Parasomnias
Confusional Arousals (Sleep Drunkenness)
Waking partially from deep sleep in a confused, disoriented state, with slow responses and little memory of it. Often called sleep drunkenness.
Overview
Confusional arousals are episodes in which a person partially wakes from deep sleep but remains confused and disoriented. They may sit up, speak slowly or nonsensically, respond poorly to questions and seem not to recognise their surroundings. Episodes usually last a few minutes, and there is little or no memory afterward.
They are common in young children and often outgrown. In adults they are frequently linked to other factors such as sleep deprivation, shift work, sleep apnea, mental health conditions, alcohol or sedating medicines.
Most episodes are harmless, but confusion on waking can lead to accidents, for example if woken suddenly to drive or operate equipment.
A 2014 US study of more than 19,000 adults found that 15.2% reported confusional arousal episodes in the previous year, most of them linked to other sleep or mental health conditions or to medications.
Common symptoms
- Confusion and disorientation after waking
- Slow speech or slow responses
- Poor memory of the episode
- Inappropriate or odd behaviour on waking
- Episodes often occurring when woken from deep sleep
Causes and risk factors
- Sleep deprivation
- Shift work or irregular schedules
- Obstructive sleep apnea and other sleep disorders
- Alcohol or sedating medicines
- Depression, anxiety or bipolar disorder
- Being woken suddenly from deep sleep
- Family history
How it is diagnosed
Diagnosis is based on a description of the episodes from the person and bed partner or family. A sleep study may be used to look for sleep apnea, seizures or other causes, particularly in adults or when episodes are frequent or dangerous.
Treatment options
Getting enough regular sleep
Reduces deep-sleep pressure that triggers episodes.
Treating underlying conditions
Managing sleep apnea, mood disorders or other contributors.
Medication review
Reducing sedating medicines or alcohol where possible.
Specialist treatment
Rarely needed, for frequent or dangerous episodes.
What you can do yourself
- Keep a consistent sleep schedule
- Avoid alcohol, especially before bed
- Allow time to fully wake before driving or making decisions
- Make the bedroom safe
When to see a doctor
- Episodes are frequent or have led to injury
- Episodes started in adulthood
- You also have daytime sleepiness, snoring or mood symptoms
- Episodes involve aggression
Frequently asked questions
Is sleep drunkenness the same as grogginess?
Everyone feels groggy sometimes on waking. Confusional arousals are more pronounced, with marked confusion and poor memory of the episode.
What causes confusional arousals in adults?
Adult episodes are often associated with sleep deprivation, sleep apnea, mental health conditions, alcohol or sedating medicines. Addressing these often helps.
Are confusional arousals dangerous?
Most are harmless. The main risk is making decisions or driving while confused, so allow time to fully wake.
Do children have confusional arousals?
Yes. They are common in young children and are usually outgrown.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.