The place of confusional arousals in sleep and mental disorders - Findingsin a general population sample of 13,057 subjects

Confusional arousals, or sleep drunkenness, occur upon awakening and remain un studied in the general population. We selected a representative sample from the United Kingdom. Germany, and Italy (N = 13,0.57) and conducted tel ephone interviews. Confusional arousals were reported by 2.9% of the sample : 1% (95% confidence interval: .8 to 1.2%) of the sample also presented wit h memory deficits (53.9%), disorientation in time and/or space (71%), or sl ow mentation and speech (54.4%), and 1.9% (1.7% to 2.1%) reported confusion al arousals without associated features. Younger subjects (< 35 years) and shift or night workers were at higher risk of reporting confusional arousal s. These arousals were strongly associated with the presence of a mental di sorder with odds ratios ranging from 2.4 to 13.5. Bipolar and anxiety disor ders were the most frequently associated mental disorders. Furthermore, sub jects with Obstructive Sleep Apnea Syndrome (OSAS), hypnagogic or hypnopomp ic hallucinations, violent or injurious behaviors, insomnia, and hypersomni a are more likely to suffer from confusional arousals. Confusional arousals appears to occur quite frequently in the general population, affecting mos tly younger subjects regardless of their gender. Physicians should be aware of the frequent associations between confusional arousals, mental disorder s, and OSAS. Furthermore, the high occurrence of confusional arousals in sh ift or night workers may increase the likelihood of inappropriate response by employees sleeping at work.