What Is Confusional Arousals? – Things To Know About Sleep Drunkenness

There is a chance that you may have experienced confusional arousals before.


What is confusional arousals?

You may have done something equally unusual as I am about to describe. This was my experience of confusional arousals that I had before.

This happened a little while ago. I woke up in the middle of the night to check what time it currently was. The watch I have has a built in backlight.

However, instead of doing the reasonable thing of reaching for my wristwatch, instead I reached for my flashlight that was hanging on a series of hooks above my bed.

When I pressed the side button to light up the face of the watch, I was actually pressing the side button on the flashlight.

After that press, I vaguely remember looking at the face of the flashlight and attempting determine what time it was. It was only at the moment did I realize that when I looked into the flashlight face it was not the face of my watch.

what is confusional arousals?
This is the flashlight that I looked into.

I believe the bright light that the flashlight emitted woke me up from that state of disorientation.

Afterwards, I was trying to figure out what I was attempting to do. For the next few minutes, I gradually came back to a conscious state and naturally I inspected to see if anything was out of place.

Ten minutes had gone by and after standing up for a bit did I realize what a peculiar experience that was.

It would seem that I experienced an episode of what is referred to as “confusional arousals”. I am not sure if that was the first time that ever happened. However, just like most people I do not recall most occurrences that well.

what is confusional arousals?

Do You Find Yourself Waking Up and Performing Unusual Tasks?

If you occassionally find yourself waking up disorientated and maybe doing weird or hazardous tasks, then it is possible that you experienced confusional arousals before.

If the official medical term of this sleep disorder seems to be a bit daunting, you can refer to its more commonly accepted name of sleep drunkenness.

In this article, you will learn more about confusional arousals, the causes, treatment options and other the interesting details about this unusual sleep disorder.

There is also very interesting research which reveals how common this sleep disorder is and the number of people who are more prone to having it.

What Is Confusional Arousals?

This video will give you  a brief overview:

The International Classification Of Sleep Disorders 3rd Edition diagnostic manual explains that confusional arousals as when a person wakes up in a confused state.

That might sound very clear, yet there are various types of confusion that can happen. An example of this is you can be confused about where you are, who you are, what is occuring around you.

If somebody speaks to you, your speech maybe slow or incoherent. There is also the possibility that you might provide short answers with no explanations to the questions that the other person is asking you. Occasionally, your responses will be difficult to understand.

This typically occurs when waking up from the slow wave stage of sleep in the beginning third of the night. However, it can happen when waking up from any of the sleep stages.

From the list of known sleep disorders, confusional arousals disorders are located under the parainsomnia category.

This category of sleep disorders includes the likes of other disturbing sleep disorders such as nightmares, sleep paralysis, and sleep talking.

What Number Of People Experience Confusional Arousals?

It is suspected that an equivalent number of women and men experience confusional arousals. This sleep disorder is seen more frequently in children and adults below the age of 35.

During 2014, several researchers from the Stanford University School Of Medicine published a very interesting research article about this sleep disorder.

The research was on the major news headlines due in part to the incredibly appealing title of “sleep drunkenness”.

An interesting aspect is that the researchers found out that it is remarkably common that certain groups of people are more prone to having it.

Interesting Discoveries

This is a list of the primary discoveries for the study that was conducted by the Stanford researchers:

  • The researchers interviewed 19,136 adults that live in the United States.
  • Out of all the adults, 15.2% of them have experienced confusional arousals disorder in the previous year. Over 50% of them had experienced more than one episode in a week.

Out of the 15.2% of adults who had experienced confusional arousals, the researchers discovered that:

  1. 8.6% of them have either have some or no memory of the episodes.
  2. 0.9% of the adults stated they have no causes that can be indentified and no related conditions that could lead to confusional arousals disorder.
  3. 31.3% of them were taking psychotropic medication. (Primarily anti-depressant medication)
  4. 37.4% of the adults had a mental disorder such as depression, panic disorder, and bipolar disorder.
  5. 14.8% of them sleepwalk.
  6. 70.8% have another sleep disorder.
  7. 84% were either taking psychotropic drugs, have a mental health disorder, or have an additional sleep disorder.


Various Types of Confusions

The study discovered that the following were the most recurrent types behavior or confusion:

  • No memory of episodes: 9%
  • Sleepwalking: 15%
  • Confused Behaviors: 20%
  • Having a hard time speaking or thinking coherently: 34%
  • Hallucinations: 36%
  • Temporospatial disorientation (in laymans terms, confused as to when or where they are): 57%

Hostile Behavior Generated By Another Individual

Have you or somebody else you know occasionally behave in hostile manner during an episode? This can cause concern and stress for everybody else whether that is your partner, roommates, or other family members.

Why does this occur?

What actions can you take?

During 2007, The American Academy Of Sleep Medicine announced a fascinating article of violent episodes that happen during episodes of confusional arousals.

They discovered that the violent episodes are not frequent. They typically happen under two conditions:

  1. When you behave in a complex manner when lying in bed during sleep and somebody else attemps to calm you down by grasping or holding you.
  2. When someone attempts to wake you up.

If this is the case, then the best course of action is to refrain from having physical contact with somebody during an episode with the exception being that they are putting themselves or others in a hazardous situation.

Do your best to avoid waking a person up who is inclined to confusional arousals.

Hazardous Factors

Taking notes from the study that was mentioned in the previous section. The American Academy Of Sleep Medicine has a list of potentially hazardous factors and causes that include:

  1. Alcohol.
  2. Depressive and bipolar disorder.
  3. Drug abuse.
  4. Being woken up abruptly.
  5. Worry and stress.
  6. Taking psychotropic medication.
  7. Sleep deprivation and lack of sleep.
  8. Other sleep disorders such as circadian rhythm sleep disorder, hypersomnia, insomnia, periodic limb movement disorder, and sleep apnea.


Treatment Options

There is no determined cure for confusional arousals, therefore there is no cure-all treatment for this sleep disorder.

If you have a child that experiences this sleep disorder, it is imperative that you inform their doctor of it. They may need to conduct some tests in order to rule out other physical causes such as epilepsy.

For adults, if an additional sleep disorder is causing the episodes. Then that other sleep disorder is what needs to be treated.

This is an important aspect that you need speak to your doctor about, especially if you have symptoms of another serious sleep disorder such as sleep apnea.

The very same principle applies to mental health conditions that can be treated and managed as well. If you are taking medications such as anti-depressants, it is to your benefit to inform your doctor of the confusional arousals episodes.

Medical checkpoints.

An important tip to keep in mind is to be mindful of your sleep patterns and ensure that you are obtaining a sufficient amount of sleep.

Do not become sleep deprived. I can personally tell you that being sleep deprived is no fun at all.

Reducing or eliminating the amount of alcohol that you consume can help out.

One of the most important pieces of advice that sleep experts recommend is to practice proper sleep hygiene. For example, eating the right foods, discovering methods to minimize stress levels, and creating a consistent bedtime routine that will help you feel calm.

There Are Others Out There

At this point if you are still worried about the behavior you, your partner, or your roommate displays. Always remember that you or somebody else is not alone. Do not feel mortified or believe that you are unusual because of your actions when you are not fully aware.

A large number of people experience sleep disorder or go through phases where outlandish events happen to them at night to a point where they believe they are going mentally insane.

However, if you are concerned and if the sleep disorder is negatively affecting your life or relationships.

It is recommended that you consult a medical professional. They will help guide you in the right direction.

Final Thoughts

Chances are you have experienced confusional arousals before and probably had some moments where you have done some funny things. Treating the underlying causes will reduce the likely hood that another episode will be triggered.

Many people have confusional arousals and although it is not heard of as much as snoring it is still a common sleep disorder.

What happens during your episodes?

Do you recall any interesting things that have happened?

Often times other people find solace in the fact that they are not the only one with this sleep disorder.

Please feel free to share your experience in the comments below.

Photo Credit: Pexels, Pixabay and Unsplash

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2 Comments on “What Is Confusional Arousals? – Things To Know About Sleep Drunkenness”

  1. Hello Abagatan,

    In the first experience, if your brother woke up in a confused state and was speaking to someone else. Then that could be considered an episode of confusional arousals especially since he had no memory of doing so. In the second experience, judging from your description it could be that your brother experienced another episode of confusional arousals due to the fact that he came back to consciousness after drinking the water.

    Best regards,
    Kenny Tang

  2. Thank you for an interesting article. 

    May I present two experiences and please try to evaluate if these experiences are considered cases of confusional arousals.

    This article brings me back to the 1970’s. I experienced my brother waking up at midnight and talking with someone else and then return to bed. When I asked him if he knows about it what happened that night, he said “no”.

    Another episode of his experience is that during the day he took a nap. All of a sudden he got up and walked for about 200 meters away from our home.  When he reached the well where we usually fetch water for drink he drank some water and he rose to consciousness. He knew that he was there. However, he went home safely.

    Are these experiences considered cases of confusional arousals?

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