Most people have more energy, think more clearly and react more quickly after a good night’s sleep.
For some people with epilepsy, sleep is specially important. This is because disturbed sleep patterns, or not having enough good quality sleep, can make seizures more likely.
There are also some types of epilepsy, where seizures have a particular connection to sleep.
Contents
- Links between epilepsy and sleep
- Stages of sleep
- The effects of having seizures on your sleep
- The effects of epilepsy treatment on sleep
- Lack of sleep as a trigger for seizures
- Epilepsy with other sleep disorders
- Alerting others to your seizures
- How to get a good night’s sleep
- Conclusion
- Further information
Links between epilepsy and sleep
There are many different types of epilepsy. And some seem to be particularly related to sleep. Three of the more common are epilepsy grand mal on awakening, juvenile myoclonic epilepsy and benign rolandic epilepsy.
Epilepsy grand mal on awakening
In this type of epilepsy, you have tonic-clonic seizures either just before, or just after, you wake. This may be in the morning, after a night’s sleep, or during the day after a nap. Tonic-clonic seizures used to be called grand mal. They are the ones most of us think of when we imagine someone having an epileptic seizure. They are sometimes referred to as convulsions.
Epilepsy Action has more information about tonic-clonic seizures.
Juvenile myoclonic epilepsy (JME)
In juvenile myoclonic epilepsy, seizures may happen shortly after waking. Or they may happen at other times, but when you are very tired. You may find that not having enough sleep could make your seizures more likely.
In JME, you have three different kinds of seizure.
- Absence seizures: you appear to be daydreaming, staring or blinking.
- Myoclonic seizures: you have brief jerking movements of different parts of your body.
- Tonic-clonic seizures: you have stiffening, then jerking of the whole of your body.
Epilepsy Action has more information about juvenile myoclonic epilepsy, absences seizures, myoclonic seizures and tonic-clonic seizures
Benign rolandic epilepsy (BRE)
If you have this kind of epilepsy, you will have focal (partial) seizures, in your sleep. Occasionally, you might have seizures when you are awake.
Focal seizures affect just a part of your body. In BRE they affect your mouth and you might dribble a lot of saliva. Sometimes they cause your arms and legs to jerk. Some people with Benign rolandic epilepsy also have tonic-clonic seizures. BRE affects almost one in five of all children with epilepsy.
Epilepsy Action has more information about focal seizures, tonic-clonic seizures, and benign rolandic epilepsy.
Stages of sleep
For some people, seizures are related to different stages of sleep. There are five stages of sleep with different brain activity in each.
1. Drowsiness - this stage lasts five or 10 minutes. Your eyes move slowly under your eyelids, your muscles begin to relax and you are easy to wake up.
2. Light sleep - your eye movements stop, your heart rate slows, and your body cools down.
3. and 4. Deep sleep - it’s not easy to wake you during these stages of sleep. If you do wake, you will be groggy and not quite with it for a few minutes. This kind of sleep allows your brain to rest and restores your energy. Your immune system is helped by deep sleep.
5. Rapid eye movement (REM) sleep - about 70 to 90 minutes into your sleep cycle, you enter REM sleep. You usually have three to five episodes of REM sleep each night. This stage is associated with processing your emotions, filing your memories and relieving your stress.
The effects of having seizures on your sleep
If you have a seizure during your sleep, it affects your sleep patterns for the rest of the night. Your sleep becomes lighter, and you wake up more often. The most serious effects are on REM sleep. REM sleep is greatly reduced, and may even disappear.
Seizures when you’re awake can also reduce your REM sleep the following night.
Although it’s important to get enough REM sleep, it’s not clear how to get enough, apart from by controlling your seizures. If your seizures aren’t fully controlled, your doctor should refer you to an epilepsy specialist for an assessment of your epilepsy and your epilepsy medicine.
If it’s not possible to control all your seizures, you should try to catch up on missed sleep, particularly in the day or two after a seizure.
The effects of epilepsy treatment on sleep
Most people with epilepsy take epilepsy medicine to control their seizures. Like all types of medicine, epilepsy medicines can have unwanted side-effects. The following epilepsy medicines may have sleep-related side-effects.
Epilepsy medicine |
Side-effect |
| Ethosuximide | sleep disturbances, night terrors |
| Lamotrigine | insomnia (difficulty sleeping), sleep disturbance |
| Pregabalin | insomnia, abnormal dreams |
| Topiramate | sleep disturbance |
|
Gabapentin
Levetiracetam Phenytoin Rufinamide Topirimate Zonisamide |
insomnia |
If you are concerned that your epilepsy medicine is causing side-effects, speak with your doctor. They may be able to help.
Lack of sleep as a trigger for seizures
For many years, it has been thought that not having enough sleep makes a person with epilepsy more likely to have seizures. This seems to be the case for some people, but not everyone. Instead, it could be lack of sleep, combined with things such as stress, alcohol or going without food that is more likely to trigger seizures.
Epilepsy with other sleep disorders
Alerting others to your seizures
If you worry about having a seizure and not having anyone to make sure you’re safe, you could consider getting a seizure alarm.
There are different kinds of alarm available. What type you would need would depend on the kind of seizures you have. For example, some alarms are sensitive to movement. So if you have tonic-clonic seizures (grand mal, convulsions) then this type of alarm will detect them. There are other types of alarm available.
Alarms would only be suitable if there was someone the alarm could alert, so that they could help you.
How to get a good night’s sleep
If you have problems getting a good night’s sleep, Ann Jacoby and Gus Baker from Liverpool University, UK, offer the following tips.
- Have a regular bedtime and getting-up time.
- Avoid taking naps during the day.
- Make sure your bedroom is at a comfortable temperature.
- Make sure the bedroom is dark and free of noise.
- Avoid stressful activities or situations before bed.
- Avoid stimulants, such as alcohol, caffeine and exercise in the late evening.
Conclusion
- Some seizures seem to be connected to sleep.
- Lack of sleep can trigger seizures for some people.
- Seizures and epilepsy medicines can affect sleep.
- Some people with epilepsy also have sleep disorders.
- If sleep disorders are treated, epilepsy may become better controlled.
Further information
You can get further information about any of the issues discussed here from your own doctor.
Read more about research into epilepsy and sleep [PDF file], featured in our members' magazine Epilepsy Today.
We can provide references and information on the source material we use to write our epilepsy advice and information pages. Please contact our Epilepsy Helpline by email at helpline@epilepsy.org.uk.
Epilepsy Action would like to thank Dr Henry Smithson, Academic Unit of Primary Medical Care, Sheffield, UK, for reviewing this information.
Dr Henry Smithson has no conflict of interest to declare.
This information has been produced under the terms of The Information Standard.
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Updated August 2012To be reviewed August 2014
Comments: read the 9 comments or add yours
Comments
I am 47 years old and over the last few years I have been experiencing sleep paralysis (occasionally) and suffering from insomnia, but this comes and goes and for the past couple of weeks, I have not had any problems. I did, however, have an experience about 3 weeks ago and have not experienced it since. I was having problems sleeping and was very restless (restless leg syndrome), although, I had been asleep on and off in the night. I was awake about 4 am with aching legs and a tingling sensation in my arms and legs. My husband went downstairs to get a glass of water when, suddenly, I felt my head beginning to shake and I had a sudden rush of pins and needles throughout my body. My mouth was paralysed, I was dribbling and moaning. I was lying on my side and awake as I was staring at the open door. It lasted just a few seconds and I was able to sit up. My husband then came back into the room unaware of what had happened. I got out of bed and felt very wobbly, dizzy and lightheaded with tingling still in my arms and legs. I felt very strange for the next couple of days and went to see my GP, who said I had had a panic attack. It certainly was not a panic attack as I was not breathing fast or heavily and was very relaxed. Sometimes, I go to bed feeling a bit 'iffy' and then I concentrate or get up and move about which seems to prevent anything happening. I have not experienced it since, but don't know if I should go back to my GP or just let it ride as being a one off thing.
My boyfriend had a fit during the night at 21 over the next few months he had another one he saw a neurologist and had all the tests which showed nothing nothing happened for over a year then again during sleep he had another and went on epilim chrono 500 he had another fit a couple of years later when he forgot to take his medication so they increased his dose, he was fit free for a couple of years so the doctor said to come off the medication then a couple of years later when i was pregnant with our 2nd child he had another during sleep so went back on the medication for 2 years then again they said to come off it so he did.
he has just had another fit over 4 years since his last .. still really scary and so weird that he goes so long without! He has a really stressful job and has suffered from chronic fatigue syndrome on and off since he was 21, He is back on the epilim now and been referred to specialist as not seeno one since he was 21 hoping that this will work .. we now have 3 kids and im terrified that they will see and be scared, I wont let them sleep in our bed now in case it happens again ... I cant sleep as i feel if he starts to have one then i need to be awake.. i wake him up any time he moves .. he hates it! but im so scared of it happening!
Also this time he has been totally exhausted since the fit which was 4 nights ago, he has been going to bed early and slept in the day for the day after the fit, is it normal to be tired for several days after?
Ok im 25 and I just had 2 Seizures in the Last 2 weeks and I am a Video Gamer but I also work to and im just wondering why I had 2 of em but mine happened when I woke up and got out of bed in the Morning and I started seeing like Fuzzy beads in my eyes like the stuff you see on a TV Screen and then I Blacked out and the first Seizure lasted about 30 minutes and the second one lasted about 15 minutes I think so.But what im asking is Trying to find a solution to what I might have can you possibly tell me what it is that Caused this? Thank You.
Hi Joe
As this appears to be your first experience of these blackouts/seizures we would advise you to see your family doctor. There could be various reasons for what you experienced. If your doctor thinks it may be epilepsy, they will refer you to see a neurologist. You can read our information on seizure types, photosensitive epilepsy (the type of epilepsy, in which all, or almost all, seizures are triggered by flashing or flickering light) and how epilepsy is diagnosed.
If you have any further questions, you may find it helpful to contact our Advice and Information Team directly. You can either, email us at helpline@epilepsy.org.uk or phone the Epilepsy Helpline freephone 0808 800 5050.
Diane
Advice and Information Team
Hi friend
I’m really sorry to hear how difficult things are for you just now. What’s happening for your boyfriend is not at all unusual. This includes the gaps between seizures, and the extreme tiredness. It’s a really good idea he is seeing a neurologist. There are large numbers of people who don’t grow out of their epilepsy. So your boyfriend may just decide, after seeing the neurologist, that it is better for him to stay on the medication.
Also there are very many parents with epilepsy. Certainly it can be scary for anyone to see someone having a seizure, but trying to keep it ‘hidden’ from them is obviously causing you huge stress.
Also I’m very concerned that your need to be awake, may be causing you both serious sleep deprivation. Things always feel so much more difficult when you haven’t had enough sleep. Also lack of sleep is a very common seizure trigger. See www.epilepsy.org.uk/info/seizures/possible-seizure-triggers for more information.
I’m wondering if you could find someone to talk to about your anxieties, for example the epilepsy helpline, your doctor, a friend? And then it may be possible to feel less anxious about the situation. If your boyfriend has a seizure, you will wake up anyway. If the children see him having a seizure, you can talk about it together and that is likely to lead to much less anxiety than your present state of mind. It may be a good idea to talk to your children about what is happening already. Then they would be more prepared for the event, if they did see him having a seizure.
We have a range of resources at http://shop.epilepsy.org.uk/ which could help you with that.
If you would like to talk any of this through further, please feel free to contact us again, either by email or the Epilepsy Helpline freephone 0808 800 5050.
Advice and Information Team
Our daughter Hannah started having seizures last June at the age of 2 1/2
It has been diagnosed as being Left Focal Tonic Clonic , with several times having her being put to sleep in A&E after an hour or some times 2 , to bring her out of the seizure .On every accasion she enters the seizure as she goes to sleep .This also causes speradick breathing with her heart rate rising to 160 - 179 bpm and O2 blood consentration dropping to as low as 66% taken at her fingers using an infra red meter .The meter is within 1% of the A&E ones when calibrated with them .Due to her stopping breathing i bought an oxygen cylinder after having to give her mouth to mouth after a 30 second lack of breathing .At the onset of her May 5th seizure i gave her 3 10 second bursts through a 60% mixer mask .She responded by stopping the seizure and sitting up talking - Making this the shortest seizure she has ever had , her June seizure saw the oxygen can run out after the first 10 second burst , just as she started to stop the seizure and was muttering words .She quickly re-entered the seizure that then lasted for 1 1/2 hours and seeing her having everything the hospital had shoved into her including our extra Buccal Medazolam as they dont stock it in A & E ?
We have asked for an oxygen cylinder to be provided but have been told that there is no evidence that oxygen brings anyone out of a seizure ?
So the 2 times out of 8 that her seizures have stopped being when i have administerd oxygen at the onset seems more than coincidental , Yet the proffessionals dont want to know ? Just like with speaker wires , oxygen free gives better transmition of the carrier wave ( Electric current ) So isnt it possible that the lack of oxygen breaks down the natural resistance in the blood / tissue and allows a spark to jump ?
The addition of the oxygen increases resistance and normalises the bodys resistance , or thats how i look at it in laymens terms .Maybe by de-evolving and adding the missing monkey tail just as a car has a dangling earth strap at the rear , the built up static could be lost to earth .......Any thoughts on the adminstration of oxygen at the onsett of a seizure will be greatly appreciated .
When I was first started having seizures they were misdiagnosed as a panic attack (subsequently they were confirmed as complex partial) and was put on anti-depressants.
My normal seizure rate was 1-2 a day whilst awake, which rocketed to around 16 whilst awake and I also got them in my sleep, o the anti-depresants. As I was unaware of what was going on, at night I just wandered into the bathroom, assuming I need to go to the toilet.
Once off the anti-depressants the seizure rate returned to a normal level and I once again had none in my sleep.
However my seizures were sleep related. I kept a seizure diary and discovered that they only occurred shortly after waking up, even if I fell asleep briefly in front of the TV.
I am a shift worker, with a very erratic shift pattern, so this was of some concern. As a consequence when returning to work I organised it so that I had a minimum amount of hours between shifts
I am pleased to say that my epilepsy is drug controlled and I've been seizure free for three and a half years.
Every time I meet a new doctor they are constantly surprised at my lack of seizures, as this seems to be a rarity in people with epilepsy working shifts, in their experience.
I have the people at GlaxoSmithKline to thank for that.
I am currently experiencing bouts were I am awake next I am unintendedly falling asleep. in a deep heavy sleep snoring and and partner moving round the room I don't hear anything. When I do wake I am very dazed and confused.
Am I asleep or is it something else ?
Hi Debs
You didn’t say if you’ve already had a diagnosis of epilepsy or if you’ve been searching the internet for some answer and come across our website. Whatever the case, you might want to get this checked out.
As your question has come from the sleep and epilepsy section of our website, you’ll see that some people can have seizures while they are asleep. Although some people do sleep after a seizure is over, no matter what time of day the seizure happens. This is when the body is recovering. Some people with epilepsy also feel dazed and confused, during a seizure or after a seizure is over. However, it’s important to talk to your doctor to get your symptoms sorted out. This is because they could be epilepsy related, but the symptoms of epilepsy can be similar to many other medical conditions.
It might help you to read another section of our website called Epileptic seizures explained and Diagnosing epilepsy.
Rosanna
Advice and Information Team