Explanations of sleep paralysis among Egyptian college students and the general population in Egypt and Denmark

Method

Participants

The three population groups included were Egyptian individuals (n = 89) recruited in Cairo, Egypt; Danish individuals (n = 59) recruited in Copenhagen, Denmark; and Egyptian undergraduate college students (n = 44) recruited from the American University in Cairo, a private university located in Cairo, Egypt (see Table 1). The participants from all three research sites had experienced SP at least once in their lifetime.

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Table 1.

Demographic characteristics of sample.

Site	n	Male	Age		Education
		n (%)	M (SD)	RNG	M (SD)	RNG
Denmark	59	32 (54)	24.9 (9.0)	18-55	16.5 (4.8)	11-44
Egypt	89	59 (66)	28.2* (8.6)	18-67	12.7** (4.8)	0-28
The American University in Cairo	44	16** (36)	20.0 (1.5)	18-24	15.5 (1.6)	12-20

Note. In the Danish sample, two participants were Norwegian nationals, and one a Swedish national, but as they were currently residing in Denmark they were not excluded from the analyses. RNG = range.

*

p < .05; **p < .01.

Results

Case Example 1: Salma’s sleep paralysis episode as a spiritual experience

Salma, a 20-year-old psychology major at the American University in Cairo, was fluent in English and came from an affluent household in Cairo, Egypt. She had experienced SP several times, but one episode stood out in her memory as particularly frightening. During this episode, she initially felt the presence of an intruder in her bedroom, and suddenly, out of nowhere, as she described it, she saw a creature that looked like “something out of a horror movie,” with fangs and a face stained with blood, standing next to her bed. Her immediate reaction was to recite verses from the Qur’an. During the SP episode, she also had an out-of-body experience, during which at one point she felt that she was floating outside her body and seeing herself lying in bed, terrified.

After this event, Salma learned about SP on the Internet. ⁶ The fact that SP usually occurred when she was exhausted and/or sleep deprived, initially made her consider a scientific explanation of the phenomenon. However, for Salma, the subjective experience of being completely paralyzed, the encounter with the bizarre-looking “bedroom intruder” and the out-of-body experience were just too strange and peculiar to be products of the brain. Moreover, she explained that the longer she engaged in Qur’anic recitation during SP episodes, the more she felt a tightening in her chest to the point that she sometimes felt that she was suffocating. For Salma, this was another indication that SP is a spiritual experience. As a Muslim, she had been told since childhood that the Jinn exist. Therefore, she rationalized that it was natural for her to conclude that a Jinn was somehow involved in her SP episodes. The 6–8 times that Salma experienced SP, she always had a strong feeling that a Jinn was present in her bedroom. Salma also believed that the frightening creature she saw during one particular episode of SP might have been a manifestation or projection of a Jinn.

Case Example 2: Ahmad’s reconciliation of beliefs

Ahmad was 28 years old and previously was a student in the English Department of the American University in Cairo. ⁷ Ahmad comes from a middle-income household and lives with his mother in downtown Cairo.

Ahmad frequently experienced SP, often accompanied by hallucinoid experiences, both when falling asleep and upon awakening. His most severe episodes of SP occurred when he was a college student, and during certain periods he experienced SP nearly every day—particularly around exam time when he was both highly anxious and his sleeping pattern was disrupted. The hypnopompic and hypnagogic hallucinations that accompanied Ahmad’s SP episodes included out-of-body experiences, sensing an evil presence, auditory hallucinations, such as hearing frightening voices calling his name and footsteps, and visual hallucinations, such as seeing “ugly” and intimidating humanoid figures hovering over him.

When Ahmad was around 20, he experienced his most frightening episode of SP, during the holy month of Ramadan: ⁸ it was 6:00 a.m. and he had just come home from congregational prayer at the local mosque, when he decided to take a nap. After falling asleep, he felt a heavy weight on his chest. When he opened his eyes, he felt as if something was holding both of his arms down and pressing heavily on his throat. Ahmad, believing that he was being attacked by the Jinn, tried to recite verses from the Qur’an, but was unable to do so. He also felt as if his legs were swirling in the air, being pulled up and down by an invisible force while simultaneously having the sensation of being sexually molested to the point of ejaculation. ⁹ A few minutes into the episode, Ahmad was finally able to recite a few Qur’anic verses, and was instantly able to move, and return to a normal state of wakefulness.

Ahmad was in shock and overwhelmed with disbelief over what had happened to him. He was certain that he had been attacked by the Jinn, but could not understand how that was possible during the holy month of Ramadan (i.e., Islam teaches that the malevolent Jinn are “chained up” during Ramadan and are thus unable to harm humans ¹⁰ ). Eager to find out why he had been attacked, he decided to visit a large mosque known to host Muslim priests and scholars from the famous Al-Azhar University ¹¹ in Cairo. There, he consulted a Muslim priest about his experience. The priest explained that although the most malevolent type of Jinn (also known as Maarid ¹² ) are unable to harm humans during the month of Ramadan, other types of “less-evil” Jinn are still able to attack humans. He also advised Ahmad that he should engage in Qur’anic recitation to keep the Jinn away, and stressed the importance of engaging in acts of worship such as regular prayer and frequent supplication.

Several years later, having read scientific literature on the topic of SP on the Internet, Ahmad no longer believes that SP is caused by Jinn attacks. Instead he believes that SP occurs as a result of “neurological factors at the level of the brain.” However, consistent with the teachings of Islam, he also believes that sleep ¹³ itself is a gateway to the spiritual world where the soul ¹⁴ is temporarily disconnected from the body and projected into another realm of existence (a spiritual realm inhabited by other souls, angels, and the Jinn). Thus, while SP is caused by neurological triggers, the experience of being “partially awake and partially asleep,” as Ahmad put it, may constitute an alternative state of being where there is no longer a clear line between the material world and the spiritual world. This, for example, explains his out-of-body experiences during SP (i.e., he is supposedly observing his body from the perspective of his soul). For Ahmad, thinking about SP in this way enabled to reconcile the strange nature of his SP, his Islamic beliefs about sleep, and his growing understanding of the scientific literature on the topic.

Case Example 3: Sulaiman the believer

Sulaiman was 30 years old and lived with his family in a poor neighborhood in the Giza area of Cairo. He worked as an Imam ¹⁵ in a nearby mosque. Sulaiman earned around US$80.00 a month, making it difficult for him to provide for his wife and son. He described himself as a firm believer in the Islamic faith and had memorized the entire Qur’an from beginning to end.

When Sulaiman was 19, he was imprisoned for 4 years, accused of being affiliated with a militant organization working to overthrow the former Egyptian government. During the first few months in prison, he was kept blindfolded in a dark, dirty, and poorly ventilated room and was frequently beaten and subjected to electric shock and other means of torture. This experience took a toll on Sulaiman and, after his release. To this day, he experiences recurrent flashbacks and nightmares of the events and becomes highly distressed and fearful when confronted with cues that remind him of his traumatic experience (e.g., police officers and dark rooms etc.).

In prison, Sulaiman began to experience frequent episodes of SP; that is, while he had experienced SP only a few times before being imprisoned, he believed he might have had up to 200 episodes of SP during his prison years alone (i.e., roughly 50 episodes a year).

Sulaiman believed that SP is most likely caused by an attack by the Jinn and that the shadow-like figure he sometimes saw approaching his body during SP was the Jinn itself. When SP occurred without the presence of this shadow-like figure, it simply meant that the Jinn was appearing in its original invisible form (i.e., as a spirit). Sulaiman’s SP episodes mostly occurred when he was fearful or distressed. He was aware that this was consistent with the teachings of many Islamic scholars who note that the Jinn are more likely to attack humans when they are in a state of excessive fear, distress, or anger (Ash-Shahawi, 2009).

As prevention against SP, Sulaiman always recited a specific verse from the Qur’an, ¹⁶ which eventually made the attacks subside, enabling him to move freely again. Sulaiman once consulted a Muslim priest about his SP who advised him to recite Qur’anic verses over a bucket of water, then pour the water over his body as protection against the Jinn. (This traditional Islamic practice is known as Ruquah and is usually used when someone is believed to be under a spell or affected by black magic17) Sulaiman abandoned this practice when he felt that it did not help prevent SP.

While Sulaiman was not aware of any Islamic literature teaching that SP is caused by the Jinn, given his personal experience of the phenomenon, this was the causal interpretation he believed to be closest to the truth. However, Sulaiman (who was not familiar with the English language) acknowledged that he had not yet come across any other causal explanation for SP. By contrast, the few times he mentioned SP to his friends and family, they too confirmed that they thought the phenomenon was caused by the Jinn.

Discussion

As hypothesized, we found that participants from the general Egyptian population were more likely to endorse supernatural causes of SP compared to participants from Denmark. Likewise, Wing et al. (1994) found that 16% of Chinese college students in Hong Kong attributed SP to supernatural causes. However, Yeung et al. (2005) found that psychiatric patients from China were not more likely to subscribe to supernatural causal explanations of SP compared to Chinese psychiatric patients residing in the US. Yeung et al. (2005) argued that this finding might stem from globalization effects, modernization, and Westernization (see also, Tamney & Chang, 2002). Cairo is a cosmopolitan city visited by many tourists every year, and similarly to China, Egypt is experiencing rapid globalization (Kuppinger, 2005). In this respect, one possible explanation for the widespread persistence of supernatural explanations of SP in Cairo, Egypt, could be the resurgence of religious thought sweeping through Egyptian society over the last three decades (Abdo, 2000), providing preconceived ideas about the world and shaping sociocultural and cognitive frameworks. However, a more likely explanation, according to Yeung et al.’s (2005) findings, is that the psychiatric patients included in the study were interviewed by psychiatrists. Under such circumstances, patients may not disclose or admit to supernatural explanations, whereas they may be more likely to espouse such views in a different setting (Yeung et al., 2005).

As expected, student participants from the American University in Cairo were less likely to endorse supernatural causes of their SP than were participants from the general Egyptian population. This finding is not surprising considering that students from the American University in Cairo are under the influence of secular and Western-style education, are instructed in English and have more exposure to Western culture, and may have more training in scientific inquiry than the general population. In the present study, several student participants explained that initially they were unsure about the cause of their SP but after searching the Internet, they adopted a more scientific view of SP. However, several student participants did not abandon their supernatural causal explanation of the phenomenon (e.g., as being caused by Jinn assaults). These participants argued that the subjective experience during SP was too “real” and “bizarre” to be explained by a physiological event. This trend has also been found in Western cultures. For example, Hufford (2005) reported that many SP sufferers in the US do not find it difficult to reconcile scientific explanations of SP with their spiritual interpretation of the phenomenon.

While participants from the American University in Cairo were less likely to ascribe supernatural causes to their SP compared to participants from the general Egyptian population, they were marginally significantly more likely to endorse supernatural causes of SP compared to participants from Denmark. This suggests that while students from the American University in Cairo might be more prone to adopt a Western and secular attitude towards SP compared to Egyptians from the general population, they are still influenced by the sociocultural framework of greater Egyptian society. For instance, while Egyptian students chiefly held that SP was caused by stress (25%), fatigue (14%), and other psychological (20%) and physiological factors (11%), the most frequent spiritual causal explanation provided by students from the American University in Cairo, similarly to participants from the general Egyptian population, was the Jinn (11%).

Perhaps the most striking finding was that as many as 48% of participants from the general Egyptian population believed their SP to be caused by Jinn assaults. This culturally related interpretation of SP is salient in this region of the world and is likely to be associated with the tendency, since the 1980s, of many Egyptians to identify with traditional Islamic thought (Abdo, 2000). In this respect, it is noteworthy that the belief in the Jinn is well-ensconced within Islamic cultural heritage (Al-Ashqar, 2005), its roots reaching back to early Islamic literature and tradition. For instance, the sacred text of Islam, the Qur’an, has an entire chapter dedicated to the topic of the Jinn (Soraah al-Jinn, or in English, the chapter of the Jinn). Similarly, the earliest adherents to the Muslim faith are said to have exorcised people possessed by the malevolent Jinn; in Islamic literature, there are many detailed descriptions of the Prophet Muhammad exorcizing individuals believed to be possessed by the Jinn, for instance, by reciting verses from the Qur’an over the afflicted individual (Philips, 1989).

However, that being said, it is also important to note that there are no Qur’anic verses or prophetic narrations that specifically link Jinn attacks to SP (i.e., being paralyzed upon falling or awaking from sleep). By contrast, many of the participants from both Egyptian samples would often remark that despite the fact that such attacks are not mentioned in religious texts, SP is precipitated by the Jinn. They found themselves compelled to believe that this was due to the subjective nature of their experience, even prior to consulting others about their SP, and, as mentioned, in some cases even after reading scientific explanations of SP on the Internet. In fact, as has been found in Western cultures (Hufford, 2005), experiencing SP became a reason for many Egyptian participants to strengthen their faith in Islam.

One manifestation of this religious conviction was the tendency to resort to traditional Islamic healing practices as prevention from “Jinn attacks.” For example, the vast majority of participants (95%) who thought their SP was caused by the Jinn would engage in Qur’anic recitation during SP to protect themselves from these assaults. In Islamic tradition, it is a well-known custom to recite verses from the Qur’an as a means of protecting oneself from the evil and malevolent Jinn (Al-Ashqar, 2005). As one classic Muslim scholar notes, “The best means which help may be sought against a jinn … is remembrance of God [i.e., prayer] and recitation of the Qur’an” (Al-Ashqar, 2005, p. 205). This well-established religious tradition may thus help explain why the local Muslim priests so frequently (90%) would advise SP sufferers to recite verses from the Qur’an during SP as a means of protection from the Jinn.

The Muslim priest would, in many cases (55%), counsel the SP sufferer to perform the five daily prayers prescribed by the Muslim faith, as a way of protecting oneself from the Jinn. This view is also consistent with the teachings of many classic and contemporary Muslim scholars (Al-Ashqar, 2005; Philips, 1989), who argue that one way to ensure divine protection against attacks from the spirit world and the Jinn, is adherence to religious practices as formulated in the Qur’an. The most important of the practices is prayer (the second pillar of the Muslim faith). On the contrary, it is held that Muslims who are not practicing the tenets of their faith, for instance by abandoning prayer, are particularly vulnerable to attacks by the Jinn. In light of this, it is interesting that several participants mentioned that their SP only occurred on nights when they were so exhausted after returning from work that they failed to pray before going to sleep. While it is well known that fatigue can contribute to the occurrence of SP (Fukuda, Miyasita, Inugami, & Ishihara, 1987), for an individual lacking scientific understanding of SP, the fact that episodes usually occurred when he/she has not prayed might be interpreted as evidence that the failure to pray had made him/her vulnerable to Jinn attacks. Experiences such as these are likely to contribute to the maintenance of religiously based interpretations of SP among Egyptians.

It is also worth noting that participants who thought SP was caused by the Jinn, and likewise experienced hypnopompic or hypnagogic hallucinations, would in the majority of cases (75%) explicitly report that the Jinn had a malevolent nature. This suggests that SP, similarly to what has been found in other cultures, is chiefly an unpleasant experience and a source of distress for the sufferer (Hinton, Pich, et al., 2005; Hufford, 2005). In addition, 22% of participants from the general Egyptian population attributed SP to the Shaitan (demons). While the Shaitan, in Islamic literature, are often understood to be synonymous with the evil-natured or malevolent Jinn (Philips, 1989), it was unclear whether any of the participants in our study referred to the two supernatural beings synonymously; when several participants were asked whether the Shaitan were equivalent to the Jinn, they responded that they were not sure.

Finally, several participants in this study (four participants in the sample from Denmark and one participant from the general Egyptian population) believed that although SP is primarily a physiological event caused by mechanisms in the brain, stress or fatigue, etcetera, it still might have some supernatural quality attached to it (e.g., as manifested in symptoms such as out-of-body experiences, and/or “a threatening presence”). An example of such a dual interpretation of SP is provided in the second case example. In this case, the individual abandoned his spiritual causal explanation of SP as Jinn attacks after reading about SP on the Internet, but still maintained that SP was a gateway to a spiritual realm. This observation is consistent with the findings of Hufford (2005), who likewise noticed how some SP sufferers in the US attempted to reconcile scientific and spiritual explanations of SP, often by incorporating scientific explanations into their already established supernatural beliefs about the experience.

This study has several limitations. First, the generic expression “Western” or “Western culture” used in this paper to contrast secular/scientific and religious meaning systems is problematic. For example, people may more readily admit to supernatural explanations of SP in a “Western” country like the US, where religion and spirituality are more acceptable, versus a place like Scandinavia, where religion, especially outward expression of religion, is less accepted as a cultural norm. Methodological limitations of this study include the small sample sizes. Also, there was a higher proportion of female participants in the student sample compared to the Egyptian and Danish general population samples. Moreover, the snowball sampling method employed in this study is likely to yield a homogenous sample, and thus potentially biased data. Additionally, explanations of SP were not examined in an in-depth manner. For example, it would have been illuminating to investigate why so many well-educated Egyptians arrive at the conclusion that SP is caused supernaturally by the Jinn, and the factors contributing to the maintenance of this explanatory framework. Similarly, it would be interesting to examine the distinctions between the Jinn and the Shaitan in relation to SP. Finally, future research can examine the prevalence and cultural meanings of supernatural causal explanations for SP, and particularly to what extent interpreting SP as caused by the Jinn, occurs in other Arabic-speaking and/or Muslim-majority countries in the region.

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Table 2.

Common causal explanation of SP across three sites.

Denmark		Egypt		The American University in Cairo
(n = 59)		(n = 89)		(n = 44)
Causal explanation	n	%	n	%	n	%
Physiological factors (not specified)	27	46	3	3	5	11
Brain and the nervous system	7	12	0	0	0	0
Fatigue	2	3	0	0	6	14
Psychological factors (not specified)	3	5	10	11	9	20
Stress	5	8	4	4	11	25
Sleep problems/nightmares	7	12	1	1	0	0
The Jinn (i.e., genies)	0	0	43	48	5	11
The Shaitan (i.e., demons)	1	2	20	22	1	2