Sleep and epilepsy
Introduction
Some people with epilepsy have seizures only when they are awake, some while asleep and some people have a mixture of both.
This information is provided to give you a clear understanding of seizures during sleep and ways in which the sleeping environment can be made a safer place for people who have sleep seizures.
Diagnosis
There are over 40 different types of seizure and some types are more likely to occur in certain stages of sleep. For this reason, it is helpful for doctors to have as much information as possible from eye witnesses about the seizure symptoms and times they occur. This will give them a good idea of the most likely seizure type and will help them to prescribe the best treatment.
Stages of sleep
There are two main states of sleep – non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM). These two sleep states are caused by activity which occurs in different parts of the brain. Generally speaking, each person’s sleep pattern follows a cycle in which REM sleep alternates with NREM periods.
In NREM sleep, there is little body movement and breathing is regular. This usually 
accounts for 75 per cent of a person’s sleeping time. During this type of sleep, generalised seizures are more likely to occur.
REM sleep is characterised by eye movement, frequent twitching of the face, arms and legs and increased and irregular breathing. This is known as active sleep and is when most dreaming takes place. Periods of REM sleep can last from a few minutes to half an hour. During this stage of sleep, partial seizures are more likely to occur.
Is it epilepsy?
There are a number of different conditions that can be confused with sleep seizures. These include: sleep walking, sleep terrors, bed-wetting, restless-leg syndrome, sleep apnoea and narcolepsy. It is very important to be correctly diagnosed, to ensure that the right treatment is prescribed.
If diagnosis is proving difficult, doctors may carry out an EEG test during sleep, to find out whether epileptic activity is the cause of the symptoms. If the symptoms are present at the time the test is carried out, but the results from this test are clear, then this would indicate that the cause is most probably not epilepsy.
Treatment
The usual way to treat epilepsy is with anti-epileptic drugs (AEDs), which aim to prevent seizures by acting in some way to control the excitability in the brain. It is important to take AEDs exactly as prescribed by your doctor, because missing doses may trigger seizures in some people. You will usually need to take your AEDs at regular intervals throughout the day, to make sure that there is a steady supply in your blood stream.
Some people may notice an increase in seizures in the second half of the night and this may be due to the reduced levels of AEDs in your blood stream. If this happens to you, it is a good idea to talk to your doctor who may suggest adjusting your medication.
First Aid
First aid procedures for seizures are basically the same for both awake and asleep attacks.
There are things you can do to help someone who is having a convulsive seizure.
- Do protect the person from injury - move any sharp or hard objects.
- Do place the person in the recovery position when the convulsive part of the seizure is at an end. This will help their breathing.
- Do be quietly reassuring.
- Do stay with the person until they have regained full consciousness or a normal sleeping pattern is resumed.
There are also things you shouldn’t do.
- Do not try to restrain the person having the seizure.
- Do not put anything in the person’s mouth or force anything between their teeth.
- Do not try to move the person unless they are in danger.
- Do not give the person anything to drink until they have fully regained consciousness.
There are some circumstances when you should call for an ambulance.
- If it is the person’s first seizure.
- If injuries have occurred during the seizure, such as a cut that needs stitching.
- If a generalised seizure shows no sign of stopping after five minutes or lasts two minutes longer than is usual for that person.
- If a second seizure occurs without the person fully regaining consciousness in between.
Safety
There are a number of ways in which you can make your sleep environment safer, to reduce the risks of danger during a sleep seizure.
Sleeping in a low bed, perhaps with protective cushions around it, can help to minimise the risk of injuries if you fall out of bed. A thick carpet or rug would provide a softer landing than hard flooring. Carpets with high wool content are less likely to cause friction burns than those with a high synthetic content.
Keep any sharp objects or pieces of furniture, such as bedside tables, away from your bed. It can also be a good idea to cover any sharp edges around your bed that can’t be moved. Towels, or pieces of foam rubber, which can be purchased from DIY shops, can be handy for this.
There are a number of different types of bed alarm available that pick up unusual sounds or movements during sleep. However, before investing in an alarm, you will want to think about whether you would find it helpful. For example, there must be somebody else available to hear the alarm for it to be useful. Your wish for privacy should also be respected, so you may choose not to be monitored in this way.
For details of companies that supply bed alarms, we have information on safety alarms on our website.
Sleep deprivation
Some people find that their seizures are triggered by lack of sleep or changes in their sleep pattern. If this happens to you, it is advisable to try to go to bed and get up at regular hours and to avoid shift work or other causes of disrupted sleep. There is no need to sleep more than usual, as some people may have their seizures triggered by sleeping for longer than they need.
Driving
The driving regulations for people who only ever have seizures during their sleep differ slightly from the regulations for people who have awake attacks. This is because the DVLA recognises that the longer a person continues to have seizures in their sleep only, the less is the risk that they will have one when they are awake.
27 April 2007
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Comments
I had the first seizure at the age of 21 while sleeping and was started with dialantin. Seizure doesn't happened while taking medicines and recurred three months after stopping medicines. My EEG was taken during awake and it was normal. At the age of 27 i again had seizure while sleeping. I went to the doctor he again took EEG and found normal. He didn't started the medicine. After three months i again had seizure and the medicine was started. I had generalised tonic clonic seizure all the times. While sleeping i used to wake up suddenly and i started hearing some hizzing noise for 4-5 sec. and then i used to lose consciousness. I have some questions. Why my EEG is normal? I am taking dialantin 300 mg and folic acid 1od. How long i have to take this medicine? is it compulsory to take folic acid?
I had my first seizure at 21 years of age during night. then after another one some 10 months later. Then another
2 in 12 month interval. That time i started taking medication. But even now iam getting atleast 1 or 2 every year.
now i am 26.
My doubt is weather my seizure is in control or not? All My seizure i got while sleeping only..And it will
last for 10-15 minutes..I had never known while it is happening. But Next day i feel dizzy & little Body tiredness & Pain. Usually My room partner & others will inform me about what happened to me yesterday.
My doubt is weather my seizure is in control or not?
I started with sleep epilepsy aged 21 and find it strange that the other notes from people say theirs started at 21 too, i am now 51, i have approx 2 in a twelve month period and know nothing until i wake up, I sleep for most of the day after they happen and my legs ache, especially my calves, as i tense/stiffen up during the seizure, i have not taken any medication for many years as it never made any difference and they still occurred, the medication made me drousy and i would be falling asleep at 8 or 9 pm i also felt less alert i felt i could not think properly. In the last year i am experiencing them a little more often but they are very mild and am unsure whether to look into medication again. Is my age making a difference, I could be starting with the menopause, will they reduce once the menopause is completed or finished.
it happened to me a number of times, my body shakes while sleeping and my mum noticed it, like vibrating, once i woke up during one of those seizures and i remembered i had a nightmare during the seizure can anyone help me please
my 7 year old daughter has had sleep epilepsy for a year and a half that we've known about. She has fits around 6 or 7am. She starts with opening her eyes banging her hands off the wall and making funny noises like she@ drowning and can't breathe. She's been on tegratol liquid since being diagnosed but they've changed it to tegratol retard two days ago as she had two fits and was drooling and choking and not breathing properly. her arms and head were jerking badly. I hope the tegratol retard lasts in her bloodstream longer and prevents this early morning sleep fits. She's never had one while awake. I've allso noticed her behavior during the day becoming worse, She seems better behaved when her fits are controlled. She always complains of sore calfs too. I'm thinking of taking her into our room to sleep. I wish I had more info on sleep epilepsy. Could she die having a fit if she's choking??
Dear Sara,I would strongly recommend you see your GP asap (take mum with you as she can tell them what happens).
I have temporal lobe epilepsy,sometimes called Jacksons epilepsy,as seizures only occur when I sleep,and usually on one side of my body.This is because its focal in the left side of my brain and th4 affects the right side of my body,(though sometimes it can spread all over the brain then I shake all over.)I usually wake up just as its ending with my right arm/leg shaking.Important things to consider is how do you feel before?(some people have auras,but not all), and how do you feel the day after???
You may have to have an EEG/MRI scan.They are a bit scary at first but dont hurt.With over 40 different types of epilepsy it may take a while to diagnose you specifically,thats if you have it at all.But all the tests and questions are worth it becuase they are for your own peace of mind,and for your own good,and if you have it,the sooner they start to treat you.
Without trying to put words in your mouth I cant stress enough you must tell them EVERYTHING about how you feel,no matter how silly or mad you might think it sounds.For instance,for years I have heard music when waking,and never told anyone in case they thought I was mad.When I eventually told my neuro she was delighted!It was the missing piece of the puzzle,perfectly 'normal' for my type of epilepsy.Its an aura and a simple seizure in itself...turns out I must have had it most of my life,but the shaking only started when I was 42.
So be brave,and start to get your self sorted.Good luck x
My son, aged 19 has had epilepsy for 6 years. In the last year, these have only been at night, or more specifically, shortly before waking. He has had at least one per month since Christmas. Although I sit with him as soon as I hear the seizure starting, he is usually on his side and, apart from feeling very tired and having a headache afterwards, he has been okay.As he is going to university in September and will be living in halls of residence, I am very worried about how best to help him. I know there are sleep alarms, but there won't be anyone to hear it. We will be meeting with the special needs department at the university shortly, but I wondered what other people have done in this situation?
Thank you for your help.
my partner has fits in his sleep, there is no way of telling the night before if he is going to have one, no change in his behaviour or actions...they are irregular and he can remember start to finish shaking, he then falls back to sleep and wakes up not remebering until he sees blood on his pillow or has wet the bed...he has been diagnosed with epilepsy even though all the tests they have done have come back negative... the docotors do not know what causes his fits and have prescribed him with teregterol retard... he had a fit this morning which is the first one i have witenessed (very stressfull and upsetting) after shaking and spitting blood from biting his tounge he was brething very loudly almost like he had a blocked nose and shook iractically but on and off not continually he seemd to come round and pushed himself up. i told him he had had a fit and to jus stay lieing down and relax, he was talking to me, looking at me but it was nonsence (talkin about the door being open and that it didnt look right and it shouldnt be legal.. very odd) then started shaking again and i was able to to keep him concentrating on me and it subsided. He then seemed to come round again and didnt know where he was... he had no idea this time he had had a fit, doesnt remember any of it, doesnt remember coming round from what seemed to be the first fit and talking to me.. he thought i had woken him up jus then... we took him to hospital with it being differant to any other fits he has had..doctors wont try and investigate more but have admitted it is strange he remebers and can feel the fits as they are happening.. anyone out there who can help atall please, we have just moved in together and i want to make sure i can do everything i can for him.
Hello. This may be a seizure or a sleep disorder. It is difficult to say without more details. Go to your GP and ask for a referral to a neurologist. Meanwhile, ask your Mum to try and record a 'seizure', maybe using a mobile phone if you can? This will really help the neurologist to see what kind of attack you are having.
You may be sent for an EEG recording. This is usually just a 20 minute recording and as it is only a brief snapshot of what your brain is doing it may be entirely normal - just as you are entirely normal between seizures. You may also be referred for an MRI, which gives a detailed image of your brain and which may explain why you are having seizures as well as exclude any possible causes that are worrying you.
Best wishes.
Hi there
Who is looking after your boyfriends epilepsy? Is it his GP? Whoever it is needs to reassess him and he must see a neurologist, preferably one who specialises in epilepsy. Not all neurologists are particularly knowledgeable and it varies. If you are not happy with the service you are getting, remember that you can ask for a second opinion. This is not a bad thing to do and we all have a right to be referred elsewhere if we are not happy with the service we receive.
Tegretol is not the only drug available for epilepsy. The neurologist needs to make sure that firstly he is taking a sensible amount and secondly that your partner remembers to take it. Then, if he continues having these seizures, a different drug such as lamotrigine or sodium valproate may be added. Most people do respond to medication, but not always the first one they try. Tegretol can actually be bad for some types of epilepsy, so it is vital that the doctor knows what type of epilepsy he has: generalised epilepsy such as you describe, if idiopathic (with no brain abnormality on MRI), can actually be made worse by Tegretol. This is a well established fact.
If I were in your situation, I would read up as much as possible about what to do when your partner has a seizure, how to keep him safe etc. This will give you more confidence and you will be less scared when it happens again. And again, don't be afraid to ask for a second opinion. Maybe go to the GP together - we all know that men can be a bit reluctant to go to the GP and your support may make all the difference.
All the best.
Hi All...I started with Epilepsy in March 2006 at the age of 27. I had no previous episodes prior to this. I only remember coming round in the ambulance and asked my other half what had happend. After a couple of hours in the hospital i was discharged and advised not to drive (tell the DVLA who revoked my licence) and make an appointment with my GP. Gp advised that it could be 'stress, lack of sleep or too much alcohol, at this point no medication was prescribed, just rest up and take a few days off work.
As i grew tired i decided to have a sleep when i have another episode (round 2) with the ambulance and an overnight stay at the hospital. I was immedietley put on Epilim Chrono 1200mg to stop any further seizures. i was discharged from hospital the next day and over the course of the next few weeks was given a MRI and seen by a Neurologist. He confirmed all was clear but advised to carry on taking the Epilim and organised an EEG. Again given the all clear but carried on taking the medication. Whilst having a conversation with the nurse that performed the EEG she said that these seizures are common and some people simply have one episode and do not have anymore. I then decided to stop taking all medication (very silly) and for three months was seizure free! then back to square one again!
I was due to see the nuerologist for a follow up and he simply confirmed that i do have a mild case of Epilepsy and actually reduced my medication from 1200mg to 600mg per day.
I have suffered 2 episodes since but looking back this has largely been down to sleep deprivation. I therefore stay away from caffene, usually have 1 alcohol night a week and assess how 'good or bad' my previous nights sleep has been. If i feel ive had a restless night i will pop a sleeping pill and have an early night.
I see many people on hear have sought the advice from their Gp but i think you should push to see a neurologist who can provide you with the best possible medication.
I do look out for the miracle cure but unless you are suffering with several seizures a day and medication does not control same you are unlikely to be elligible for intrusive surgery.
Whilst we are normally 'not concious' when our respective episodes occur it can only be a frightening reality for our loved ones.
my advice is to push your Gp into referring you or your children to a neurologist...hope this helps x
Hi Guys,
I have mentioned to my partner a number of times the kind of things I experience whilst I'm asleep and he thinks I may just be having a re-curring dream but this morning I had one that lasted longer and now I'm not too sure. My sister mentioned a few years ago that it may be epilepsy.
When I have one of these episodes it frightens me.
I am 28 years old, male and in good health. The first episode that really sticks out hapened about 6-7 years ago. I had just nodded off in bed after a night out and then I felt as though something was pushing me down in my bed and I couldn't move, I was sort of paralysed. I was aware/had a sense of awareness all around me and then the only way that I can describe what happened next is if you imagine just opening a bottle of fizzy pop and then pouring a glass, the frantic bubbles that you see, well that's how my whole body especially my head feels. (sorry there is no other way that i can descrive it). It feels as though my whole body is 'fizzing' and the sound is like a long 'buzzing' sound that goes louder and then quieter. I put this down to the night out before and maybe I was dreaming.
I have spoke to a few people since where they have expereineced some of this where they cannot move and I have thoght well maybe it's quite common.
From then I had these episodeds very rarely.
Over the last 2 years they are becoming very common and are still doing so.
I still feel like I cannot move and in a parlyzed state as though I'm geting pushed down. I have the awareness of things around me i.e I hear people going up and down the stairs. The volume of the 'buzziness' and 'fizziness' are there. During these times I have tried to speak to tell my partner but can't speak and I have tried to will my arm to touch him to make him aware but cannot. My partner hasn't noticed anything either which again leads me to believe I'm dreaming. I only experience these when I just drop off to sleep wake up. I also get a deja vu feeling sometimes as if i can remember a comment/conversation that I've had and that comes and goes very quickly along with my stomach sinks very quickly and my heart sort of skips which wakes me up???
Today I just got back home from dropping my partner at work and fell asleep on the sofa. I had an episode which lasted much longer than normal, (the fizzing and buzzing). I also thought that I had got up and caught a glimpse of myself in the mirror which i didn't.
I wasn't worried about any of this before and thought that I was dreaming? Now because they are increasing, now probably to twice a month I'm starting to worry.
I'm def going to my doctor to discuss this but I was wondering what you guys thought? do any of you have these symptoms and what do you think to the fizzing/buzzing?
Cheers