Confusional arousals are episodes in which a sleeping person wakes up—or seems to wake up—but behaves strangely as though they are disoriented or confused.
This article covers the causes and symptoms of confusional arousals along with how they are diagnosed and treated.
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What Causes Confusional Arousals?
Confusional arousals tend to happen during the transition from the deepest stage of sleep, stage 3, to a lighter stage of sleep mixed with wakefulness.
Research suggests that confusional arousal happens when different regions of the brain fail to fully communicate with each other. As a result, some parts of the sleeper’s brain stay asleep while others suddenly awake.
Possible causes of interrupted sleep leading to confusional arousal include:
Risk Factors
Certain subsets of adults are more likely than others to have confusional arousals and sleep drunkenness. These include people with:
Children, especially kids under 5, are most likely to experience confusional arousals as compared to adults. According to the American Association of Sleep Medicine (AASM), around 17% of children have confusional arousals. By contrast, they occur in only 3% to 4% of adults.
Symptoms
If you’re a parent and have ever witnessed your child seem to wake up and “stare right through you” or not respond when you say her name, in all likelihood they were having an episode of confusional arousal. Adults who have confusional arousals sometimes come across as hostile or aggressive.
During confusional arousal, a person’s behavior may seem a lot like that of someone who’s intoxicated. In fact, a nickname for confusional arousal is “sleep drunkenness.”
Diagnosis
If you’re having confusional arousals or sleep drunkenness, you probably won’t know unless someone witnesses them. People don’t remember these episodes, so your only clue will be if you’ve been told you seem confused or behave aggressively or act hostile when you wake up and that this behavior happens regularly.
In that case, you may want to see a sleep specialist. To confirm that you’re having confusional arousals, the healthcare provider will get a complete medical history from you. They may have you keep a sleep diary for a couple of weeks and/or do an in-lab sleep study to observe things like your breathing rate and limb movements while you snooze.
Treatment
If it appears you’re having confusional arousals because you have some type of sleep disorder, treating that will likely put an end to them.
For adults, it also might be beneficial to cut back or quit drinking alcohol. And of course, it’s important to always get a full night of sleep, so adjusting your bedtime and creating a sleep environment that will help you get all the shut-eye you need also may help.
If all else fails, your healthcare provider may prescribe medication such as an antidepressant or a sleeping pill. These medications may disrupt sleep depth, reducing the likelihood of waking from a prolonged period of slow-wave sleep. In addition, there are devices such as the Lully Sleep Guardian that can prompt awakenings in children.
A Word From Verywell
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sleep Foundation.What are confusional arousals and sleep drunkenness.American Academy of Sleep Medicine,Confusional arousals—overview, and facts.Stanford Medicine.Confusional arousals.Additional ReadingDurmer, JS and Chervin, RD. “Pediatric Sleep Medicine.“Continuum.June 1, 2007;13(3):153-200.American Academy of Sleep Medicine,Confusional Arousals—Overview, and Facts.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sleep Foundation.What are confusional arousals and sleep drunkenness.American Academy of Sleep Medicine,Confusional arousals—overview, and facts.Stanford Medicine.Confusional arousals.Additional ReadingDurmer, JS and Chervin, RD. “Pediatric Sleep Medicine.“Continuum.June 1, 2007;13(3):153-200.American Academy of Sleep Medicine,Confusional Arousals—Overview, and Facts.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sleep Foundation.What are confusional arousals and sleep drunkenness.American Academy of Sleep Medicine,Confusional arousals—overview, and facts.Stanford Medicine.Confusional arousals.
Sleep Foundation.What are confusional arousals and sleep drunkenness.
American Academy of Sleep Medicine,Confusional arousals—overview, and facts.
Stanford Medicine.Confusional arousals.
Durmer, JS and Chervin, RD. “Pediatric Sleep Medicine.“Continuum.June 1, 2007;13(3):153-200.American Academy of Sleep Medicine,Confusional Arousals—Overview, and Facts.
Durmer, JS and Chervin, RD. “Pediatric Sleep Medicine.“Continuum.June 1, 2007;13(3):153-200.
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