Among a psychiatric population of Cambodian refugees (N = 100), 42% had current - i.e. at least once in the last year - sleep paralysis (SP). Of those experiencing SP, 91% (38/42) had visual hallucinations of an approaching being, and 100% (42/42) had panic attacks. Among patients with post-traumatic stress disorder (PTSD; n = 45), 67% (30/45) had SP, whereas among those without PTSD, only 22.4% (11/45) had SP (χ 2 = 20.4, p <.001). Of the patients with PTSD, 60% (27/45) had monthly episodes of SP. The Cambodian panic response to SP seems to be greatly heightened by elaborate cultural ideas - with SP generating concerns about physical status, ‘good luck’ status,‘bad luck’ status, sorcery assault, and ghost assault - and by trauma associations to the figure seen in SP. Case vignettes illustrate cultural beliefs about, and trauma resonances of, SP. A model to explain the high rate of SP in this population is presented. SP is a core aspect of the Cambodian refugees response to trauma; when assessing Cambodian refugees, and traumatized refugees in general, clinicians should assess for its presence. © 2005, Sage Publications. All rights reserved.

Panic attacks Post-traumatic stress disorder Khmer refugees Sleep paralysis

cultural anthropology symptomatology visual hallucination parasomnia Panic Disorder refugee anxiety disorder Cambodia cognitive defect human comorbidity Refugees middle aged Sleep Paralysis panic mental health care Humans sleep disorder male social belief female questionnaire high risk population Article wakefulness Spiritualism Questionnaires major clinical study frequency analysis posttraumatic stress disorder disease association physical performance