Knowledge, Attitudes, Practices, and Perceptions of Sleep Paralysis Among Medical Science Students in Guinea

Sleep paralysis (SP) is a transient inability to move or speak at sleep onset or on awakening. Data from sub-Saharan Africa are scarce. We surveyed 320 medicine, pharmacy and dental students at three universities in Conakry, Guinea, between April and September 2025, using a questionnaire with closed and open questions. Overall, 61.9% (95% CI 56.4–67.0) reported at least one lifetime SP experience, and 39.7% reported recurrent episodes with inability to move. The most frequent features were inability to move (91.4%), inability to speak (82.8%), intense fear (61.6%) and a sense of presence (60.1%); 52.5% of affected students had prayed during an episode. In a pre-specified multivariable model, each additional correct answer on an eight-item knowledge test was associated with higher odds of reporting SP (adjusted OR 1.31, 95% CI 1.12–1.54). A lower attitude score was associated with lower odds (adjusted OR 0.35, 0.13–0.91), but not after excluding students who answered neutrally to every statement; sex was not independently associated. These cross-sectional associations most likely reflect learning after episodes. Free-text answers combined biomedical and spiritual explanations, including witchcraft and evil spirits. Teaching on SP and its cultural interpretations in medical curricula is warranted.