The essential features of confusional arousals are mental confusion or confusional behavior during or following arousals from sleep, typically from deep non-rapid eye movement (NREM) or slow-wave sleep (SWS) in the first part of the night, but also upon attempted awakening from sleep in the morning. The notion of confusional arousals in children has received less attention overall compared with that concerning adults. The impression gained in adults is that, especially in response to forced awakenings, the behavioral disturbance in adult episodes is more forceful, vigorous and resistive, sometimes leading to violent behavior. Childhood confusional arousals do not usually require treatment, only advice to parents that they can be considered to be a passing phase. The same cannot necessarily be said of confusional arousals in adult life when they have more of a tendency to persist, depending on their etiology and relationship to other sleep disorders.