Wednesday, March 2, 2011

Confusional Arousals a Parasomnia is a Sleep Disorder

Recently I wrote about Rapid Eye Movement Sleep Behavioral Disorder in which I talked about parasomnias and what they were. Confusional Arousals, a parasomnia, is a sleep disorder that causes a person to yell or thrash about in bed while they are asleep. Sometimes confusional arousals are referred to as sleep drunkenness or severe morning sleep inertia, but confusional arousals occur during the night and severe morning sleep inertia happens upon wakening. Both cause the person to react very slowly to stimulation and if they do wake, they will have a hard time understanding what is happening to them. Trying to calm a person in this state can be difficult because it is very hard to waken them until the arousal is over, then they can be calmed to fall back to sleep easy. Symptoms include slow speech, confused thinking, poor memory or short response to questions and requests. These events can last a few minutes to a few hours.

[caption id="attachment_930" align="alignright" width="169" caption="Confusional Arousals a Parasomnia is a Sleep Disorder - Yelling and Thrashing During Sleep"][/caption]

Confusional arousals happen in young children, teen and adults. Sometimes with adults they can become very aggressive and can cause stress in their relationships. Children confusional arousals can seem frightening to watch as the child is yelling and flinging their arms and legs about. If their eyes are open they may look like they are staring right at you but will not respond or might even become agitated to your approach to wake them. Remember yelling or shaking the child awake will only cause them to become more frightened and it will take them longer to go back to sleep once the episode is over. Young children’s episodes can last longer than those that occur with teens or adults. Once they are teens other sleep disorders can happen along with their confusional arousals like sleepwalking or obstructive sleep apnea (OSA), a sleep disorder that causes periods when breathing stops which interrupts deep sleep. A doctor may recommend the removal of tonsils and adenoids to alleviate the obstruction to the airway passage. Teens are more likely to have vivid dream due to outside influences such as horror movies or even the news that they act out during sleep, a rapid eye movement sleep behavioral disorder.

Are you suffering or at risk for confusional arousals? You are more likely to have this disorder if it is in your family history but if you work the late or split shift, sleep deprivation, drink alcohol in excess, suffer from bipolar or depressive disorders, stress/anxiety and/or abuse drugs you are also at risk. Confusional arousals are also associated with other sleep disorders such as; hypersomnia, insomnia, OSA, periodic limb movement disorder (PLMD) and circadian rhythm sleep disorders.

[caption id="attachment_929" align="alignright" width="362" caption="Confusional Arousals a Parasomnia is a Sleep Disorder - Epworth Sleeping Scale (ESS) "][/caption]

If you are having difficulty getting through the day, lack focus and motor function it is advised to talk to your doctor, but you may want to keep a sleep journal for at least two weeks before your appointment to help the doctor diagnosis your condition. The sleep journal should include all confusional arousals, how many hours you sleep every night and if you get sleepy during the day. Dr. Murray Johns was the Founding Director of the Sleep Disorders Unit at Epworth Hospital, Melbourne, Australia. He developed the Epworth Sleeping Scale (ESS) a questionaire that assesses a person’s daytime sleepiness. However, many people with a variety of sleep disorders have normal ESS scores. It is just an example of some of the questions you should ask yourself to determine if you need consultation or treatment for your condition. Once you see your physician he will want your family medical history along with all herbal supplements, OTC’s and prescription drugs you are taking.

He may recommend a sleep study or polysomnogram that will monitor your brain waves, heart beat and breathing patterns while you sleep. They can also watch to see if your arms and legs move or determine if you have another sleep disorder like OSA or periodic limb movement disorder.

In most cases, no treatment is necessary. These events rarely indicate any serious underlying medical or psychiatric problem. In children, the number of events tends to decrease as they get older, although they may persist into adulthood. Remember to clear the bedroom of obstructions, secure doors and windows with locks and alarms and try to have the person to sleep on the first floor to avoid injury. If any underlying causes are indicated they need to be treated first. Treatment for confusional arousals may include prescription drugs like clonazepam or behavioral modification techniques. Behavioral modification techniques can be to make sure they have good sleeping habits which include getting the proper amount of sleep for their age group to decrease the chance for an episode and/or 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.

he content provided in Confusional Arousals a Parasomnia is a Sleep Disorder is for information purposes only, intended to raise the awareness of different solutions for you or your families sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.

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