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Sleep and epilepsy

This information looks at the links between epilepsy, seizures, epilepsy medicines and sleep disturbance. It also looks briefly at sleep disorders and how they can also affect people with epilepsy.

If your seizures are related to sleep, it also gives hints and tips for how you can sleep better and get better seizure control.

When sleep seizures happen

Sleep seizures can happen any time you’re asleep, whether it’s during the night or a day time nap.

It’s possible to have any type of seizure during your sleep including focal seizures. In focal seizures, epileptic activity starts in just a part of your brain.

Possible effects of seizures on sleep

There are several different stages of sleep including rapid-eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. REM sleep is important because it’s when your brain processes your emotions, files your memories and relieves your stress. Non-REM sleep (restorative sleep) is important for restoring normal brain functions.

If you have a seizure during your sleep, it affects your sleep for the rest of the night. It makes your sleep lighter, and you wake up more often. Your REM sleep is greatly reduced, and may even disappear. Seizures when you're awake can also reduce your REM sleep the following night. REM sleep happens about 70 - 90 minutes into your sleep cycle. It’s usual to have several periods of this stage of sleep each night

If you have seizures during sleep you will also have less deep non-REM sleep.

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 controlled, try to catch up on any missed sleep, particularly in the day or two after a seizure. You could also ask your doctor to refer you to an epilepsy specialist for an assessment of your epilepsy and your epilepsy medicine.

Possible effects of epilepsy medicines on sleep

Most people with epilepsy take epilepsy medicines to control their seizures.  Epilepsy medicines can have unwanted side-effects. These include sleep-related side-effects. These are some examples:

Epilepsy medicineSide-effect 

Ethosuximide
Topiramate

Sleep disturbances (broken sleep)
Gabapentin
Lamotrigine
Levetiracetam
Phenytoin
Pregabalin
Rufinamide
Topirimate
Zonisamide
Insomnia (difficulty sleeping)

If you think your epilepsy medicine is causing side-effects, talk to your doctor or epilepsy nurse as they may be able to help.

Epilepsy with sleep disturbance or sleep disorders

People with epilepsy have a higher chance of also having disturbed sleep or 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 or disturbances can affect seizures because broken sleep can trigger seizures. So sleep disorders, including the conditions mentioned above can make seizures more likely, as they interfere with sleep.

If there's any possibility that you have a sleep disorder, your doctor might 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. 

Fatigue and epilepsy

Fatigue is a feeling of overwhelming tiredness, weakness or exhaustion that can be mental, physical or both. If you have epilepsy, you are more likely to be affected by fatigue than other people. This might be because your sleep has been disrupted, possibly because of seizures or the effect of epilepsy medicines. Being depressed can also make fatigue worse.

Epilepsy Action has more information about epilepsy and depression and epilepsy and fatigue .

What people tell us about sleep

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

“I used to keep my phone next to me in bed. I looked at social media before I went to sleep and if I woke up in the night. But then I realised I was waking up just to check my phone and I was getting really tired during the day. The crunch came when I started having more seizures. It made good sense to leave my phone in another room, and suddenly I was sleeping much better and not having as many seizures.”

 "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."

"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 learned 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."

Tips for getting more sleep

There are some things you can do that may help in getting more sleep:

  • Keep regular sleeping hours
  • Avoid caffeine-containing drinks late in the day

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
  • Comfortable temperature
  • Comfortable bed

SUDEP and sleep

Sudden unexpected death in epilepsy (SUDEP) happens when a person with epilepsy dies suddenly and unexpectedly, without any obvious cause. If you have uncontrolled tonic-clonic seizures in your sleep, and sleep alone, you are at increased risk of SUDEP. In tonic-clonic seizures, the epileptic activity affects both sides of your brain.

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. The type you need will depend on the type 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, but alarms will only be useful if there’s someone the alarm could alert, so they can help you.

Epilepsy Action has more information about alarms.

Can I drive if I have sleep seizures?

If your seizures always start when you’re asleep, you may still be able to drive even if you continue having seizures. They don’t need to be at night. A seizure that starts during a daytime nap also counts as a sleep seizure.

Before they allow you to drive, the driving agency would need to be satisfied that:

  • You’ve never had an awake seizure and
  • You’ve been having sleep seizures for at least 12 months. The 12 months applies from the date of your first seizure

 OR

  • If you stop having awake seizures, but still have sleep seizures, you can drive when you’ve been having sleep seizures only for at least 3 years. The 3 years is from the date of your first sleep seizure, after your last awake seizure

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. If you are unable to access the internet, please contact our Epilepsy Action Freephone Helpline on 0808 800 5050.

Code: 
F014.04

Epilepsy Action would like to thank Professor Phil Smith, Consultant Neurologist, University Hospital of Wales, for his help in producing this information.

Professor Smith has declared no conflict of interest.

  • Updated December 2018
    To be reviewed December 2021

Comments: read the 8 comments or add yours

Comments

My nephew suffers from Myoclonic epilepsy some times the seizures can last just 30 seconds and sometimes up to 3 minutes give or take. I'm just wondering if it is normal that he sleeps for a long period of time after he has had a 'big' seizure as he can sometimes sleep for up to six hours afterwards and his doctors don't really seem to be too interested and often doubt anything his mother tells them when he goes for check ups, thanks.

Submitted by Paige on

Hi Paige
Thank you for contacting us about your nephew.

The recovery from a myoclonic seizure is very individual. Some people may need to sleep for some hours afterwards.

It may help his mother to share this information with his epilepsy specialist if she keeps a note of it in his seizure diary, alongside his seizure activity.

If we can be of any more help, please feel free to contact us directly. You can either email helpline@epilepsy.org.ukor phone the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards
Diane
Epilepsy Action Helpline Team

Submitted by Diane, Epilepsy... on

My grandson (24yrs) has only recently been actually diagnosed with epilepsy. He suffers from disturbed sleep (waiting for appointment with sleep clinic) and night sweats (smelly). Would a cold shower before bedtime or tepid shower help and in the morning should he have a cold or hot shower ? He has a partner and these sweats are causing her some discomfort through disturbed sleep and smelly sweaty bed. Any advice?

Submitted by margaret jenkins on

Hi Margaret

A cool shower before bed may help reduce his sweating. Other tips that may help include keeping the room cool at night, wearing light clothing made from natural fibres, avoiding potential triggers such as spicy food, caffeine, smoking or alcohol, and losing weight if he’s overweight. A morning shower will help to wash off any sweat from the night, but it shouldn’t matter if it’s hot or cold. 

Some types of epilepsy medicine can cause disturbed sleep and sweating as side-effects, so your grandson may wish to discuss this possibility with his specialist.

Grace

Epilepsy Action Helpline Team

Submitted by rich on

Do you have any references I can look at in relation to the side effects of sleep disturbance when taking Ethosuximide please? I'm struggling to find any further information about this.

Submitted by Jo on

Hi Jo

Here is the list of possible side effects of ethosuximide. Sleep disturbance is listed under ‘rare’.

And here is a list of self-reported side effects as part of the Yellow Card scheme. Sleep disturbance is not listed separately. Here is our general information about sleep and epilepsy. And this is a link to the referenced copy of the page.

I have also found a research article which gives some general information on epilepsy and sleep. It also has a specific paragraph on ethosuximide.

I hope this information is useful for you.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by Cherry-Epilepsy... on

I was diagnosed with Epilepsy when I turned 17, I went through stages of being swapped and changed on medication and finally when I turned 29 I asked for the operation to be done to have part of my left temporal lobe removed. I’m now 40 and I’m taking a total amount of 14 tablets per day (5 different types) I still have mild seizures and sometimes grand mal whilst asleep. My question is, I wake up alot of times and my pillow is soaked with sweat and the blankets can be quite damp too. I also sweat alot on a general basis. Can this be caused by the mixture of medication or just one of medications that I’m taking?

Thanks
Darren

Submitted by Darren Leech on

Hi Darren

It does sound as though you have had a difficult time with your epilepsy and getting the right epilepsy medicines to give you better seizure control. Yes some epilepsy medicines can cause you to sweat more. Sweating may also be an effect of any night time seizures as well. If you wanted to discuss the side effects of any particular epilepsy medicines you take you would be welcome to ring the Helpline (freephone 0808 800 5050). We are open 8.30 – 8pm Monday to Thursday, 8.30am to 4.30pm Friday and 10am – 4pm Saturday

Regards

Mags

Epilepsy Action Helpline Team

Submitted by rich on

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