Imagine being awakened from a deep sleep where, instead of feeling ready to take on the day, you feel confused, tense, or a sense of an adrenaline rush. If you’ve experienced such feelings, you may have had an episode of sleep drunkenness.

Sleep drunkenness is a sleep disorder that describes feelings of sudden action or reflex upon waking up. It’s also called confusional arousal. Cleveland Clinic estimates that it happens in 1 in 7 adults, but the actual number of people can be much greater.

Read on to learn more about sleep drunkenness and how to deal with it.

Symptoms of sleep drunkenness may include the following:

  • confusion upon being awoken, also known as confusion arousal
  • startled reflexes
  • blunt responses
  • physical aggressiveness without remembering it happened
  • slow speech
  • poor memory or feelings of amnesia
  • brain fog during the day
  • difficulty concentrating

While it’s common to want to hit the “snooze” button after your alarm goes off, sleep drunkenness causes many people to repeatedly go back to sleep without fully waking up first.

Episodes of confusional arousal tend to last for 5 to 15 minutes. According to the American Academy of Sleep Medicine, some episodes may last as long as 40 minutes.

After sleeping, your brain doesn’t just suddenly wake up — it has to first go through a natural process called sleep inertia. You experience grogginess and perhaps the initial difficulty in getting out of bed right away.

Sleep drunkenness bypasses the sleep inertia phase, so your brain and body don’t get the opportunity to transition into the awakened phase.

The potential causes of sleep drunkenness may be related to other factors that affect your sleep. These can include sleep disorders, such as sleep apnea, as well as general sleep deprivation.

Restless leg syndrome may be another cause of sleep drunkenness because it can affect your quality of sleep at night.

Other factors that can trigger sleep drunkenness include:

  • work schedule, especially varying shifts
  • changes in mood as well as bipolar disorder
  • drinking alcohol
  • anxiety disorders
  • stress and worries, which can become exacerbated at night when you’re trying to sleep

According to Cleveland Clinic, sleep drunkenness may also be caused by getting either too little or too much sleep. In fact, some estimates indicate that 15 percent of sleep drunkenness is linked to getting nine hours of sleep per night, while 20 percent of reported cases are linked to getting less than six hours.

People who experience sleep drunkenness are also more likely to have longer periods of deep sleep. Confusional arousals are also most commonly occur at the first part of the night during your deep sleep cycle.

Sleep drunkenness is a common occurrence that doesn’t have one particular cause. Instead, researchers have identified possible contributing factors, such as:

  • A preexisting mental health disorder. One studyfound that 37.4 percent of people with confusional arousal also had an underlying mental health disorder. While bipolar and panic disorders were most prevalent, anxiety, depression, and post-traumatic stress disorder (PTSD) were also noted.
  • Taking antidepressants. The same study also found that 31 percent of people who reported sleep drunkenness also took psychotropic medications. These primarily included antidepressants.
  • Getting too little sleep on a regular basis. Insomnia is another related risk factor that can lead to this type of sleep deprivation.
  • Getting too much sleep on a regular basis. This could also be related to an underlying health condition.
  • Hypersomnia. This refers to excessive daytime sleep as well as constant difficulty getting up in the morning. Hypersomnia may occur with or without sleep drunkenness.
  • Having a family history of parasomnias. These include:
    • sleep drunkenness
    • sleep walking
    • restless leg syndrome
    • sleep apnea

Diagnosing sleep drunkenness is often a multi-step process. Your friends or your partner may tell you that you’ve acted strangely upon waking up but you might not remember. An occasional episode isn’t concerning. However, if sleep drunkenness occurs at least once a week, it’s time to see a doctor.

Your doctor will review your records, looking for any risk factors, such as preexisting medical conditions or any psychotropic meds that you currently take. A sleep study may be ordered as well. This might show some clues, including a higher than normal heart rate during sleep.

There’s no single treatment used for sleep drunkenness. Most of the treatment measures involve lifestyle measures.

Your doctor may recommend one or more of the following:

  • avoiding alcohol, especially right before bedtime
  • getting a full night’s sleep — between seven and nine hours — every night
  • avoiding daytime naps
  • taking antidepressants as prescribed
  • starting sleep medications, which are only prescribed by doctors in severe cases

While sleep drunkenness doesn’t necessarily require treatment, you might want to see your doctor if it’s causing dangerous side effects. These can include:

  • injuries to yourself and others upon waking up
  • missed work
  • sleeping on the job
  • frequent daytime naps
  • persistent insomnia
  • waking up tired
  • problems in your relationships

Your doctor will evaluate your symptoms and your overall health history to determine if any testing is needed. This may include a sleep study.

Sleep drunkenness is a common event. If you’re feeling confused, aggressive, or panicked upon awaking, then you might have had an episode.

Seeing your doctor is the first course of action. A sleep study can also determine what’s going on and help your doctor develop a treatment plan for a good night’s rest — and awakening.