Editing Sleep paralysis (section)

== Diagnosis ==
Sleep paralysis is mainly diagnosed via clinical interview and ruling out other potential [[sleep disorder]]s that could account for the feelings of paralysis.<ref name=":0" /><ref name=Goldstein /> Several measures are available to reliably diagnose<ref name="FISP" /><ref name=":7">{{cite book|title=Sleep Paralysis: Historical, Psychological, and Medical Perspectives|last=Sharpless, B., and Doghramji, K|publisher=Oxford University Press.|year=2015}}</ref> or screen (''Munich Parasomnia Screening'')<ref>{{cite journal|last1=Fulda|first1=Stephany|last2=Hornyak|first2=Magdolna|last3=Müller|first3=Karin|last4=Cerny|first4=Lukas|last5=Beitinger|first5=Pierre A.|last6=Wetter|first6=Thomas C.|date=2008-03-01|title=Development and validation of the Munich Parasomnia Screening (MUPS)|journal=Somnologie - Schlafforschung und Schlafmedizin|language=en|volume=12|issue=1|pages=56–65|doi=10.1007/s11818-008-0336-x|issn=1432-9123|doi-access=free}}</ref> for recurrent isolated sleep paralysis.

===Diagnosis===
Episodes of sleep paralysis can occur in the context of several medical conditions (e.g., narcolepsy, [[hypokalemia]]). When episodes occur independent of these conditions or substance use, it is termed "isolated sleep paralysis" (ISP).<ref name=":7" /> When ISP episodes are more frequent and cause clinically significant distress or interference, it is classified as "recurrent isolated sleep paralysis" (RISP). Episodes of sleep paralysis, regardless of classification, are generally short (1–6 minutes), but longer episodes also have been documented.<ref name="Cheyneninenine" />

It can be difficult to differentiate between [[cataplexy]] brought on by narcolepsy and true sleep paralysis, because the two phenomena are physically indistinguishable. The best way to differentiate between the two is to note when the attacks occur most often. Narcolepsy attacks are more common when the individual is falling asleep; ISP and RISP attacks are more common upon awakening.<ref name=FISP>{{cite journal |last1=Sharpless |first1=B. |last2=McCarthy|first2=K.|last3=Chambless|first3=D. |last4=Milrod|first4=B. |last5=Khalsa |first5=S. |last6=Barber |first6=J. |title=Isolated sleep paralysis and fearful isolated sleep paralysis in outpatients with panic attacks |journal=Journal of Clinical Psychology |year=2010 |volume=66|pages=1292–1306 |doi=10.1002/jclp.20724 |pmid=20715166 |issue=12 |pmc=3624974}}</ref>

===Differential diagnosis===

Similar conditions include:<ref name="Sharp2015">{{cite book |last1=Sharpless |first1=Brian A. |last2=Doghramji |first2=Karl |title=Sleep Paralysis: Historical, Psychological, and Medical Perspectives |date=2015 |publisher=Oxford University Press |isbn=978-0-19-931380-8 |pages=170–181 |url=https://books.google.com/books?id=DNymCAAAQBAJ&pg=PP1 |language=en}}</ref>
* [[Exploding head syndrome]] (EHS) potentially frightening parasomnia, the hallucinations are usually briefer and always loud or jarring. There is no paralysis during EHS.
* [[Nightmare disorder]] (ND); also REM-based parasomnia.
* [[Sleep terrors]] (STs) are potentially frightening parasomnia, but are not REM based and there is a lack of awareness to surroundings, characteristic screams during STs.
* [[Noctural panic attacks]] (NPAs) involve fear and acute distress but lack paralysis and dream imagery.
* [[Post-traumatic stress disorder]] (PTSD) often includes scary imagery and anxiety but not limited to sleep-wake transitions.