Abstract

The brain mechanisms by which we transition from sleep to a conscious state remain largely unknown in humans, partly because of methodological challenges. Here we study a preexisting dataset of waking up participants originally designed for a study of dreaming (Horikawa, Tamaki, Miyawaki, Kamitani, 2013) and suggest that suddenly awakening from early sleep stages results from a two-stage process that involves a sequence of cortical and subcortical brain activity. First, subcortical and sensorimotor structures seem to be recruited before most cortical regions, followed by fast, ignition-like whole-brain activationdwith frontal regions engaging a little after the rest of the brain. Second, a comparably slower and possibly mirror-reversed stage might take place, with cortical regions activating before subcortical structures and the cerebellum. This pattern of activation points to a key role of subcortical structures for the initiation and maintenance of conscious states. (c) 2021 Elsevier Ltd. All rights reserved.