What could cause sleep paralysis and night sweats?

Question

Hello doctor,

I am a 19-year-old female, 5'0" feet, currently taking Vilazodone, Aripiprazole, Quetiapine, and Prazosin. I experience intense, violent, lucid nightmares every night, often accompanied by sleep paralysis and night sweats.

In my dreams, I frequently find myself flying above my room, looking down on everything, with recurring themes of blood and death. Additionally, I experience piercing ear-ringing noises that resemble an aftershock, which makes my head feel like it's dilating and causes numbness in my hands and feet.

Could these symptoms be related to my medication, or is there another underlying cause?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

It sounds like you are experiencing severe lucid nightmares, sleep paralysis, night sweats, and sensory disturbances such as ear ringing and numbness. Given your medications (Vilazodone, Aripiprazole, Quetiapine, and Prazosin), here are some possible explanations and next steps:

Possible causes

Medication side effects:

Quetiapine (Seroquel) and Aripiprazole (Abilify) can contribute to vivid dreams, nightmares, and sleep disturbances.
Vilazodone (Viibryd) is known to cause intense, bizarre dreams and night sweats in some individuals.
Prazosin, often used for PTSD (post-traumatic stress disorder)-related nightmares, typically helps reduce them, but if it’s not effective for you, a dosage adjustment may be needed.
Sleep paralysis & lucid nightmares: Sleep paralysis often occurs due to disrupted REM (rapid eye movement) sleep, which your medications may influence. The sensation of flying, seeing your room from above, and recurring imagery of blood and death suggest heightened REM sleep activity with possible hallucinations.
Neurological or circulatory issues (ear ringing, numbness, headaches): Ear ringing (tinnitus) and numbness in your hands and feet could be related to side effects from medication, blood pressure changes, or migraines. Quetiapine and Aripiprazole can affect blood pressure and circulation, potentially causing numbness. Vilazodone withdrawal can lead to "brain zaps," headaches, and sensory disturbances.

What you can do?

Consult your doctor ASAP(as soon as possible):

Your nightmares and sleep disturbances are severe and could be linked to your medication combination.
Ask if adjusting Prazosin (or trying an alternative) might help.
Discuss whether modifying or switching Quetiapine or Vilazodone could reduce symptoms.

Improve sleep hygiene:

Consider melatonin (consult your doctor first) or meditation apps to help regulate REM sleep.
Reduce screen time before bed.
Keep a sleep diary to track patterns and changes.

Rule out other conditions:

A neurologist might assess whether the ear ringing, numbness, and headaches are linked to migraines or circulation issues.

Since these symptoms are persistent and significantly impact your sleep, it is crucial to discuss them with your doctor. Would you like help preparing specific questions for your next appointment?

I hope this information helps you.

Please let us know if you have any further queries.

Thank you.