Spontaneous and induced out-of-body experiences during sleep paralysis: Emotions, "AURA" recognition, and clinical implications.

Sleep paralysis is characterized by the incapacity to perform voluntary movements during sleep/wake transitions, and could bring great discomfort. During sleep paralysis, out-of-body experiences can occur. Out-of-body experiences refers to the sensation of being outside of the physical body and perceiving the world from this outside perspective; however, they are pleasant in comparison with other sleep paralysis hallucinations. Lucid dreams are dreams in which a subject becomes aware of being dreaming while the dream occurs. Here, we designed an online survey to study the predominant and specific emotions during sleep paralysis and/or out-of-body experience events as well as the somatosensory perceptions that preceded their occurrence. The sample (N = 329) was divided into experimental groups depending on the presence/absence of out-of-body experiences, capacity to induce (or not) out-of-body experiences, and perception/no-perception of the sleep paralysis. We showed that more positive emotions were associated with out-of-body experiences and more negative emotions were associated with sleep paralysis episodes, and for those who claim the ability to induce out-of-body experiences, positive emotions were more frequent in their episodes. We found that subjects perceived auditory, tactile and visual sensations before sleep paralysis episodes, and we proposed that these could be an "aura" of sleep paralysis. Furthermore, subjects that had out-of-body experiences but had never felt the sleep paralysis, perceived tactile and visual sensations to the same extent as subjects with out-of-body experiences that felt the sleep paralysis. Therefore, we proposed that the "aura" recognition could be used under controlled conditions for out-of-body experiences induction in patients with sleep paralysis to diminish the negative symptoms associated with sleep paralysis episodes.