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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 medicineSide-effect 
Ethosuximidesleep disturbances, night terrors
Lamotrigineinsomnia (difficulty sleeping), sleep disturbance
Pregabalininsomnia, abnormal dreams
Topiramatesleep 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. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 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 6 comments or add yours

Comments

I have had JME for 18 years, I am now 31. I am overweight and really struggle to sleep. I was recently advised to use a CPAP machine which I couldn't get used to plus when I was getting good sleep, because I am so used to having disturbed sleep of say 3-4 hours a night, when I got 7-8 hours I felt awful and the seizures came back. I don't know what to do anymore as I need the sleep but when I get it, I'm ill.
I've tried little things like making my room comfortable, etc. One thing advised is a comfy bed but being a mature student, I cannot afford one. Are there any grants available for such thing?
Thanks in advance

Submitted by Lee Fitzpatrick on

 

Hi Lee

 

That sounds like a difficult situation to be in.

 

I wonder if you’re taking Epilim for your JME? A common side effect of Epilim is weight gain. So, if you haven’t already done so, you may want to talk to your neurologist about the possibility of changing to another epilepsy medicine.

 

I wonder if the British Snoring and Sleep Apnoea Association may have any useful information for you.

 

The best place to look for possible grants is the Turn2Us website. You can do your own search or you can ring their helpline on 0808 802 2000.

I really hope something in this information will help things to improve for you.

 

Regards

 

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

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

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