Confusional Arousal Disorders

Confusional arousal disorders are parasomnia disorders assumed to be due to an abnormal arousal mechanism.

These arousals occur when a person is in a mixed state of being both asleep and awake, generally coming from the deepest stage of nondreaming sleep.

This means a person is awake enough to act out complex behaviors but still asleep and not conscious or able to remember these actions.

Night Terrors

Confusional arousals happen mostly in the first half of the night, in case with night terrors. They can last from 5 to 45 minutes, but usually settle after about 5 or 10 minutes. The episode may seem to settle, then start again.

A child will begin with groaning, which typically progresses to crying, thrashing around, sitting or standing (as opposed to night terrors, which begin suddenly), if he or she is having confusional arousals.

Causes Of Confusional Arousal Disorders

These confusional arousal disorders are likely to run in families and are more frequent in children. Being over exhausted, having a fever or taking certain medications may make it worse.

Because confusional arousal disorders are less common in adults, having an evaluation is important. In some cases, other conditions, such as sleep apnea, heartburn, or periodic limb movement during sleep trigger these confusional arousal disorders.

The Other Causes Of Confusional Arousal Disorders

• Psychotropic medication use
• Drug abuse
• Consumption of alcohol
• Recovery from sleep deprivation
• Being forced to wake up

Confusional Arousal Disorders Diagnosis

For the diagnosis of confusional arousal disorders, overnight sleep study of the patient should be noted. This is called a polysomnogram. The polysomnogram charts your brain waves, breathing as you sleep, and heartbeat.

It also records your arms and legs movements. This shows if there are other disorders that are causing your sleep problems. Two examples of these disorders are periodic limb movement disorder and sleep apnea.

Confusional Arousal Disorders Treatment

It is needed to treat other sleep disorders that may be the cause of the unusual behavior. It is also important for you to always get a full night’s sleep. Treatment by a sleep specialist may be necessary, if it is a severe case that leads to injury or involves violence, disturbs the bed partner or family, or excessive eating.

Treatment might involve medical intervention with prescription drugs or behavior modification through hypnosis or relaxation/mental imagery. Types of medication that are used for treatment are antidepressants and sleeping pills. See your doctor for advice about this and any other form of treatment.

Confusional Arousals Disorders Self Care

• Following good sleep habits helps to decrease the chances of an attack.
• Behavioral waking episodes later in the night can worsen confusional arousals earlier in the night, so elimination of these problem wakings can help reduce or eliminate confusional arousals.
• Medication can be tried if the arousals are very frequent and disturbing others. The tranquilizer clonazepam is most often used at bedtime for this problem (0.125-0.5 mg). It is given for a few weeks and then usually withdrawn without resumption of the attacks.