Are some cases of sleep paralysis an expression of a dissociative condition? Dramatic resolution of sleep paralysis in an adolescent after administration of aripiprazole

Recurrent isolated sleep paralysis (SP) is characterized by an inability to perform voluntary movements at sleep onset (hypnagogic) or at sleep offset (hypnopompic) in the absence of a diagnosis of narcolepsy. Consciousness is preserved with full recall of the event. An episode of sleep paralysis lasts seconds to minutes and usually resolves spontaneously. Other features of sleep paralysis may include auditory and visual hallucinations, a sense of pressure on the chest, and high prevalence of depression which has led to the hypothesis that it is an atypical symptom of depression. This hypothesis is supported by studies showing that specific antidepressants can relieve the symptoms of SP [1]. An early study reported three cases of isolated sleep paralysis controlled by L-tryptophan with or without amitriptyline (both increased CNS 5- hydroxytryptamine [5-HT] availability) while imipramine showed no efficacy because it predominantly affects norepinephrine reuptake [2]. We report the case study of a 15 year old girl with sleep paralysis and dissociative disorder successfully treated with aripiprazole.