A 5-year-old girl is brought by her parents who report that twice weekly she sits up in bed about an hour after falling asleep, mumbles incoherently, appears confused, and pushes away attempts at comfort. She has no memory of the events. She is otherwise developmentally normal. Which feature best distinguishes these episodes from sleep terrors?

• A Occurrence during the first third of the night
• B Lack of recall of the event the next morning
• C Occurrence during NREM slow-wave sleep
• D Absence of autonomic activation such as tachycardia and diaphoresis ✓

Explanation

Confusional arousals are characterized by mental confusion and disorientation upon arousal from slow-wave sleep, with minimal autonomic activation. Sleep terrors feature intense fear, screaming, and prominent autonomic signs (tachycardia, diaphoresis, mydriasis). Both occur in NREM sleep in the first third of the night and are not recalled, so those features do not distinguish them.

Reference: Principles and Practice of Sleep Medicine, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.