Confusional arousal

  Can you give me some information on what confusional arousal is, the symptoms of it, and how common it is? I have a one year old who wakes up several times a night, but acts strangely. He is much more agitated than during the day. He won't allow us to hold him, he throws his head back and arches away from us. When we lay him down, he writhes around like he is possessed. Sometimes we can snap him out of it by nursing or turning the light on. He also sleeps very lightly for extended periods of time, sometimes hours, tossing and turning. I was reading about sleep and came across confusional arousal. Could this be what he has? Do children outgrow this kind of behavior? Thank you, Amanda

[HVM Ph.D. - KDK]

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Dear Amanda,
Confusional arousal is one type of pediatric sleep disorder. During a confusional arousal the child may display bizarre behavior, agitation, crying and moving rather wildly about or thrashing. During an episode of confusional arousal the child might sit up and talk or scream - this is due to their feeling frightened and confused, and the child will generally be unresponsive to the attempt of parents to reassure or calm him.
It is generally better to allow the child to return to sleep, not to attempt to fully waken the child. Though a child might appear to be fully awake during an episode of confusional arousal, the child actually is only partially awake - i.e., part of the brain is in deep sleep and part wakes up.
As a child develops, the mechanism by which sleep moves in cycles through several stages (deep sleep, light sleep, dreaming sleep) becomes more refined. Confusional arousals are normally viewed as a normal feature of this maturational process.
The symptoms you describe are certainly typical of confusional arousals. A worthwhile book to examine to learn more about normal childhood sleep and sleep disorders is Solve Your Child's Sleep Problems (by Richard Ferber).
On a cautionary note, the symptoms of confusional arousal are very much like those of complex partial seizures, and it would probably be worthwhile to have a discussion with your pediatrician to consider this possibility. If the ultimate diagnosis is that of confusional arousal, don't try to wake your son up. Rather, quietly and gently 'guide' him back to sleep. But don't be surprised if the episodes last for fifteen minutes or so, though this is not the usual duration of an episode. Usually the episodes last for only a brief period of time.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options that pertain to your specific medical condition or situation.
*Keyword: Confusional arousal, sleep disorder