While at boarding school, some twenty-something years ago, there was a particular girl in our dormitory whose stories were very colourful. Throughout the day, she would beguile us with tales of mystical creatures called ‘bush babies’ who cried like babies in the night and consumed students who went out at night in search of them. At night, we would settle at her bedside, enthralled, and listened to the story of ‘Lady Qwas Qwas’ another mythical creature or witch rather, who roamed from one boarding school to another, wearing high heeled shoes at night searching for her long-lost child. I am well aware of how foolish all this sounds now, but back then, the tales made sense to our young impressionable minds.
There was a story of hers, however, that remained in my mind long after I had left school. It was the story of ‘Danau’ a djinn whose purpose was to paralyze students while they were asleep, such that when one woke up, one would not be able to move or scream for a few tortuous minutes while the djinn forcefully pinned him down to his bed. She described the episode so vividly it scared us enough to always say our prayers before we went to bed. Later, during training, I would learn that the concept of sleep paralysis exists and is categorised under sleep disorders call Parasomnia.
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About one in five people have had sleep paralysis at least once. But despite its prevalence, it has largely remained a mystery. For centuries, cultures across the world have attributed these hallucinations to black magic, mythical monsters, even paranormal activity. Scientists have since dismissed such explanations, yet these cultural beliefs persist.
Imagine waking up in the middle of the night to an unearthly figure with blood dripping down its fangs. You try to scream, but you can’t. You can’t move a single muscle! If this sounds familiar, you’ve probably experienced an episode of sleep paralysis, which involves the inability to move or speak upon falling asleep or awakening and is often coupled with hallucinations.
These hallucinations—often involving seeing and sensing ghostly bedroom intruders—are interpreted differently around the world. In Egypt, sleep paralysis is often thought to be caused by a Djinn, a supernatural creature that terrorizes and sometimes kills its victims. In Italy, some interpret sleep paralysis as an assault by the so-called ‘Pandafeche’, a figure described as a malevolent witch or terrifying giant cat. In South Africa, Indigenous people believe the state to be caused by ‘segatelelo’ (black magic), involving menacing dwarf-like creatures called ‘tokoloshe’, and in Turkey, it is the ‘karabasan’—mysterious spirit-like creatures. In contrast, the Danish people offer a less imaginative explanation: they largely attribute sleep paralysis to physiological risk factors such as stress.
So, it is safe to say that, it is not only Nigerians that are fetish.
A few years ago, a young man came to me with symptoms that made me remember the girl from my secondary school days. He said he was having trouble sleeping and that when he eventually did fall asleep, his dreams were plagued by nightmares. After a few more consultations and his confidence in me increased, he was able to share his thoughts about him being possessed. He broke down and described his episodes of sleep paralysis despite his vehement Du’a before sleep. In the typical Nigerian context, he believed his mother when she said he was possessed by evil spirits (again, djinn) and so had travelled to many prayer houses across Nigeria in search of a cure. In his quest for help, he showed me the markings on his back, which he sustained in Ilorin when an Alfa had decided to flog the evil spirits out of him. Several years later, the scars were still there as a reminder and the ‘djinn’ had not moved an inch from his body. Exhausted, Aminu* had decided to try the hospital as a last resort.
And it is precisely for this reason- believing that sleep paralysis is caused by dark magic other than it being a medical condition, that makes the condition so unpopular in medicine.
Baland Jalal, a neuroscientist at the University of Cambridge and current fellow at Harvard University, says the lack of scientific research into sleep paralysis likely stems from a place of confusion—no one really knows what to make of it.
“People understand what it means to have OCD and to wash your hands several times a day,” Jalal says, “But what does it mean if somebody saw a ghost in their room?”
Aminu’s *case became my motivation to read all about the different types of sleep disorders. His case was a mixture of insomnia and parasomnia. Additionally, he was a naturally anxious person who viewed the glass as perpetually half empty. For such a young man in his twenties, he had undergone so much trauma: parents divorced, indifferent stepmother and an inability to secure admission in a tertiary institution. He worked at a business centre as at the time of presentation. He dreaded the night so much so that he would have palpitations as dusk approached. Night-time meant sleep. And sleep meant tossing around in bed, nightmares and the frightening transient paralysis he experienced around 4am.
This common condition is often first noticed in the teen years. But men and women of any age can have it. Sleep paralysis may run in families. Some factors that may be linked to sleep paralysis 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, use of certain medications, such as those for ADHD and substance abuse.
Anxiety and stress predispose people to an attack, so those who dread it are often more likely to experience it. Indeed, sleep paralysis is nearly twice as common in Egypt, compared with Denmark. And as discovered in Italy, those who believe their sleep paralysis may have a supernatural cause are also more likely to hallucinate during the attack—including experiencing a ghostly “sensed presence.” Once sleep paralysis occurs, it is subsequently interpreted through the lens of fear, leading to more anxiety and unwanted awakenings—and effectively, more sleep paralysis. This vicious cycle—which is called the “panic-hallucination model”—continues to feed into itself until sleep paralysis becomes chronic, prolonged and, worse yet, potentially psychopathological.
However, sleep researchers conclude that, in most cases, sleep paralysis is simply a sign that your body is not moving smoothly through the stages of sleep. Rarely is sleep paralysis linked to deep underlying psychiatric problems.
The treatment of sleep paralysis is largely ambiguous. Most people need no treatment for sleep paralysis. Treating any underlying conditions such as narcolepsy or anxiety or depression with medication may help improve symptoms. Largely though, physicians rely on counselling people on sleep hygiene. These are a set of guidelines that help improve our quality of sleep and can be found online.
In Aminu’s case, just counselling him on his condition, the cause, and treatment plan was enough to make him weep tears of gratitude. All he wanted to confirm was that he was not going mad nor was he possessed. Within a few months, his sleep had improved tremendously with the help of medication and he no longer looked forward to the night with dread.
Doctor-1, ‘Danau’-0.
*Name changed for ethical purposes.
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