Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection

Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection

Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection

Sleep Paralysis: Night-Mares, Nocebos, and the Mind-Body Connection


Sleep Paralysis explores a distinctive form of nocturnal fright: the "night-mare," or incubus. In its original meaning a night-mare was the nocturnal visit of an evil being that threatened to press the life out of its victim. Today, it is known as sleep paralysis-a state of consciousness between sleep and wakefulness, when you are unable to move or speak and may experience vivid and often frightening hallucinations. Culture, history, and biology intersect to produce this terrifying sleep phenomenon. Although a relatively common experience across cultures, it is rarely recognized or understood in the contemporary United States.

Shelley R. Adler's fifteen years of field and archival research focus on the ways in which night-mare attacks have been experienced and interpreted throughout history and across cultures and how, in a unique example of the effect of nocebo (placebo's evil twin), the combination of meaning and biology may result in sudden nocturnal death.


On a winter morning in early January 1981, Xiong Tou Xiong, a twenty-nineyear-old man, was found dead in the bed of his Portland, Oregon home. He had not been ill; his death was sudden and unexpected. Two days later, Yong Leng Thao, a forty-seven-year-old man, died on the way to a Portland hospital after his wife found him lying in his bed, unresponsive (Davidson 1981). He had been up late watching television with an uncle and had gone to bed after midnight, briefly waking his wife. Both were soon asleep. “Then came his labored breathing, so loud that it awakened her. She shook him. … [In the] next moments of horror, she realized that she could do nothing more” (Curry 1981, B16).

Both of the men who died were Laotian Hmong refugees who had recently immigrated to the United States. Their deaths were brought to the attention of Larry Lewman, the medical examiner of Multnomah County. In reviewing recent reports, Lewman soon found two additional cases of sudden, unexpected death. Searching for further clues, he telephoned the coroner’s office in St. Paul, Minnesota, a city in which, like Portland, many Southeast Asian refugees had settled. As forensic scientist Michael McGee recalls, he was told: “We have a large Southeast Asian population here, and we can’t figure out what’s happening. We have no idea why these people are dying. Would there be any chance you guys are experiencing the same thing?” (Meier 2004).

In fact, death records in St. Paul showed that four Laotian Hmong refugees had died suddenly in their sleep. A mysterious pattern was beginning to emerge: all of the victims had died unexpectedly; all were men between the ages of twenty-five and fifty; all were apparently healthy; and all had died while they were asleep. Also, in all cases for which autopsies had been conducted, findings were negative.

Sudden deaths among the Hmong continued throughout the mid-1980s, but no medical cause could be found. In 1986, when I first learned of the . . .

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