states account for most infections
The NCDC reported that 85 per cent of all confirmed cases originated from Ondo, Bauchi, Taraba, Edo and Benue states, while the remaining 15 per cent were reported elsewhere.
Ondo accounted for the largest share of confirmed infections at 30 per cent, followed by Bauchi (26 per cent), Taraba (14 per cent), Edo (nine per cent) and Benue (six per cent).
People aged 21 to 30 years remained the most affected group, although confirmed cases ranged from one to 93 years.
The male-to-female ratio among confirmed cases stood at 1:0.9, indicating nearly equal infection rates between men and women.
Why deaths remain high
The NCDC attributed the elevated fatality rate to several persistent challenges, including late presentation of cases, poor health-seeking behaviour driven by the high cost of treatment, inadequate environmental sanitation in high-burden communities, low public awareness, and infections among healthcare workers.
The agency disclosed that one healthcare worker was infected during week 26.
Response efforts intensified
To contain the outbreak, the NCDC said the National Lassa Fever multi-partner, multi-sectoral Incident Management System remains activated to coordinate surveillance, case management, risk communication and response activities nationwide.
During the reporting week, the agency and its partners supported case management training for healthcare workers, active case search and contact tracing, infection prevention and control (IPC) training, community engagement activities, distribution of personal protective equipment, laboratory testing, and high-level field missions to affected states.
The NCDC urged state governments to sustain year-round community engagement on Lassa fever prevention, while healthcare workers were advised to maintain a high index of suspicion for the disease, initiate timely referral and treatment, and adhere strictly to infection prevention and control procedures.
READ ALSO: NCDC updates Lassa fever death rate to 19.3% as outbreak reaches 23 states
Lassa fever
Lassa fever is an acute viral haemorrhagic illness caused by the Lassa virus, which is transmitted to humans primarily through contact with food or household items contaminated by the urine or faeces of infected rats.
It can also spread from person to person through contact with bodily fluids.
The disease often begins with fever, weakness, and headache, and may progress to more severe symptoms such as bleeding, difficulty breathing, swelling, and organ failure.
Early diagnosis and prompt treatment with Ribavirin are critical for improving survival.
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