Sleep Disorders Insomnia & More Disorders Understanding Confusional Arousals or Sleep Drunkenness By Brandon Peters, MD Brandon Peters, MD Facebook Twitter Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial process Updated on March 04, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Kashif J. Piracha, MD Medically reviewed by Kashif J. Piracha, MD LinkedIn Kashif J. Piracha, MD, is board-certified in internal medicine and nephrology. He has an active clinical practice at Methodist Willowbrook Hospital in Houston, Texas. Learn about our Medical Expert Board Print Confusional arousals are episodes in which a sleeping person wakes up—or seems to wake up—but behaves strangely. The affected person may seem disoriented or unresponsive; if anything is said, it probably won't make a lot of sense or even be coherent because the speech is slow or slurred. 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." What are the symptoms and causes of confusional arousals and how should it be diagnosed and treated? Ray Kachatorian / Getty Images Confusional Arousals Are Parasomnias Confusional arousals, or sleep drunkenness, are grouped with a number of sleep disorders called parasomnias. These are sleep-related behaviors. Other examples of these include sleepwalking and sleep terrors. These partial or incomplete awakenings may be affected by sleep inertia. Parasomnias like 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. This deep slow-wave sleep predominates in the first third of the night, and may be more intensely experienced by children and adolescents. This is when growth hormone is normally released. 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. Who's At Risk? Besides kids, certain subsets of people are more likely than others to have confusional arousals and sleep drunkenness. These include folks with: Jobs require rotating or night shift workOther sleep disorders like sleep apnea or periodic limb movements of sleepSleep deprivationAlcohol use near bedtimeExcessive stress and worryBipolar disorder or chronic depression When the amount of slow-wave sleep or sleep fragmentation is increased, this can predispose towards the condition. 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 she was having an episode of confusional arousal. Adults who have confusional arousals sometimes come across as hostile or aggressive. The episodes are fairly brief, usually lasting less than 10 minutes, and may include simple movements and confused speech. Confusional arousals are characterized by amnesia and are not typically remembered the next day. Causes Confusional arousals also can happen in the wake of recovery from sleep deprivation or being forced to wake up; drug abuse or drinking too much alcohol; taking psychiatric medications; obstructive sleep apnea; and periodic limb movement disorder—sudden jerking movements of the legs during sleep that's sometimes associated with restless legs syndrome. 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 and 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 If bothered by persistent or recurrent confusional arousals, consider consultation with a board-certified sleep physician. It may be possible to identify techniques or treatments to reduce their frequency. Was this page helpful? Thanks for your feedback! Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Sleep Medicine, Confusional arousals—overview, and facts. Additional Reading 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.