Arousal Sleep Disorders Part I

Sat, Jul 11, 2009

Arousals Part1Parasomnias

From  the post Parasomnias Disorders:

  • Parasomnia is an episode that happens during sleep.
  • Parasomnia could be induced or resulting from sleep, such as: sleepwalking, sleep talking, sleep terror, and nightmares
  • Parasomnias are disorders that infiltrate into the sleep process and create disruptions into sleep-related actions.
  • Parasomnias usually associated with REM sleep.

The parasomnias are divided into four groups:

  • Arousal disorders
  • Sleep-wake transition disorders
  • Other parasomnia disorders  

What are Arousal Disorders?

Arousal Sleep Disorder is parasomnia disorder. It is considered to happening due to an abnormal arousal function. Classical sleep arousal disorders: sleepwalking, sleep terrors and confusional arousals (see corresponding post for more details).

Confusional Arousals. What is it?

  • Confusional arousals is a parasomnia.
  • Confusional arousals usually happens when a person is getting confused during sleep the initial part of the night sleep and following arousals from sleep.

Study shows that only 4% of adults report confusional arousals; however, they are very common in children. Confusional arousals in children, most of the time, associated with their accidental movements in bed and resulting dreams forcing them shifting from a restful sleep to a lucid stage of sleep. See Night Dreaming post for more details.

  • Confusional arousal takes place as you wake up or right after awakening.
  • A person acts in a way that something is quite different from the normal and/or very strange. It appears that the person doesn’t know where he or she is or what they have been doing. The person’s behavior may include:
  • Confused thinking
  • Slow speech
  • Poor memory
  • Dull responses to requests or asked questions

What causes arousal disorders?

Arousal disorders maybe triggered by other sleep disorders, such as sleep apnea, restless legs, or periodic limb movement during sleep. When you visit your sleep doctor, he or she will check your sleep patterns, as well as your medical history before establishing an actual treatment.

How are arousal disorders treated?

Treatment by a sleep professional may be necessary, especially when there is a harsh incident that leads to personal injury or involves violent behavior, such as extreme eating, or disturbance to the bed-partner or your family. Medical treatment with prescription drugs or with behavior modification through hypnotherapy might advisable.

What confusional arousal look alike?

  • It may look to you that you are fully awaken even though you have a lucid state of mind.
  • Episodes of confusions are often initiated when someone tries to wake you up.
  • You can experience sleepwalking or loud shouting during this episode.
  • Teeth grinding is also possible.
  • Actual duration of confusional arousal could last from a few minutes to a few hours.
  • Due to a deep sleep stage, person usually keeps no memory of arousal incidents.
  • Confusional arousals tend to happen as a person wakes from a slow-wave sleep, usually from non-REM sleep.
  • It is known that confusional arousal is the most common in the first third of the night, however, it has been reported many cases that it may happen later in the night or during a daytime nap or even falling asleep in front of the computer.
  • Mixing dreams with reality fools adults (in some rare cases) to display a very inappropriate behavior. Their actions can be aggressive and even hostile. The latest is similar to people behavior when they are under the influence of alcohol.
  • This type of behavior can put a great restrain on the relationships with others people, especially with bed partner.
  • Luckily, the extreme behavior is not common for people who are subject to confusional arousals.

Severe Morning Sleep Inertia

One type of confusional arousals is called severe morning sleep inertia. Let’s see what it is:

  • It can affect everyone, kids, teens and adults.
  • Occasionally, it is called sleep drunkenness.
  • The symptoms of sleep drunkenness are similar to regular confusional arousals that are happening early at night.
  • The only difference is that severe morning sleep inertia happens in the morning when you are waking up.
  • It seems that this sleep disorder tends to reoccur every morning for several years without diminishing its regularity.
  • Severe morning sleep inertia can cause you to be late for work or school and reduce your performance.
  • Sometimes, severe morning sleep inertia can be a source of conflicts with family members.
  • It can also lead you to a car accident in the morning or to episodes of narcolepsy.

Confusional Arousals in Children

To the most parents, all incidents of confusional arousals in their children look really weird and terrifying:

  • It is common to see your child staring right through at you with a great confusion on his or her face.
  • Resistance and visible agitation from your kids become apparent when you try to calm them down upon awakening.
  • Most episodes of confusional arousals last from 5 to 15 minutes, however, some reports indicate those incidents lasting as long as 30 to 45 minutes in some kids.


Confusional arousal episodes are reasonably harmless in most children. They become are less obvious after the age of 5. It has been noticed that children who experience confusional arousals quite often sleepwalk when they are teens.

Statistics of Confusional Arousal

  • Confusional arousal occurs at the same frequency among both men and women.
  • However, those rates are greater among children and adults under the age of 35.
  • About 3 to 4% of adults have confusional arousals and 17% of children
  • It is possible to have confusional arousal disorder if any of your relative also has it.

What is the risk?

These are several factors that may increase their risk of experiencing confusional arousals:

Watch video: Child Sleep Parasomnia


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