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Confusional Sleep Arousal - How a little-known sleep disorder can disrupt your slumber

Confusional Sleep Arousal - How a little-known sleep disorder can disrupt your slumber

Some people are awoken during the night to find their partner sitting up in bed staring at something in the room and then they go back to sleep while others are rudely awakened by a loud yell coming from their child’s room. Usually it’s nothing to worry about; quite frequently this event is known as ‘confusional sleep arousal’.

What is confusional sleep arousal?

Confusional sleep arousal is a type of parasomnia (when a person acts in an abnormal way during sleep) that usually occurs during the non-rapid eye movement stages of sleep; during the first half of the night. The sleeper comes out of the deep sleep stage into a lighter sleep and sometimes even wakefulness; the sleeper may sit up, walk around the room while letting out a groan, a scream or a sentence that doesn’t make sense. However in the scenario where you do hear a yell, you shouldn’t wake the sleeper as it can make the episode worse and attempting to wake them can make them feel distressed. During the event the sleeper may look disorientated, confused and if awake, respond very slowly to you; an episode can last anywhere from a few seconds to several minutes and can go on for a few hours (with repeated episodes throughout the night) before going back to sleep; the sleeper usually has no recollection of the event the next morning.

Confusional arousal is more common in children as it’s usually seen as part of the developmental process of the deep sleep stages; according to Net Mums most children should grow out of this phase by the age of six. Men and women are equally affected by this parasomnia and it can run in the family; relatives don’t need to suffer from confusional arousal, they may suffer from other parasomnias such as sleepwalking, sleep talking and night terrors.

A similar condition which mainly affects teens and adults is called ‘excessive sleep inertia’ also known as ‘sleep drunkenness’. The symptoms are the same as confusional arousal however the difference is that excessive sleep inertia occurs in the morning when a person is waking up. This type of arousal can last for many years and can cause daytime sluggishness.

How is it triggered?

Confusional arousals can be brought on by a number of factors; the more common factors are:

  • Sleep deprivation – staying up late every night and then waking up for a certain time all soon adds up on how many hours of sleep you owe your body; you start and forget simple tasks, become very emotional and in more severe cases you can start to see things that aren’t even there.

  • Disrupted sleep pattern – sleep patterns are usually disrupted by an illness, travel or by having numerous naps throughout the day. Also certain foods and drinks can make it difficult for you to go to sleep and stay asleep.

  • Emotional stress – this can be provoked from a life event or an environmental factor; it can leave stressful thoughts in your head which can make it difficult for you to get to sleep at the start of the night but it can also disrupt your sleep cycles which cause the confusional arousals to happen.  

  • Some medications - certain medications such as sedatives, antihistamines, tranquilisers and hypnotics can trigger confusional arousal.

How can I manage it?

Confusional arousals are usually harmless but if you are told that you experience these through the night there are a number of ways to try and manage them:

  • Make sure you are getting the sufficient amount of hours sleep each night. An adult needs between 7 and 9 hours sleep a night to function properly throughout the day; according to The National Sleep Foundation pre-schoolers need between 11 and 13 hours and toddlers need between 12 and 14 hours of sleep.

  • Have a pre-sleep routine which you stick to every night. Your circadian rhythm (one of the cycles of your internal body clock) determines the time in which you eat, sleep etc… usually by external factors such as light; it can take a few days for your rhythm to maintain a constant cycle so do be patient in the first week if you have to readjust it. Once in a routine you will fall asleep and wake up almost around the same time every day. Your pre-sleep routine should relax you and clear away any worrying or stressful thoughts – key factors that prevent you from sleeping. In the hours leading up to your bedtime try taking a warm bath, reading a chapter from your favourite book or catching up with family on their events from the day; avoid using technology in the hour leading up to bed as the light emitted from the screens can slow down the production of melatonin (a hormone which regulates your sleep-wake cycle).

  • Ensure that your sleep environment is safe. Sometimes during a confusional arousal episode you can get out of bed and walk around; make sure any large, sharp or dangerous objects are stored away to avoid any accidents.

If you are someone who witnesses a partner or family member going through an episode of confusional sleep arousal do not disturb them; sometimes they are unresponsive because they are still sleeping while it’s happening and it may prolong the experience. If woken up you run the risk of confusing, frightening and distressing the sleeper. If this condition is becoming a regular occurrence after trying the above methods then please do seek further help from your local doctor who can look over your symptoms and help you get to the root of your problem.


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