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Are confusional arousals pathological?
Maurice M Ohayon1, Mark W Mahowald2, Damien Leger2
1From the Division of Public Mental Health and Population Sciences, Stanford Sleep Epidemiology Research Center (M.M.O.), School of Medicine, Stanford University, CA; Minnesota Regional Sleep Disorders Center (M.W.M.), Department of Neurology, Hennepin County Medical Center, The University of Minnesota Medical School, Minneapolis; Université Paris Descartes (D.L.), APHP, Hôtel-Dieu de Paris, Centre du Sommeil et de la Vigilance, France. mohayon@stanford.edu.
Confusional arousals (CAs) are common, often linked to sleep or mental health disorders, and sometimes associated with psychotropic medications like antidepressants. Most CA cases are not medication-induced.
Area of Science:
- Sleep Medicine
- Psychiatry
- Epidemiology
Background:
- Confusional arousals (CAs) are disruptive sleep events.
- Understanding their prevalence and associations is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate the association between confusional arousals (CAs) and mental disorders or psychotropic medications.
Main Methods:
- A cross-sectional study of 19,136 US adults using the Sleep-EVAL expert system.
- Data collected on sleep habits, health, and diagnosed conditions (DSM-IV-TR, ICSD-II, ICD-10).
Main Results:
- 15.2% of the sample reported CAs; 84% were linked to sleep/mental disorders or psychotropic drugs.
- Sleep disorders (70.8%) and mental disorders (37.4%) were significant factors, particularly bipolar and panic disorders.
- Antidepressants were the most common psychotropic medication used by individuals with CAs.
Conclusions:
- Confusional arousals are highly prevalent and frequently associated with underlying sleep or mental health conditions.
- While medications, especially antidepressants, can be associated with CAs, most cases occur independently of drug use.
- Sleep and mental disorders are key independent factors contributing to the occurrence of CAs.
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