Neurology
April 10, 2006
Kevin R. Nelson, Michelle Mattingly, Sherman A. Lee et al.
120 citations
People who have had a near-death experience (NDE) are more likely to have previously experienced REM sleep intrusion—such as sleep paralysis or sleep-related hallucinations—than those who have not. This supports the hypothesis that REM intrusion, which can occur during wakefulness, contributes to the subjective aspects of NDEs. In a study of 55 individuals with NDEs and matched controls, sleep paralysis and visual or auditory hallucinations during sleep were substantially more common in the NDE group. The findings suggest that under life-threatening circumstances, an NDE is more likely in those predisposed to REM intrusion, possibly involving suppression of the locus ceruleus.
Neurology
March 5, 2007
Kevin R. Nelson, Michelle Mattingly, Frederick A. Schmitt
60 citations
Among 55 people who had a near-death experience (NDE), those who also reported an out-of-body experience (OBE) during the NDE showed more signs of REM sleep intrusion—such as sleep paralysis or hallucinations—during the transition between wakefulness and sleep, compared to matched controls. The findings suggest that OBE in the context of NDE may be linked to a predisposition of the arousal system to allow REM-related phenomena to intrude into waking or sleep-transition states. This connection is supported by similar OBE reports in narcolepsy, a disorder of state boundary control, where OBE diminishes with treatment.
Nature reviews. Neurology
June 1, 2025
Charlotte Martial, Pauline Fritz, Olivia Gosseries et al.
19 citations
Near-death experiences (NDEs) are episodes of disconnected consciousness with prototypical mystical features, often occurring during actual or perceived physical threat. Various explanatory theories have been proposed, but integration has been limited. Converging evidence from neuroscience—including non-human studies, psychedelic-induced mystical experiences, and research on the dying brain—now offers a comprehensive explanation. This Review discusses psychological and neurophysiological processes underlying NDEs, including cellular and electrophysiological brain network changes and neurotransmitter alterations. The authors propose a model encompassing a cascade of concomitant processes within an evolutionary framework and consider how NDE research informs debates on consciousness emergence near brain death.
Brain Commun
June 22, 2021
Kevin R. Nelson
3 citations
The text explores whether the phenomenon of feigning death, a passive defensive strategy observed in many animals, might be related to or even evolve into the human experience of near-death experiences. It examines the physiological and psychological parallels between thanatosis (tonic immobility) and reported near-death states, suggesting a possible continuum or shared underlying mechanism.
The Oxford Handbook of Psychedelic, Religious, Spiritual, and Mystical Experiences
June 20, 2024
Kevin R. Nelson
Near-death experiences arise from a blend of waking and REM sleep consciousness caused by reduced blood flow to the brain (ischemia). When the brainstem arousal system is disrupted by ischemia, it can produce a hybrid state called REM intrusion, which explains key features of near-death: seeing light, appearing motionless, out-of-body sensations, euphoria, and a rich narrative landscape. REM intrusion also accounts for why diverse conditions, including non-threatening ones, can trigger near-death and why cerebral ischemia most often does so. Evidence shows that people who have near-death experiences are physiologically susceptible to REM intrusion. Near-death experiences share features with mystical experiences but remain distinct, driven by different neurophysiologic processes.
Annals of the New York Academy of Sciences
November 1, 2014
Kevin R. Nelson
Near-death experiences—sensations of light, out-of-body episodes, and encounters with deceased loved ones or spiritual beings—arise from brain activity rather than a single physiological or biochemical system. During impaired cerebral blood flow from syncope or cardiac arrest, the boundary between consciousness and unconsciousness blurs, and a person may enter a borderland of heightened awareness. Consciousness can fluctuate as blood flow crosses critical thresholds. Brain ischemia disrupts the balance between conscious states, leading the brainstem to blend REM and waking into an unfamiliar reality. Most people who have near-death experiences have brains predisposed to fusing REM and waking consciousness, and they are as likely to have out-of-body experiences during that blended state as during near-death itself.