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Sleep and epilepsy

This information looks at the connection between epilepsy, seizures, medicines and sleep. It also gives hints and tips for better sleep and better seizure control if seizures are connected with sleep.

Can epilepsy affect my sleep?

There are some types of epilepsy where seizures have a particular connection with sleep.  And seizures can be related to different stages of sleep. There are several stages of sleep, with different brain activity in each.

What are the different stages of sleep?

Stage 1 Non-REM sleep

Drowsiness - this stage lasts 5 or 10 minutes. Your eyes move slowly under your eyelids, your muscles begin to relax and you are easy to wake up.

Stage 2 Non-REM sleep

Light sleep - your eye movements stop, your heart rate slows, and your body cools down.

Stage 3 Non-REM sleep

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.

REM sleep

Rapid eye movement (REM) sleep - about 70 to 90 minutes into your sleep cycle, you enter REM sleep. You usually have 3 – 5 episodes of REM sleep each night. This stage is associated with processing your emotions, filing your memories and relieving your stress.

Possible effects of seizures on sleep

If you have a seizure during your sleep, it affects your sleep for the rest of the night. Your sleep becomes lighter, and you wake more often. The most serious effects are on REM sleep, which 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 do that, apart from controlling your seizures. If your seizures aren't fully controlled, ask your doctor to 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.

Possible effects of epilepsy medicines on sleep

Most people with epilepsy take epilepsy medicines 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.

How could my type of epilepsy affect my sleep?

There are many different types of epilepsy. And some seem to be particularly related to sleep. Three of the more common are generalised tonic-clonic seizures on awakening, juvenile myoclonic epilepsy, and benign epilepsy of childhood with centro-temporal spikes.

Generalised tonic-clonic seizures 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.

Juvenile myoclonic epilepsy (JME)

In JME, your seizures usually happen shortly after waking. They may happen at other times when you are very tired. Not having enough sleep could make your seizures more likely.

Epilepsy Action has more information about juvenile myoclonic epilepsy

Benign epilepsy of childhood with centro-temporal spikes (Benign rolandic epilepsy)

If you have this type of epilepsy, you will have focal (partial) seizures, in your sleep. Occasionally, you might have seizures when you are awake.

Epilepsy Action has more information about benign rolandic epilepsy

Focal (partial) seizures

In focal seizures, epileptic activity starts in just a part of your brain. And it is common for focal seizures to happen while you are asleep.

Epilepsy Action has more information about focal seizures

Why it's important to get enough sleep

People tell us that they have more energy, think more clearly and react more quickly after a good night's sleep. Between 2 and 9 people in every 10 with epilepsy find not having enough sleep makes their seizures more likely. 

Tips to help you get enough sleep:

  • Keep regular sleeping hours
  • Wind down by:
    • Writing a 'to do' list
    • Doing relaxation exercises
    • Listening to a relaxation CD
    • Reading a book
    • Listening to the radio
  • Create the right environment in the bedroom
    • No TV or electronic devices
    • Dark
    • Quiet
    • Tidy
    • Smells fresh
    • Good temperature for you
    • Have a comfortable bed

We all have different ways of getting enough sleep. This is what some people with epilepsy say:

"If I don't get enough sleep, I'm far more likely to have a seizure next morning. I need about 8 hours, so I always aim to be in bed by 10 pm, so I can read for an hour before going to sleep."

"I've recently become a mum, so as you can imagine, lack of sleep is a huge issue. Luckily, my partner is really supportive and does what he can to help. He does a lot of the night time feeds. If he's away, my friend stays with us for the night, so she can do them. My health visitor has given me loads of helpful advice about setting a sleep routine for the baby. As soon as she is sleeping more soundly, so will the rest of us!"

"Sleep is a real problem for me sometimes, especially if I'm feeling stressed, or I've had to work in the evening. I've learnt to never go to bed until I'm feeling sleepy – some nights this can be after midnight, if I've been working late. If I haven't fallen asleep within half an hour, I'll get back up and make myself a hot milky drink, then wait until I feel sleepy."

Epilepsy with sleep disorders

People with epilepsy have a higher chance of also having a ‘sleep disorder'  than people who don't have epilepsy.  Sleep disorders include obstructive sleep apnoea, restless legs syndrome, narcolepsy and night terrors. Sleep disorders can affect seizures because broken sleep can trigger seizures.

You can get information about sleep disorders from NHS Choices
Website: nhschoices.uk

If there's any possibility that you have a sleep disorder, your doctor may be able to refer you for a sleep study. Sleep studies can take different forms and can help to show exactly what problems you're having while you're asleep. 

SUDEP and sleep

Some people only have seizures during their sleep, some people have seizures when awake and asleep, and some people never have sleep seizures.  
Sudden unexpected death in epilepsy (SUDEP) happens when a person with epilepsy dies suddenly and unexpectedly, and no obvious cause of death can be found.  SUDEP has been shown to be connected with seizures but an exact cause has not been found.  But we do know that if you have uncontrolled tonic-clonic seizures  in your sleep, and sleep alone, you are at increased risk of SUDEP. 

Epilepsy Action has more information about SUDEP

If you are still having seizures, see our information about getting the right treatment and care for your epilepsy

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 need will depend on the types of seizures you have. For example, some alarms are sensitive to movement. So if you have tonic-clonic seizures during sleep, then this type of alarm should detect them. There are other types of alarm available.

Alarms will only be useful if there is someone the alarm could alert, so they can help you.

Epilepsy Action has more information about alarms

Anti-suffocation pillows

Some people who have sleep seizures use anti-suffocation pillows. These may be safer than ordinary pillows, although we don't have any research to prove this. If you are thinking about buying an anti-suffocation pillow, discuss this with your epilepsy nurse or epilepsy specialist, to see if they think this will help you.

Further information

You can get further information about any of the issues discussed here from your family doctor, epilepsy nurse or epilepsy specialist.

If you would like to see this information with references, visit the Advice and Information references section of our website. Or please contact the Epilepsy Action Helpline on freephone 0808 800 5050.

Code: 
F014.03

Epilepsy Action would like to thank Dr Phil Smith, Consultant Neurologist, University Hospital of Wales, for his help in producing this information. Dr Smith has declared no conflict of interest.

This information has been produced under the terms of The Information Standard.

  • Updated August 2015
    To be reviewed August 2018

Comments: read the 21 comments or add yours

Comments

thank you so much for this site I found I had a massive benign brain tumour while living in UK in 1996 due to years of undiagnosed night seizures. I had the surgery back here in Aust. But came back to UK to marry my Brittish boyfriend.

I joined the UK epilepsy association as I then had simple partial seizures due to brain scar. Your association so very helpful that I would ring when I had night problems as it was our day. This was in my early days of epilepsy now by chance I asked Google a question re rare jaw snap action as I fall asleep.

You have also given me vital understanding of my sleep difficulties since neurologist took my tegretol down which has made a huge difference to memory thankfully but with my medication of lamotrigine up I didn't realise it was the reason for all my sleep problems until I asked Google about this jaw snap. Thank you.

We go back to UK every year or two so I would like to donate to your good site and also will use it more now I have found it.

Cheers, Elaine

Submitted by elaine lillystone on

I am 16 i have been suffering from absence seizeres since i was 10 and grad mals since i was 6

My grad mals are now controlled by 1,500 g twice a day of keppra and two operations removing a bengin brain tumor one in 2012 and 2013 . However depise this i am still suffering from peit mals .

They hadnt happened for at least a year in 2014 and now are happening again in clusters over the last week i have had 5 fits .

I dont know what to do it is affecting my college education and my genral life .

Can medication stop working after a period of time . Would it be a good idea to see other medication options

Submitted by Sally on

Hi Sally

I’m sorry to hear your seizures have returned. It sounds like a very difficult time for you.  

It would be good if you spoke to your doctor or epilepsy nurse about your seizures and treatment. There are many different epilepsy medicines available, so it could be worth discussing if Keppra is still right for you. They can review your treatment and look at possible reasons for your seizures to have returned. They may suggest trying a different epilepsy medicine or ask you to take another epilepsy medicine along with your Keppra. 

There are other treatment options for epilepsy. These are usually looked into if you have tried various types of epilepsy medicines and you are still having seizures.

Some people with epilepsy use complementary treatments to try and lower the number of seizures they have. Or they use them to improve their quality of life.

There is no scientific evidence to suggest that any type of complementary treatment can reduce or stop seizures. If you are thinking about trying any, talk this over with your doctor or epilepsy nurse.

As your epilepsy is affecting you at college, if you haven’t already, it would be advisable to talk to your form teacher, head of year or SENCO. Your college have a duty to support you so you do as well as possible in your studies. You could also talk to them about how you are feeling emotionally. The college also have a duty to help with how you are feeling. This is referred to as social wellbeing.

I hope this is of help. If we can be of any more help, please feel free to contact us again. You can either email helpline@epilepsy.org.uk  or phone the Epilepsy Helpline freephone 0808 800 5050.

Regards

Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

I MYSELF SURESH RAGHUNATH KASHID , MALE , AGE :- 45 Years
I am suffering by epilepsy since last ten years ,. The fact that I have suffered ten times during last ten years all time affected time is during 1.00 P.M. TO 5.00P.M.
I have taking Eption 100 mg ( Twice a day ) , and Gardinal 60 mg ( Per day )
Can I get better medicine and advice .

Yours

S.R. KASHID .

Submitted by SURESH RAGHUNAT... on

Dear Suresh

Thank you for your question.

The epilepsy medicines you are on, are older ones. There are more and newer medicines available in the UK.

And here is all our information about epilepsy treatment.

I’m not sure where you live, so I am linking you to the list of international epilepsy organisations. The ‘chapter’ drop down list enables you to choose the country where you live. Hopefully you will be able to get more useful information from them.

Cherry
Epilepsy Action Advice and Information Team

Submitted by Cherry, Epileps... on

Hi Iv been on 200mg of lamotagine a day for over 2 years now and for the last year I been having real bad nightmares like I'm getting stabbed or stabbing someone or my girlfriend cheating on me but there getting worse and really really getting me down waking up 5 times a night soaking with sweat !! Then iv got to leave for work at 6am . Please somone give me some advice is it the tablets ?

Submitted by Ross on

Hi Ross

I have replied to you by private email. Do hope things improve for you soon.

Cherry
Epilepsy Action Advice and Information Team

Submitted by Cherry, Epileps... on

I'm on TOPIRAMATE(CABERMAZEPINE) 1200 mg DAILY
And GABAPENTIN(NEURONTIN) 700 mg DAILY
And ZONISAMIDE(ZONEGRAN) 400 mg DAILY

These medications have contributed to INSOMNIA...My night time has become my daytime meaning the body system consumes the medical anomaly throughout the night and by morning (between 5am and 6am) when I have repeatedly visited the loo my sleep kicks in.

But only for a short while when my morning alarm goes off at 9am for my morning dosage.....It's a battle!

Submitted by Lenny on

Hi Lenny
What you are experiencing sound terrible. If you haven’t already, why don’t you talk to your epilepsy specialist, epilepsy nurse or your family doctor about your insomnia. They may be able to suggest something to help.

I hope things improve for you really soon.

Regards

Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

I was diagnosed with tonic seizures about a year ago. In the last 3 months I have fallen out of bed twice. Once hitting my head and cutting it open. I don't remember any of these. Could I be having seizures at night. I also sleep walk as advise would be much appreciated

Submitted by Lisa Gomez-Prince on

Hi Lisa

Yes it is possible you have having seizures at night. Sometimes people put something soft by their bed to cushion a fall. It’s also a good idea to move anything with sharp corners away from the bed if at all possible. You might find our information on safety in the bedroom useful.

There is some information about sleep walking, on the NHS Choices website.

I hope this is useful.

Cherry
Epilepsy Action Advice and information Team

Submitted by Cherry, Epileps... on

I'm trying to find out whether not getting enough sleep is likely to increase my likelihood of having another seizure, but this statement in this article is very unclear:
"Between 2 and 9 people in every 10 with epilepsy find not having enough sleep makes their seizures more likely."
Somewhere between 20% and 90% of people finding that lack of sleep increases seizure likelihood doesn't really narrow it down much! Is this a mistake or is there no better information on this?
By way of background, I have epilepsy, and am fortunate enough to have it perfectly controlled by Lamotrigine (50mg twice a day), since starting the medication over 10 years ago. However, I have recently noticed frequent spells of dizziness and lack of balance during the day. I'd like to rule out a link to epilepsy if I can. I have also had less sleep than usual recently and wondering if it could cause the seizures to return.
Thank you.

Submitted by Kathy Thompson on

Hello Kathy

I appreciate your comment about the wide range given for people reporting a lack of sleep increasing seizures. It is understandable that this range would feel frustrating, but it is possible that it reflects how different epilepsy can be for each person. All of the information on our website is based upon evidenced research. 

For some people, there are certain things which can make the chances of having a seizure more likely. These are called seizure triggers. Some people do report that not getting enough sleep can be a trigger for them. You may find it helpful to keep a seizure diary to try and identify whether you have any seizure triggers.

If you are worried that you may be experiencing a change in your seizures at the moment, then it would be worth you talking to your neurologist or epilepsy nurse. This will give you the opportunity to talk about what has been happening, and to check that your epilepsy medicines are still the best ones for you.

If you would like to talk more about this, or if we can be of any more help, please feel free to get in touch with our helpline team.

Karen
Epilepsy Action Advice and Information Team

Submitted by Karen@Epilepsy ... on

I had my first ever seizure 22 nov 2015 in bed general tonic clonic lasting about 2mins witnessed by husband. Second seizure 10 jan 2016 after being awakened by motorbikes outside this time only lasted around 30 seconds. I bit my tongue in both seizures. I am almost 29. Ct scan was normal awaiting mri & neurologist appointment. Why has this happened at my age?

Submitted by Aimee on

Hello Aimee,
My wife had her very first seizure jan, 20 2016. Then 3 weeks later & again this morning the 16th of feb. She just turned 30 in December. Your info sounds almost identical to hers. She had the e.e.g. that showed hardly anything. She goes into the mri this friday. I was wondering if you have found anything more with your mri. We're all really scared of the unknown! If you could reply that would be incredibly appreciated!
I pray you & family find the answers your looking for !
Thanks, Coal

Submitted by Coal on

robert my son had a sickness and he was being sick and bringing his medication up And hed been doing so well so he had to go in hospital becoz the seziures had got out of controll so theyve increased his keppra but hes high all the time he had to stay in hospital for 2 weeks And hes disabled he cant talk i dont know if its the staying in hospital for 2 weeks or the keppra dont know what to do for the best

Submitted by ruth booth on

Hi Ruth
It must be a very worrying time for you.

It’s possible for keppra to cause side-effects when increased. But these should lessen or disappear once your son’s body has had a few days or weeks to get used to taking it.

If your son is still in hospital you could ask his doctors if it could be his keppra causing the change in his behaviour. If they think it could be, they might make changes to his treatment to see if this helps.

As your son is having seizures again, is he being seen by an epilepsy specialist? If not, it would be a good idea if he could be referred to one. Let us know where you are, and we’ll try to point you in the right direction.

If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards
Diane
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

Hey sir
My question is about my brother one week ago he was sleeping suddenly hes started deep breathing with sound like hes in scary dream. I tried to wake him up he didnt awake then upon had eyes like hes compused looking me i tried to make him calm like half n hour after he start taking talking normally he cut has thung with teeth and he got back pain also and he remember anything also what ever happend? I took him to hospital dr. Did blood test ct scan for brain everything is normal dr. Him depakine 200mg tablets twice a day to use and given appointment for neirologist.? Still we dont know what happend to him

Submitted by Sameer on

Hi Sameer
It must have been very worrying when this happened to your brother. You might want to have a look at some more of our information about epilepsy. When your brother sees the neurologist he should be able to find out more about what happened to him.

This tell you about seizures: epilepsy.org.uk/info/seizures/generalised-seizures

This shows you what to do when someone has a seizure: epilepsy.org.uk/info/firstaid

Best wishes.

Shelley
Epilepsy Action Advice and Information Team

Submitted by Shelley, Epilep... on

I was diagnosed with epilepsy when I was 3 years old and had my last seizure at age of 10. Came of tegretol 200mg twice a day gradually from age 10-16years old. Epilepsy came back having sleep seizures when I was 22years old I'm now 32 and still having sleep seizures when choosing wakes me up I feel scared tense body's stiff and it lasts for maybe 2-3minutes. On 275mg lamotrigine twice a day. Think I'm going to ring my epilepsy specialist nurse today as I'm a full time student doing childcare and it's affecting me having to take time of from learning at my placement at a nursery and my course only has 5 weeks to go. And I'm determined to complete this. Do you recommend anything else???

Submitted by Miss Kimberley ... on

Hi Kimberley
Thanks for your message. It sounds like you are going through a tough time at the moment. Ringing your epilepsy nurse sounds like a good idea. I hope they are able to help.

If you are having to take time off from your placement because of your epilepsy you might want to talk to your course tutor or the disability officer at your college. Under the equality laws they have a duty to make reasonable adjustments to help you complete your course. This might include making allowances for the time you’ve had to take off, or helping you to catch up with anything you’ve missed. Our advice for students with epilepsy page has more information.

Some people with epilepsy find that certain things make them more likely to have seizures, for example lack of sleep or stress. These are often called seizure triggers. If you think anything might be triggering your seizures, finding ways to avoid your triggers might help.

I hope this information helps. Good luck with your course, and if you have any other questions please feel free to contact us at the Epilepsy Action Helpine.

Best wishes
Grace
Epilepsy Action Advice and Information Team

Submitted by Grace, Epilepsy... on