A detail from a printed page, the paragraph titled "History of the nightmare."

Night-Mares in the Stacks

By Nicole Baker ~

For centuries, sleep paralysis has afflicted people around the world. Known colloquially in English as “old hag” syndrome, sleep paralysis has been given many names, but it is often believed to be caused by a malevolent creature from beyond the veil, attacking sleeping victims. Science has more recently attempted to explain this phenomenon as waking during REM sleep, when the body is naturally paralyzed to prevent it from enacting dreams. In this state of being partially conscious and paralyzed, individuals can also experience auditory and visual hallucinations. The term nightmare can be derived from the Middle English word “mare,” meaning a female evil spirit, thought to lie upon and suffocate sleepers. Throughout history, records of this phenomenon have included nightmare spirits that may take the form of an old woman, a black dog, or even, as in this scene by Swiss artist Henry Fuseli, an ape arriving on his ghastly steed.

A woman lies on her back, head and shoulders hanging off the bed, an ape like creature sits on her chest and a horse's head looks on through a curtain.
“The Nightmare” by Henry Fuseli, 1781
Wikimedia Commons

This famous painting from Fusili’s vivid imagination was a sensation and has remained powerful and popular.

A young woman has fainted and is lying over the edge of a bed; a devil is sitting on her lap, and a horse's head is peeking through the bed curtains.
Engraving based on “The Nightmare” by Henry Fuseli in Medical Advisor and Guide to Health and Long Life, No. 9, 1824
National Library of Medicine #101449084

Fusili himself painted another version and there have been many derivatives.

An illustraton of a man with long wavy hair and a mustache.
Isbrand Diemerbrock, etching
National Library of Medicine #101412454

The earliest written account of sleep paralysis with hallucinations was published in 1664 by Dutch physician Isbrand Van Diemerbroeck, an accomplished physician and author who published on multiple subjects. His most popular book, Tractatus de pest, on the Black Death, was reprinted nine times and translated from Latin into both Dutch and English. The work was based on his experiences working in Nijmegen, the oldest city in the Netherlands, during the 1635 epidemic. Like many 17th-century people he believed the plague was a punishment dealt by God for sins of the people of the Netherlands.

He was also known for his work on anatomy and he attempted to assign an anatomical cause to the episodes of sleep paralysis he encountered. He related the case of an otherwise healthy fifty-year-old woman who:

“…sometimes believed the Devil lay upon her and held her down, sometimes that she was choaked by some great Dog or Thief lying upon her breast, so that she could hardly speak or breath, and when she endeavoured to throw off the burthen, she was not able to stir her members” (Diemerbroeck 183).

A detail from a printed page, the paragraph titled "History of the nightmare."
The Anatomy of Human Bodies; comprehending the most modern discoveries and curiosities in that art, by Isbrand Diemerbrock, 1694
National Library of Medicine #2332037R

He theorized that while lying in a supine position to rest, the hinder ventricle of the brain near the spine would be compressed, impacting the muscles and causing difficulty breathing, making it difficult to move and increasing pressure on the brain. His suggested preventative treatment for this patient involved blood-letting the afflicted, and incorporating various herbs and flowers in drink, snuff, and even by wearing some upon her head while she rests.

Another researcher named John Bond, in his 1753 work An Essay on the Incubus, or Night-Mare, also attributed the cause to supine positioning and an abundance of blood flow to the heart and brain. He further attempted to link sleep paralysis to other health issues:

“The disease called the night-mare is not a daemon, but rather the fore-runner of the epilepsy, madness, or a mortification… and there are many instances of people being found dead in their beds of this disorder” (Bond 63).

Nearly a hundred years later, in 1838, John Gideon Millingen wrote in Curiosities of Medical Experience that the nightmare could be explained by digestive ailments and that it generally occured after a heavy dinner before bed. Additional considerations he suggests include an anxious disposition and a sedentary lifestyle.

Millingen also includes in his discussion of nightmares an anecdote relating the experience of a French Physician accompanying a battalion of 800 soldiers in Italy. At the end of a long hard march the men rested in cramped conditions at an abandoned monastery overnight, which they had been warned by the locals was haunted.

“We laughed at their superstitious fears, but were much amazed when, towards midnight, we heard loud cries, and the soldiers rushed tumultuously, and in evident terror, out of their rooms. Interrogated as to the causes of this alarm, they all affirmed that the devil was in the abbey; that they had seen him enter in the shape of a large black dog, that had jumped upon their breasts and disappeared. To convince them of the absurdity of their fears was of no avail; not a single man could be persuaded to return to his quarters, and they wandered about the town until day-break. The following morning I questioned the most steady non-commissioned officers and the oldest-soldiers; and though under ordinary circumstances they were strangers to fear, and never gave credit to any tales of supernatural agency, they assured me that the dog had weighed them down and nearly suffocated them. We remained that day in Tropea, and had no other quarters to occupy but the same monastery, and the soldiers would only take up their residence on the condition that we should remain with them: the men retired to sleep—we watched; all was quiet until about one in the morning; when they awoke in the same terror, and fled the building in dismay. We had looked out most attentively, but could not perceive the cause of this commotion. The following day we returned to Palmi; and, although we marched over a great part of Italy, and were frequently equally crowded and uncomfortable, a similar scene never recurred.” (Millingen 178-9)

Millingen speculated on possible medical explanations for this extraordinary event including some unhealthy gas in the crowded area, unwholesome fruit eaten on the march, or bodily constriction from lying in their uniform gear.

The experience of sleep paralysis has long been a source of fascination and variations of this imagery can appear in unusual places. This version is part of a lantern slide collection, used in the treatment of patients at St. Elizabeths Hospital in the mid-19th century. This startling image has a nightmarish quality though its exact purpose is unknown.

Wooden framed glass slide with color image.
Nightmare Turtle Magic Lantern Slide
National Library of Medicine #101594732

According to the National Institute of Neurological Disorders and Stroke (NINDS), sleep paralysis can sometimes be linked to other sleep disorders such as narcolepsy. In addition to common symptoms such as excessive sleepiness and suddenly falling asleep, NINDS notes that narcolepsy may be associated with sleep paralysis and hallucinations while falling asleep or waking. Sleep disorders like these can now be observed during overnight sleep studies, utilizing removable sensors that “record brain waves, heart rate, breathing effort and rate, oxygen levels, and muscle movements before, during, and after sleep.”

While we now understand a lot about the sleeping brain and sleep disorders, for some, the experience of sleep paralysis remains the stuff of nightmares.

For current information about sleep disorders visit MedlinePlus, an online health information resource from the National Library of Medicine.

A young white woman in a library setting.Nicole Baker is a Reference Librarian in the History of Medicine Division at the National Library of Medicine.


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