Out-of-body experience and arousal

In a study of more than 13,000 Europeans, 5.8% reported the out-of-body experience (OBE) form of autoscopy.¹ Occurring in diverse clinical settings, OBE is also typical of near death experience (NDE). NDE are responses to life-threatening crisis characterized by a combination of dissociation from the physical body, euphoria, and transcendental or mystical elements. Persons with NDE may have an arousal system predisposed to allowing intrusion of REM sleep elements during the transition between wakefulness and sleep.² The arousal system is comprised of brainstem structures controlling or influencing sleep-wake states, alertness, and attention. REM intrusion manifests as the atonia of sleep paralysis (or cataplexy), as well as visual or auditory hallucinations. Although not considered REM intrusion, OBE and the REM state have an established relationship that is incompletely understood. In the state boundary disorder of narcolepsy, individuals often give accounts of OBE,^3,4 which diminish after the narcolepsy is treated.⁴ In this study, we investigated if OBE in subjects with NDE could be regarded an arousal phenomenon by occurring during sleep transition or corresponding to REM intrusion.

Structured interviews were conducted and REM intrusion measured in 55 subjects with NDE, and compared to age- and gender-matched controls as previously described.² All gave informed consent as approved by the institutional review board. OBE during NDE was determined by the Greyson questionnaire asking if the respondent “Clearly left the body and existed outside it.” For OBE of sleep transition, subjects …