If your child wakes you in the night by shouting, screaming or thrashing about – all while they’re still asleep – they could be having confusional arousals. But what exactly are these sleep disorders – and how should you deal with them?
What are confusional arousals?
Confusional arousals are sleep disorders that occur when your child is in a mixed state of being partly awake and partly asleep.
They usually happen during the first half of the night, when your child is coming out of the deepest stage of sleep, although if he has several during the night, they may spill over into the second half, too.
They’re most common in children under six, and typically start at around 18 months. It’s thought that about 17% of kids are affected; most will outgrow the problem.
How to spot the signs of confusional arousals
Unlike night terrors, which begin suddenly, confusional arousals often start with a child moaning and fidgeting.
In a mild confusional arousal, he may simply wake up, look around, appear disorientated and then go back to sleep.
In more severe cases, he might become very restless and agitated, kicking and thrashing around in bed or even standing up. It may look as if he’s having a tantrum.
He’s likely to seem confused and disorientated.
Although your child’s eyes are open during a confusional arousal, he’s not awake, so he won’t respond if you try to comfort him. In fact, you should avoid trying to wake him, as he may become aggressive.
A confusional arousal will usually settle after five to 10 minutes, but they can go on for as long as 45 minutes.
After this, your child will go back to sleep and have no recollection of the episode the next day.
What causes confusional arousals?
Confusional arousals in toddlers and pre-school children are more likely if your child’s normal sleep pattern is disturbed, for example by a change to his daytime nap routine, travel or a stressful event like moving house or starting nursery.
They can also be triggered by overtiredness, a high temperature and certain medications.
Confusional arousals often run in families, and are more common in kids who have night terrors or sleepwalk.
Helping your child with confusional arousals
There’s not much you can do to treat confusional arousals, and most children eventually grow out of them.
Unlike with nightmares, your child is unlikely to have any memory of a confusional arousal when he wakes, so discussing it with him tends not to help. You can, however, try to have a more general chat to see if something is making him feel stressed or anxious.
If your child continues to have confusional arousals over the age of six, it’s worth discussing it with your doctor to rule out other conditions such as sleep apnoea (episodes of interrupted breathing overnight).
In the meantime:
- Ensure your child is getting enough sleep.
- Keep to regular day and night-time routines to help set his body clock.
- Make sure the bedroom is safe to avoid accidental injury.
- Let each episode run its course, without interfering (unless your child wants to be comforted or you need to keep him safe).
- Don’t make a big deal of it, and warn siblings not to tease your child about it.