Kendall Jenner Freaked Out By Sleep Paralysis

If it occurs upon .In a sneak peek from this week’s Keeping Up with the Kardashians, 20 year old Kendall Jenner speaks to momager Kris Jenner about her upcoming appearance schedule.  It includes stops in Paris, Milan and London. Kendall is reluctant to do this because she was recently diagnosed with sleep paralysis. This is a disorder where the sleeper feels like they are unable to move while falling asleep or waking up (see below):

“I can’t travel that much.  I’m like, scared. I’m freaking out because of these f—ing paralysis things. I’m scared to fall asleep because it keeps happening to me. It almost feels like my heart stops.”

Although Kris tries to explain to Kendall’s that her career as a model requires her to do a lot of travel, Kris understands that Kendall has a real issue, saying:

“Kendall basically lives on an airplane. So the anxiety on an airplane and the sleep paralysis is a huge problem. Sometimes it’s been so bad that she’s been paralyzed from even getting on an airplane.  I’ve had to get on a plane and fly from L.A. to London just to get her from London to New York! So it’s becoming a real problem.”

Kendall tells her mother that her health “is a bigger deal,” that it is “genuinely frightening and I don’t know how much of it I can do.”

Kendall ultimately did drop out of many of her show commitments. She did walk in New York Fashion Week, but skipped London, Paris and Milan. In October, she did join her sisters in Paris for Fashion Week. It was there that sister Kim was robbed at gunpoint.

A short primer on sleep

According to How Sleep Works, the definition of sleep is “a naturally-occurring, reversible, periodic and recurring state in which consciousness and muscular activity is temporarily suspended or diminished, and responsiveness to outside stimuli is reduced”. It is different from hibernation, coma, or unconsciousness due to anesthesia because it is easily reversibility.

Sleep is divided into two broad types: rapid eye movement (REM sleep) and non-rapid eye movement (NREM or non-REM sleep). Each type has a distinct set of physiological and neurological features associated with it.

REM Sleep

REM stands for “rapid eye movement” but involves many other aspects including virtual paralysis of the body. It is associated with dreaming, unsynchronized and faster brain waves, and loss of muscle tone.  During non-REM sleep, the brain uses significantly less energy during sleep than it does in waking. In areas with reduced activity, the brain restores its supply of adenosine triphosphate (ATP), the molecule used for short-term storage and transport of energy.

sleep-cycles-scholarpediaREM sleep occurs in cycles of about 90-120 minutes throughout the night, and it accounts for up to 20-25% of total sleep time in adult humans  As the name suggests, it is associated with rapid, random side-to-side movements of the closed eyes. This may relate to the internal visual images of the dreams that occur during REM sleep.

Breathing is more rapid and irregular during REM sleep than during non-REM sleep, and the heart rate and blood pressure also increase to near waking levels.

Although the muscles are more relaxed during non-REM sleep, they become completely paralyzed and unresponsive during REM sleep. This virtual absence of muscle tone and skeletal muscle activity is known as atonia. It occurs because the brain impulses that control muscle movement are completely shut down. The exceptions to this include muscles which controll the eye movements and muscles with essential functions such as the heart and diaphragm muscles. These which keep us alive during sleep.

Non-REM Sleep

Non-REM sleep is defined as any sleep which is not REM sleep It consists of three separate stages (stage1, stage 2 and stage 3). These are followed in order up and down as the sleep cycles progress.

The Stages of Non-REM Sleep

Stage 1 (NREM1 or N1): a stage between wakefulness and sleep, sometimes referred to as somnolence or drowsy sleep.

  • Muscles are still quite active
  • Eyes roll around slowly and may open and close from time to time
  • Breathing gradually becomes more regular
  • Heart rate begins to slow
  • Sudden twitches or hypnic (hypnagogic) jerks (sudden short micro-awakenings often accompanied by a falling sensation) are quite common.

Stage 2 (NREM2 or N2):

  • Muscle activity decreases further
  • conscious awareness of outside world fades completely
  • Brain waves: Characterized as sleep spindles and K-complexes present- serve to protect sleep and aid in sleep-based memory
  • Sleepers pass through this stages several times a night
  • 45-50% of total sleep time for adults

Stage 3 (NREM3 or N3): known as deep or delta or slow-wave sleep

  • Sleeper even less responsive to outside world.
  • Occurs in longer periods in first half of the night (especially first two sleep cycles)
  • 15-20% total sleep time for adults
  • Brain temperature, breathing and heart rates, and blood pressure at lowest levels
  • Dreaming possible and more common than in other nonREM stages (but not as common or vivid as in REM sleep)
  • Parasomnias, such as night terrors, sleep-walking, sleep-talking and bedwetting occur.
  • Information process and memory consolidation take place.

What is Sleep Paralysis?

Sleep paralysis is a phenomenon in which an individual, either during falling asleep or awakening, briefly experiences an inability to move, speak, or react. This is a transitional state between wakefulness and sleep, characterized by an inability to move muscles. Sleep paralysis is closely related to REM atonia, the paralysis that occurs as a natural part of REM (rapid eye movement) sleep. Sleep paralysis occurs either when Ifalling asleep, or when awakening from sleep. When it occurs upon falling asleep, the person remains aware while the body shuts down for REM sleep, a condition called hypnagogic sleep paralysis. Hypnopompic sleep paralysis is when it occurs upon awakening. In this case, the person becomes aware before the REM cycle is complete .

sleep-paralysisSleep paralysis may be accompanied by terrifying hallucinations to which one is unable to react due to paralysis, and physical experiences (such as strong current running through the upper body). These hallucinations often involve a person or supernatural creature suffocating or terrifying the individual, accompanied by a feeling of pressure on one’s chest and difficulty breathing. Another common hallucination type involves intruders (human or supernatural) entering one’s room or lurking outside one’s window, accompanied by a feeling of dread.

What causes sleep paralysis?

Genetics plays a big role in sleep paralysis- it tends to run in families. Other linked factors include:

  • Lack of sleep
  • Sleep schedule that changes
  • Mental conditions such as stress or bipolar disorder
  • Sleeping on the back
  • Other sleep problems such as narcolepsy or nighttime leg cramps
  • Use of certain medications, such as those for ADHD
  • Substance abuse

The underlying mechanism results from disrupted REM sleep, when there should be a general inability to move muscle to prevent the sleeper from acting out their dreams. About 8% of people experience sleep paralysis at one point in their life.

What is the treatment for sleep paralysis?

According to WebMD, most people need no treatment for sleep paralysis. Treating any underlying conditions such as narcolepsy may help if you are anxious or unable to sleep well. These treatments may include the following:

  • Improving sleep habits — such as making sure you get six to eight hours of sleep each night
  • Antidepressant medication, prescribed to regulate sleep cycles
  • Treating any mental health problems that may contribute to sleep paralysis
  • Treating any other sleep disorders, such as narcolepsy or leg cramps

 

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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