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A confusional arousal is when a sleeping person appears to wake up but their behavior is unusual or strange. The individual may be disoriented, unresponsive, have slow speech or confused thinking. Confusional arousals typically occur in the first 2 hours of falling asleep during a transition from "deep" sleep to a lighter stage of sleep. The episode may last only a few minutes or continue on for a longer period of time. There is usually little or no recall of the arousal or any event that may had occurred during the episode the next morning.
Confusional arousals can occur at any age, but are more common in children. Sleep disruptions caused by health problems (such as fever), travel, abrupt sleep loss, migraine, and irregular sleep-wake schedules may trigger an episode. Another sleep disorder such as sleep-disordered-breathing and to a lesser extent restless legs syndrome or nocturnal asthma may also be seen in association with the confusional arousals.