Confusional awakenings: Explanation, cause, how to treat it?

What is confusional awakening?

Confusional awakening is a parasomnia, in other words a sleep disorder, appearing during the phase of deep slow sleep (at the beginning or at the end of the night). The

sleep disordersappearing during this period can be of several types: confusional awakenings,night terrors or thesleepwalking. Unlike nightmares or sleep paralysis which only appear in paradoxical sleep (in the middle of the night), confusional awakenings leave no memory of the person who experiences them.

Also called "sleep drunkenness", this disorder can be similar to the behavior of a person in a state of intoxication, associatingdifferent symptoms: confusion of words, disorientation in time and space, psychomotor slowing (slowness of speech, slowness of ideas, etc.) but also difficulties in understanding. It is observed in particular when the person is suddenly awakened.

In some cases, the behavior may be maladaptive or even violent that the person cannot explain upon awakening, these episodes generally being accompanied by complete amnesia of the confusional episode.

The causes of confusional awakenings in children

Confusional awakenings are very common in babies and toddlers, with a prevalence close to 15%. Although they generally appear at the start of the night, they can be repeated during the night but also appear during the siesta. These episodes can last nearly an hour and are disturbing for both the child and the parents.

Among the identified causes of confusional awakenings in children, we find in particular:

• an irregular sleep pattern
• sleep deprivation, when the child goes to bed too late or does not take a nap
• hypersomnia
• stress or anxiety induced by an environmental event (change of school, death, family conflicts, etc.)
• drinking large quantities of drinks before bedtime, which distends the bladder and causes discomfort

Faced with sleep disorders in a young child, it is important to consider these different possible causes, in order to better adapt the daily routine and the environment of the latter.

The causes of confusional awakenings in adults

Less frequent than in children, confusional arousals are found in 3 to 5% of the adult population. These episodes can appear in both men and women and generally do not exceed 15 minutes.

While nocturnal awakenings have, until now, been the subject of little research, some researchers have taken an interest in their probable causes. In adults, these confusional episodes are mainly induced by:

• lack of sleep or, conversely, hypersomnia
• drinking before bedtime
• a disorganization of the sleep/wake rhythm
• a mood disorder (depression, anxiety disorder, bipolar disorder)
• taking psychotropic drugs
• stress caused by personal or professional concerns
• sleep apnea

Consequences of confusional awakening

While they may seem trivial, confusional episodes represent an embarrassment or even a danger, especially when they persist over time.

They are mainly an annoyance for the spouse, sometimes forced to take a separate room in front of the agitation of the confused person, who wakes up with a start, is completely incoherent and speaks loudly.

They are, obviously, a nuisance for the person who is a victim since the sleep is of poor quality and necessarily leads to daytime fatigue.

The person can then enter a vicious circle, knowing that fatigue can itself be responsible for the confusional awakenings. Finally, confusional awakenings can present a danger, especially if the person gets up with a start, risking bumping or injuring themselves if the environment is not suitable.

Solutions against confusional awakenings

Faced with confusional awakenings: what to do?

This is the question asked by many parents of children who experience them, but also by adults who experience them and are helpless in the face of their consequences.

In the first place, they should question the probable causes of these nocturnal awakenings: is the sleep sufficient and of good quality? Do you take medication or consume alcohol in the evening? Are you particularly stressed at the moment? So many questions that you should not hesitate to discuss with your doctor in order to be able to act as best you can.

Therefore, make sure you adopt the right reflexes and an irreproachable lifestyle. Go to bed at fixed times and make sure your nights are long enough to avoid the accumulation of fatigue. For young children, make sure that the night-wake-nap rhythm is constant, or even reintroduce naps for children who no longer take them.

This will prevent them from being too tired at bedtime in order to limit the deep sleep phase at the start of the night. Limit alcohol intake in the evening as much as possible, but also drink too much before bedtime (water, milk, etc.). Also try to reduce sources of stress, by trying relaxation or even considering psychotherapy. Regarding the environment, make sure your room is tidy, and put away anything that could pose a danger if you get up, haggard, in the middle of the night.

The homeopathy is particularly indicated in the face of confusional awakenings, and parasomnias in general, to soothe the person and promote quality sleep. Rather than opting for self-medication, it is better to approach your doctor who will advise you on a homeopathic medicine depending on the disorder encountered. The effectiveness of homeopathic treatments in sleep disorders seems proven, especially in children, with use over a few days.

Finally, in the event of a persistent disorder, consider consulting a sleep specialist who can recommend the performance of in-depth examinations (EEG, video recording of sleep, etc.) in order to eliminate the hypothesis of epilepsy frontal and specify the nature of the parasomnia.