Predictive Factors and Characteristics of Sleep Paralysis Episodes among University Students in Jordan: A Cross-sectional Study
Background
Sleep paralysis (SP) is characterized by rapid eye movement, sleep atonia, brain wakefulness, and a hypervigilant state.
Objective
This study assesses the predictive factors and characteristics of SP episodes among university students.
Methods
A self-reported questionnaire was administered through the university’s email to students from Jordan. It inquired about SP, sleep hygiene, and perceived stress using the Unusual Sleep Experience Questionnaire, the Sleep Hygiene Index, and the Higher Educational Stress Inventory, respectively. In addition, frequency and episode features were measured, and students’ demographic data were gathered.
Results
A total of 455 students were enrolled in the study. Most participants exhibited good sleep hygiene (77.6%) but also reported high stress levels. The frequency of SP episodes was associated with the duration of the episodes, prone position, and multiple sleeping disorders. In contrast, no association was found with sleep duration, sleep latency, or the presence of multiple psychiatric disorders.
Conclusion
This study is the first to examine the characteristics of SP episodes and predictive factors among university students in Jordan, highlighting the importance of recognizing factors associated with SP. This study paves the way for more extensive research on students, particularly examining the effect of stress on different aspects of their lives that could predispose them to various medical conditions, including SP.
- Sharpless BA. A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatr Dis Treat. 2016;12:1761-1767. doi: 10.2147/NDT.S100307
- Iranzo A. Parasomnias and sleep-related movement disorders in older adults. Sleep Med Clin. 2018;13(1):51-61. doi: 10.1016/J.JSMC.2017.09.005
- Cheyne JA, Newby-Clark IR, Rueffer SD. Relations among hypnagogic and hypnopompic experiences associated with sleep paralysis. J Sleep Res. 1999;8(4):313-317. doi: 10.1046/J.1365-2869.1999.00165.X
- Farooq M, Anjum F. Sleep Paralysis. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2025.
- Olunu E, Kimo R, Onigbinde EO, et al. Sleep paralysis, a medical condition with a diverse cultural interpretation. Int J Appl Basic Med Res. 2018;8(3):137-142. doi: 10.4103/IJABMR. IJABMR_19_18
- Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2018;38:141-157. doi: 10.1016/J. SMRV.2017.05.005
- Hefnawy MT, Amer BE, Amer SA, et al. Prevalence and clinical characteristics of sleeping paralysis: A systematic review and meta-analysis. Cureus. 2024;16(1):e53212. doi: 10.7759/ CUREUS.53212
- Colombo C, Cellini N. Lifetime prevalence and characteristics of sleep paralysis in Italian university students population. Sleep Med. 2024;122:106-112. doi: 10.1016/J.SLEEP.2024.08.013
- Wróbel-Knybel P, Karakuła-Juchnowicz H, Flis M, et al. Prevalence and clinical picture of sleep paralysis in a polish student sample. Int J Environ Res Public Health. 2020;17:3529. doi: 10.3390/ ijerph17103529
- Muzammil MA, Syed AR, Farooq MH, et al. Frequency and factors of sleep paralysis among medical students of Karachi. Cureus. 2023;15(7):e41722. doi: 10.7759/cureus.41722
- Riaz M, Rabbani MH, Sabir MJ, Khan MA, Manzoor N, Chaudhry MN. Predictors of sleep paralysis and relationship of sleep paralysis with sleep quality in university students of Islamabad. J Pak Med Assoc. 2022;72(3):448-451. doi: 10.47391/ JPMA.1313
- Jalal B, Hinton DE. Sleep paralysis among Egyptian college students: Association with anxiety symptoms (PTSD, trait anxiety, pathological worry). J Nerv Ment Dis. 2015;203(11):871-875. doi: 10.1097/NMD.0000000000000382
- Benham G. Sleep paralysis in college students. J Am Coll Health. 2022;70(5):1286-1291. doi: 10.1080/07448481.2020.1799807
- Duarte JM, Lisi GR, Carroll BT, Garro MF, Appiani FJ. The prevalence of sleep paralysis in medical students in Buenos Aires, Argentina. J Neurosci Rural Pract. 2023;14(2):272-275. doi: 10.25259/JNRP_16_2022
- Ohaeri JU, Adelekan MF, Odejide AO, Ikuesan BA. The pattern of isolated sleep paralysis among Nigerian nursing students. J Natl Med Assoc. 1992;84:67-70.
- Lišková M, Janečková D, Klůzová Kráčmarová L, Mladá K, Bušková J. The occurrence and predictive factors of sleep paralysis in university students. Neuropsychiatr Dis Treat. 2016;12:2957-2962. doi: 10.2147/NDT.S115629
- O’Hanlon J, Murphy M, Di Blasi Z. Experiences of sleep paralysis in a sample of Irish university students. Ir J Med Sci. 2011;180(4):917-919. doi: 10.1007/S11845-011-0732-2
- Awadalla A, Al-Fayez G, Harville M, et al. Comparative prevalence of isolated sleep paralysis in Kuwaiti, Sudanese, and American college students. Psychol Rep. 2004;95(1):317-322. doi: 10.2466/PR0.95.1.317-322
- Paradis C, Friedman S, Hinton DE, McNally RJ, Solomon LZ, Lyons KA. The assessment of the phenomenology of sleep paralysis: The Unusual Sleep Experiences Questionnaire (USEQ). CNS Neurosci Ther. 2009;15(3):220. doi: 10.1111/J.1755-5949.2009.00098.X
- Costa J, Helou S, Sleilaty G, Costa T, El Helou J. Validity and reliability of an Arabic version of the Sleep hygiene index. Sleep Med. 2021;80:260-264. doi: 10.1016/J.SLEEP.2021.01.040
- Masha’al D, Hayajneh AA, Tawalbeh LI. Psychometric evaluation of the Arabic version of the higher education inventory scale for nursing students. BMC Psychiatry. 2021;21(1):1-13. doi: 10.1186/S12888-021-03082-9/TABLES/6
- Wróbel-Knybel P, Flis M, Rog J, Jalal B, Wołkowski L, Karakuła-Juchnowicz H. Characteristics of sleep paralysis and its association with anxiety symptoms, perceived stress, PTSD, and other variables related to lifestyle in selected high stress exposed professions. Int J Environ Res Public Health. 2022;19(13):7821. doi: 10.3390/ IJERPH19137821
- Ohayon MM, Zulley J, Guilleminault C, Smirne S. Prevalence and pathologic associations of sleep paralysis in the general population. Neurology. 1999;52(6):1194-1200. doi: 10.1212/ WNL.52.6.1194
- Stefani A, Högl B. Nightmare disorder and isolated sleep paralysis. Neurotherapeutics.
