Everything You Need To Know about Confusional Arousals

What Are Confusional Arousals?

Confusional arousals is a sleep disorder that causes you to wake up or seem to wake up and feel confused and disoriented. Episodes are usually brief and last from 1 to 10 minutes. They involve small hand movements but rarely some bigger activity like standing or walking.

Speech will also be slow and slurred and everything that’s said won’t be coherent and have much sense.Those who experience confusional arousals won’t remember them later.

These arousals are grouped together with a number of other sleep disorders under NREM parasomnias because they happen during the transition from the deepest stage of sleep to a lighter stage of sleep and wakefulness.

During a confusional arousal, a person’s behavior may resemble the behavior of someone who is drunk and that’s why this sleep disorder is also known as “sleep drunkenness”.

Symptoms of Confusional Arousals

Confusional arousals occur during the first third of the night after at least two hours of sleep and they involve brief periods of arousals which usually last less than 10 minutes. However, these episodes also may occur later during the night or during a daytime nap.

During these arousals, people may seem to be awake even though they have a foggy state of mind and they are confused, disoriented and unable to think clearly and quickly.

These episodes also may include simple movements and confused and slow speech. Some people may grind their teeth and in rare cases walk or act inappropriately or even aggressively. Confusional arousals are not typically remembered the next day.

One variation of this sleep disorder is known asĀ severe morning sleep inertia. It is common among adults and teens and its symptoms are the same as those of confusional arousals that occur at night with the only difference that severe morning sleep inertia happens in the morning while you are waking up.

This can happen every morning and sometimes appear for years and those suffering from it will often miss time and perform poorly at school or job. It can also affect their mood, cause daytime sleepiness and lead to accidents.

Who Can Be Affected?

Confusional arousals are common in those who spend more time in NREM sleep. Children, especially young children under the age of 5, are most likely to experience confusional arousals and around 17 percent of children have them. But, contrary to this, only 3-4 percent of adults have confusional arousals.

Besides kids, some people are at higher risk of having this sleep disorder than other people like those who already have some sleep disorder such as sleep apnea, whose job involves night shift work, those who are constantly under stress or deprived of sleep, who suffer from chronic depression or bipolar disorder, drink alcohol right before bedtime, etc.

What Causes Confusional Arousals?

It is believed that confusional arousals are mostly influenced by genetics. However, they can also happen while recovering from sleep deprivation, when someone wakes you up suddenly, as the result of drug or alcohol abuse, etc. Some psychiatric medications and those medications that deepen sleep increase the risk of experiencing confusional arousals.

Certain factors that disturb normal sleep cycles like traveling, stress, anxiety or other sleep disorders including obstructive sleep apnea and periodic limb movement also can trigger confusional arousals.


If you’re having confusional arousals, you probably won’t know this unless someone witness them. So, if someone tells you that you seem lost, confused or behave in a strange way when you wake up and if this happens regularly, then you may want to see a sleep specialist.

Sleep specialists will review your medical history and sleep patterns and if symptoms point to another sleep disorder like those we mentioned above, they may order an overnight polysomnogram. This will allow them to monitor your heart, brain and lung activity overnight and help them determine if an existing sleep disorder is causing confusional arousals.

You also may be required to keep a sleep diary for a couple of weeks which will give them clues to what might be causing your problems and help them find the right solution.


Confusional arousals are usually harmless and don’t require any treatment, but if it appears you are having them because you already have some other type of sleep disorder, treating that disorder will often solve your problems.

Also, cutting back on alcohol and getting a full night of sleep can help, as well as adjusting your bedtime and creating a cozy sleeping environment that will stimulate restful sleep. Read our top 10 best mattresses guide and see how you can improve your sleep by getting one of the most comfortable mattresses available on today’s online mattress market.

Still, there are some reports that show that certain medications like antidepressants and sleeping pills have helped some people. These medications may disrupt the depth of your sleep and reduce the likelihood of experiencing confusional arousals. Ask your doctor for advice about this and other kinds of treatment.