Association Between Sleep Quality and Sleep Paralysis Among College Students: A Cross-Sectional Study

Abstract:

Background and Objective: Sleep paralysis (SP) is a parasomnia characterized by temporary muscle atonia during sleep-wake transitions, often accompanied by vivid hallucinations and intense fear. College students are more susceptible to SP due to irregular sleep schedules, high academic stress, and psychosocial pressures. The aim of this research is to investigate the association between sleep quality and the prevalence of SP among college students and identify key predictors influencing its occurrence. Methods: A cross-sectional study was conducted involving 203 undergraduate students aged 18-24 years. Data were collected using validated tools, including the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and the Waterloo Unusual Sleep Experiences Questionnaire (WUSEQ) for SP evaluation. Descriptive statistics and multiple regression analyses were performed. Results: SP prevalence was found to be 41.2%. Poor sleep quality (PSQI > 5) significantly increased SP frequency (OR = 2.48, 95% CI: 1.72-3.58, p<0.001). Stress levels (β = 0.34, p<0.001) and irregular sleep schedules (β = 0.31, p<0.001) were major predictors. Visual hallucinations were experienced by 52.5% and auditory hallucinations by 46.4% of respondents reporting SP. Conclusion: Poor sleep quality strongly correlates with SP in college students. Interventions targeting sleep hygiene, stress management, and awareness are essential to mitigate its impact. Implications: Institutions should implement health programs addressing sleep hygiene and mental health to reduce the prevalence and impact of SP, promoting overall student well-being. Keywords: Sleep paralysis, Sleep quality, College students, Stress management, Hallucinations.

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