Confusional arousals

Arousal disorders, including sleepwalking, sleep terrors, and confusional arousals, are the most common forms of parasomnias. They are predominantly associated with arousals from slow-wave sleep, which in turn occur most prominently in the first third of the night. They can present as one disorder or any combination of the three forms mentioned. Awakening the person during the arousal type of parasomnia is difficult; the affected individual usually will not remember the event on awakening in morning. Confusional arousals can occur throughout the night but are seen most commonly during the first half of the major sleep period when NREM density is highest. Confusional arousals are estimated to affect 4 percent of adults. It is characterized by abrupt awakenings with apparent confusion, diminished vigilance, disorientation and occasional violent or inappropriate behaviour (Farid et al, 2004). Confusional arousal typically appears in young children up to the age of five years. Polysomnographic recordings of affected individual show clear association of confusional arousal episodes with slow-wave sleep mainly in the first part of the night. Confusional arousals usually are not harmful to the patient and are usually self-limited. Usually, there is no indication to intervene during the episodes of confusional arousal (Young, 2008).

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