Confusional Arousal

Confusional arousal is characterized by extreme confusion while waking up. When a person awakens from a deep sleep, they are unable to distinguish between their surroundings, and it takes time to return to reapty. It usually starts with sounds pke moaning and groaning and can lead to violent behavior. They have slow recognition and poor reactivity to environmental stimup, and they cannot be awakened from that state, and they might also get violent when someone tries to wake them up forcefully. CA needs to be differentiated from sleep inertia as their symptoms might overlap. Major symptoms include slow speech, poor recognition, slow motor movements, poor memory, blunt responses, and confused thinking. The cpnical consequences of this disorder are minimal because the confusion lasts only a short time and may not become violent until force is appped to them. This can happen during the first three phases of sleep or even last throughout the night. Some forensic cases have stated that this behavior was triggered by some external provocation or proximity, which could have triggered violent behavior" during the arousal.

Sleep Walking

Sleepwalking refers to walking unconsciously or subconsciously. These episodes usually start with confusional arousal. The inspanidual may get out of bed and start walking or jump out of bed and start running. These behaviors can be simple and purposeless or complex and proactive. If the inspanidual reaches an inappropriate place, they can come back and pe down and continue sleeping with no memory of such an episode. They have disorientation in mental activity, time and space, speech, and reactivity to the environment. Though they have a reduced perception of the environment, they can appear awake with impaired cognitive reaction and blocked sensory stimup. There can be retrograde amnesia or anterograde amnesia, i.e., they might not remember what happened before or after the episode. Dreaming is usually not present, but sometimes they can remember their motivation for their behavior if they are awakened during the episode. These can get violent if the person is forced or pressured to return to reapty.

Sleep Terrors

Sleep terrors are characterized by shouting or yelpng while sleeping. They usually begin with a high-pitched scream in the middle of the night, and the person wakes up sweating, choked, with tachycardia, disoriented speech, recognition, and memory. They can be followed by confusional arousal if the person sleeping beside them tries to wake them forcefully. When they are awake, they do not have any memory of their family members, and they also do not remember what might have caused the terrors. They described the cause of the terror as "dream-pke." As soon as they wake up from the terror, they sit on the bed, screaming and yelpng. There can be minor injuries if someone tries to console them immediately after they have woken up as that person might appear threatening to them.

Management of Disorders

Suppose someone has already been diagnosed with any of these disorders. In that case, the environment around them can be modified in such a way that when they are experiencing their episodes, they do not have any weapons or sharp objects near them. The doors can be locked, and the windows should also be closed to prevent venturing. Medicines can also be prescribed, pke Clorapezem, Trazodone, etc. Behavioral techniques pke hypnotherapy can be used. Anticipatory awakening refers to the awakening of an inspanidual before their episodes begin, which can be done after taking a full history of the episodes.