Use of safety measures for the patient and family by clearing the bedroom from obstacles, securing the windows, or installing locks or alarms. Medications are necessary if the patient is in danger from his or her behaviour. In this case, Imipramine or low-dose Clonazepam is beneficial. Epidemiology
The current prevalence of confusional arousals varies according to the year and the sample population and is approximately 4% (4.2% in 1999 in UK sample population, 6.1% (15–24 years old), 3.3% (25–34 y.o.) and 2% (35+ y.o.) in 2000 in UK, Germany and Italy sample population, 6.9% in 2010 in Norway sample population with a lifetime prevalence of 18.5%). The current prevalence of confusional arousals in children (3–13 y.o.) is higher and around 17.3%. Confusional arousals without a known cause or associated condition is uncommon (for about 1% of cases ).The contribution of genetics and family link is strong and episodes of confusional arousals can occur in several members of the same family. Risk factors
Some independent risk factors associated with confusional arousals have been identified. According to studies, they are shift work, hypnagogic hallucinations (also known as hypnagogia), excessive daytime sleepiness, insomnia and hypersomnia disorder, circadian rhythm sleep disorder, restless legs syndrome, obstructive sleep apnea syndrome (OSAS), bipolar disorder, daily smoking, and age of 15–24 years. These risk factors of confusional arousals are somehow related to mental disorders and medical conditions and affecting mostly younger subjects regardless of gender.
Precipitating factors include sleep deprivation, use of hypnotics or tranquilisers before bedtime, and sudden awakening from sleep (e.g., telephone ringing, alarm clock).In the ICSD-2 alcohol intake had been considered as a precipitating factor of confusional arousals. In the ICSD-3 the relation between alcohol use and disorder or arousal have been excluded. Moreover, the alcohol blackout has been added as a differential diagnosis. These changes have important implications for forensic cases. == References ==