It is taken for granted that parasomnias like "sleep paralysis" and "sleep apnea" are organic/somatic disorders. If there are psychogenic factors in these illnesses, it is assumed that they play an ancillary role, and in all likelihood have nothing to do with the primary etiology. The medical logic used to justify such an assumption is that stress is a non-specific noxious factor. It has a psychophysiologic role but there is no evidence that the nature of the psychological conflicts determines as to what part of the body and what pathophysiological process will succumb to the stress.
Over time another factor got added to the dream. Paranormal entities! She could feel the presence of other people in the dream but whom she could not see, This led her to start believing in ghosts, and her house being haunted. Sometimes the fear of ghosts was so strong that out of fright she would stop breathing as not to make those ghosts aware of her presence.
Does the germ of sleep apnea lies in such fright emerging in sleep/dream?
Over time these ghosts became more aggressive and she would feel them covering her face and nose, or submerging her in water. She would hold her breath in response, till she could hold the breath no more, forcing her to swim upwards to the surface, ending with her waking up gasping for air.
The ghost like entities would walk past her, watch over and touch her, sit or stand next to her bed. She hated the touching. It would make her twitch and jerk. Sometime touching would go to the extent of moving her hand or caressing her face. She described the experience as if she was being messed around with. But she rejected the construction that the touching perhaps had its roots in sexual touching that she may have experienced as a child. She said she was never sexually or physically abused.
However, the construction led her to admit that lately this ghost like character which messed with her, had been taking on the visage of her father and her boyfriend. And their presence in the dream gave her some comfort and lessened the scary feeling. It also lessened the fear associated with the dream of drowning and struggling to come to the surface for air, the sleep apnea dreams.
Patient also brought a recurrent dream which bolstered the view that behind the sleep paralysis there was fear of going out of control. Ever since her teenage years - perhaps around 15 or 16 years when she started driving - she would have dreams in which she would be driving and would suddenly find that her brakes are not working. The accompanying affect was that of fear. "For I am a very controlled person. Though at times I have been reckless and irresponsible. But for the most part I hate being out of control."
Now we know from psychoanalytic literature that brakes failing in one's vehicle in dreams is a typical symbol of one's libido being out of control. So once again the theme of this recurrent dream of her vehicle being out of control was continuation of the dream of her passion for her father - walking out of the grandparents house for him - being out of control.
And she added, "Nothing could make me more miserable than dreaming this very big object communicating with the very small one. I would wake up bowling my eyes out. I would be so scared too."
The big and small objects symbolized the differences between the sexes. Her utter sadness, anxiety and fear attached to the dream were connected with her comparing her genitals with that of male sex and feeling miserable about it. She claimed that she really feared her father, and felt greatly inferior to him specially when she compared her subdued squeaky female voice to his deep masculine one.
It was this meanness of her mother to her father that made her feel sad, miserable and sympathetic towards her dad. And it was this sympathy for her dad, and the counter impulse that she should side with her mother lest it provokes her wrath that had weaved the dream of sleep paralysis.