Confusional Arousals | PlushBeds Green Sleep Blog

Confusional Arousals


Not being fully asleep nor fully awake, confusional arousals cause their subject to be dazed and confused during periods of transitions from sleep, usually upon waking. Along with sleepwalking and night terrors, confusional arousals are labeled as one of the three classical parasomnia arousal disorders.

Confusional arousals occur in as many as 15 percent of preschool children and toddlers, according to Dr. Alan Greene. They are also referred to as “sleep drunkenness”, and more adults than children experience them.

What does a confusional arousal episode look like?

In children, confusional arousals usually occur during the first third of a child’s night of sleep, and particularly when the child is overtired or has had an irregular sleep-wake cycle the preceding few days. They occur during the non-REM stages of sleep, particularly stages one and two. Less intense episodes occur during morning awakenings after a full night’s sleep.

A confusional arousal episode begins with the child moving about, and moaning softly. However, this quickly progresses to the child thrashing about wildly and the child making loud verbal outbursts. If the child gets up, he or she may stagger, as if drunk.

Children and toddlers experiencing a confusional arousal are slow to react to your commands. They may have difficulty understanding your questions, or even recognize it is you asking them. They will appear confused and mentally disoriented. They may have short-term memory lapses, and the next day they likely won’t even know they had an episode. Some experts contend that confusional arousals are a variation of night terrors in children.

While many episodes last between five and fifteen minutes, they have been known to last 30 minutes or longer.

confused child

Are confusional arousals a concern?

In most cases, a confusional arousal episode is harmless, albeit frightening for a parent to witness. However, they sometimes signal another underlying sleep disorder, such as sleep apnea, nocturnal asthma, or restless leg syndrome. If you child is having episodes that appear to be confusional arousals, it’s important to see your doctor to determine if another underlying sleep disorder is at play.

What can I do if my child has confusional arousals?

If an underlying sleep disorder is diagnosed, then treating that underlying condition may stop the confusional arousals. If no underlying sleep disorder is identified, there are a few things you can do as a parent to help reduce or eliminate your child’s confusional arousals.

1) Keep a regular sleep schedule. Try to ensure your child goes to bed and gets up approximately the same time each night, as well as sticks to his nap schedule. Avoid letting your child become sleep-deprived or overly tired.

2) Respond to your child in a reassuring, calm manner. Speak softly and slowly so as not to frighten your child.

3) Keep objects out of the way. For safety, keep objects away from the bed and not on the bed stand that may injure your child as he or she thrashes about during a confusional arousal episode.

4) Don’t try to wake your child. Watch your child as the confusional arousal episode ensues, but don’t try to nudge him to wake up. Instead, wait until your child falls back to sleep.

Although it’s always best to consult your doctor or a sleep specialist if your child is having problems sleeping, rest assured that chances are confusional arousals in children will run their course, and diminish or disappear as your child gets older.

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