Prisoners of the Body: The Link Between Interoception and Sleep Paralysis
You wake up. Your eyes are open. You see the familiar contours of your bedroom ceiling. But you cannot move. Not your arms, not your legs, not a single finger. You try to scream, but no sound escapes. A shadowy figure looms in the corner of your vision, and a crushing weight presses against your chest. The fear is visceral, primal, absolute.
For roughly one in four people, this is not a nightmare. It is sleep paralysis, a temporary but terrifying condition that blurs the line between sleep and wakefulness. A new study published in the Journal of Sleep Research (DOI: 10.1111/jsr.70393) by researchers at Sapienza University of Rome and the University G. d’Annunzio of Chieti-Pescara offers a fresh explanation for why some people experience it and others do not.
The answer, it turns out, may lie in how closely we listen to our own bodies.
What They Found
The researchers, led by Giacomo Forte, surveyed 210 adults from the general Italian population to investigate the psychological and sleep-related factors associated with sleep paralysis. They asked participants about their sleep quality, insomnia symptoms, anxiety levels, and interoceptive sensitivity, a measure of how attuned a person is to internal bodily signals such as heartbeat, breathing, hunger, and tension.
One in four participants, 25 percent, reported having experienced at least one episode of sleep paralysis in their lifetime. The most commonly described sensations matched the classic portrait of the phenomenon: an inability to move or speak, tingling sensations, sealed eyelids, vivid and often frightening cognitive scenes, the felt presence of another being in the room, and an overpowering fear of death.
What surprised the researchers was what did not correlate with sleep paralysis. Contrary to earlier findings, sleep paralysis was not significantly tied to poorer overall sleep quality or chronic anxiety. The experience does not appear to be simply a symptom of a restless night or a worried mind.
Instead, sleep paralysis was associated with two specific factors: symptoms of insomnia and, most strikingly, heightened interoceptive sensitivity. People who reported sleep paralysis scored higher on measures of body awareness. They were more likely to notice subtle bodily cues, to use those cues to regulate their attention and emotions, and to feel distressed by physical sensations that others might ignore.
Why It Matters
Interoception, the sense of the internal state of the body, is sometimes called the “hidden sense.” It is what tells you that your heart is racing, that you are hungry, that you need to breathe deeper. It operates below the level of conscious thought, but it shapes our emotional experience and our sense of self in profound ways.
The study suggests that individuals with heightened interoceptive sensitivity may be especially vulnerable to sleep paralysis because they are more aware of, and more reactive to, the unusual bodily states that occur during REM sleep. During rapid eye movement sleep, the brain paralyzes the body’s voluntary muscles to prevent us from acting out our dreams. This state is called REM atonia. Normally, it fades as we wake up. But in sleep paralysis, the atonia persists into wakefulness, leaving the conscious mind trapped inside a body that will not obey commands.
A person with high interoceptive sensitivity may detect this state of paralysis more acutely and interpret it as threatening, which in turn amplifies the fear and the sense of helplessness that define the experience. The result is a self-reinforcing loop: the more you notice the paralysis, the more frightening it becomes, and the more frightening it becomes, the more you notice it.
The authors frame this in compelling terms. Sleep paralysis, they suggest, may emerge where the boundaries among body, sleep, and consciousness become blurred. It is not merely a sleep disorder. It is a breakdown in the usual architecture of self-awareness, a moment when the brain can no longer distinguish between being asleep and being awake, between signals from the outside world and signals from within.
This perspective has practical implications. Current treatments for sleep paralysis often focus on improving sleep hygiene, reducing stress, and addressing underlying sleep disorders. The new findings suggest that interoceptive sensitivity itself could be a therapeutic target. Cognitive and behavioral interventions that help people reinterpret bodily signals, such as mindfulness-based approaches or interoceptive exposure therapy, might reduce the frequency or intensity of episodes by changing how people relate to the sensations that accompany REM-to-wakefulness transitions.
Limits
The study has limitations that deserve attention. The sample of 210 adults, while adequate for statistical analysis, is relatively small and drawn from a single country. Larger and more diverse samples will be needed to confirm whether the findings generalize across different populations and cultural contexts. The survey relied on self-reported data, which can be influenced by memory bias and the subjective interpretation of experiences. People who are highly attuned to their bodies might be more likely to remember and report sleep paralysis episodes, which could inflate the apparent association.
Importantly, the study is cross-sectional, meaning it captures a snapshot in time. It cannot establish whether heightened interoceptive sensitivity causes sleep paralysis, whether sleep paralysis increases interoceptive sensitivity, or whether a third factor, such as a shared neurological predisposition, underlies both. Longitudinal studies that track people over time will be necessary to disentangle cause from correlation.
Additionally, the study measured interoceptive sensitivity through questionnaires rather than objective physiological tasks, such as heartbeat detection tests. While questionnaires are a valid tool, they capture subjective beliefs about body awareness rather than actual perceptual accuracy.
The Bottom Line
Sleep paralysis is not just a strange thing that happens in the middle of the night. It is a window into the relationship between the body and the conscious mind. This study adds an important piece to the puzzle by showing that people who experience sleep paralysis are not necessarily worse sleepers or more anxious people. They are people who feel their own bodies more intensely, for better and for worse.
The same sensitivity that may make sleep paralysis more terrifying could, in other contexts, be a gift. Heightened interoceptive awareness has been linked to better emotional regulation, greater empathy, and a stronger sense of embodied presence. The challenge, for those who suffer from sleep paralysis, is learning to turn down the volume on that inner signal without losing its richness entirely.
As Forte and his colleagues put it, the experience of sleep paralysis represents a “dissociation between body and mind,” a rupture in the normally seamless integration that makes us feel like unified selves. Understanding the mechanisms behind that rupture is not just about treating a sleep disorder. It is about understanding what it means to be embodied in the first place.
Source
Forte G, Giaccari D, Favieri F, Casagrande M. (2025). Interoceptive Sensitivity and Sleep Paralysis: A Study of Body Awareness in REM Sleep Dissociation. Journal of Sleep Research, e70393. DOI: 10.1111/jsr.70393. PMID: 42283104.