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P12 Treating sleep paralysis: setting up a service to provide group cognitive behavioural therapy for sleep paralysis at the royal london hospital for integrated medicine
  1. Susan Cross and
  2. Hugh Selsick
  1. Royal London Hospital For Integrated Medicine, University College London Hospitals NHS Trust, UK


Introduction The insomnia team at the Royal London Hospital for Integrated Medicine (RLHIM), part of UCLH, is the largest NHS provider of Cognitive Behavioural Therapy for insomnia (CBTi). As part of our service development plans we are expanding the courses of treatment we offer.

It is estimated that 8% of people experience Isolated Sleep Paralysis at least once in their life. Episodes can occur just after falling asleep or upon waking, and are characterised by a temporary inability to move, often accompanied by terrifying hallucinations, and the feeling of suffocation.

The aims of our therapy are to reduce patient’s fear and anxiety, reduce the frequency and duration of episodes, and make each episode less distressing.

Method During the COVID pandemic, our CBTi service moved from face-to-face to group sessions over zoom. The Sleep Paralysis groups were introduced in 2022, running on similar lines, incorporating treatment plans suggested by Sharpless and Doghramji.1 Our Sleep Paralysis therapy course consists of 4 hour-long sessions covering education about the condition and the underlying physiology, sleep hygiene, diaphragmatic breathing, disruption techniques and strategies to manage hallucinations. Each session ends with ‘homework’ – techniques for patients to practice daily.

Results To date we have run 4 small groups of up to 4 patients, with a growing waiting list with 37 referrals in 2022, and 20 in the first 6 months of 2023

Discussion Therapy is well received by patients, who welcome the opportunity to talk about their condition with people who understand their experiences. Patients would like the addition of a face-to-face session to facilitate more peer support. Therapists would like face-to-face sessions to improve practical training for diaphragmatic breathing.

Conclusion Further work is needed to identify appropriate outcome measures, or to develop a new measure.


  1. ‘Sleep Paralysis: Historical, Psychological, and Medical Perspectives’ Brian A Sharpless and Karl Doghramji; 2015, Oxford University Press ISBN 978-0-19-931380-8

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