A restful night’s sleep aids the brain in its recovery from the day’s activities, allowing us to perform better the following day. Seizures can make some people with epilepsy feel fatigued during the day, while sleep deprivation can make others more susceptible to seizures.
Epilepsy and sleep are intertwined in a myriad of ways. The brain is active while we sleep, digesting information that aids our cognitive development. During the various stages of sleep, the brain’s activity alters.
Different stages of sleep
The two types of sleep, which alternate in frequency and duration, occur in an alternating pattern.
- Sleep is broken down into stages of non-rapid eye movement (NREM) and light and deep sleep (REM).
- sleeping with rapid eye movement (REM)
Non-rapid eye movement sleep
- Stage one – during this initial stage of NREM sleep, our muscles begin to relax and we are able to be awakened up easily.
- Stage two: As we move from stage two to stage three, deep sleep, our heart rate and breathing slow down even further, increasing the risk of seizures for those with epilepsy.
- Stage three is a deep state of slumber (sometimes called slow-wave sleep). Our breathing and pulse rate drop down and our brain produces ‘delta waves,’ a type of brainwave associated with deep sleep.
- It becomes increasingly difficult to be roused from a deep slumber as delta waves rise. In this stage, we are often unclear if we are awakened. During deep sleep, sleepwalking and night terrors are more likely to occur than during light sleep.
NREM sleep is thought by scientists to be critical to the development of long-term memories and the strengthening of connections between brain cells. In addition to aiding the body’s recovery from the day’s activities, a good night’s sleep also aids the brain in its own recovery.
Rapid eye movement sleep
When you’re in the next stage of deep sleep, that’s when you have the most vivid dreams. During REM sleep, the brain works to sort out all the information it has gathered during the course of our waking hours.
It’s not entirely apparent what REM sleep and dreaming are for. Theoretically, this may help us make sense of our thoughts and ideas, as well as our feelings and memories associated with them.
Memory and judgment might be harmed by a lack of sleep. Additionally, it can have an effect on our mood and the functioning of our immune system.
A lack of sleep, for example, can be a cause for seizures in certain people. Some varieties of epilepsy can cause a person to have a seizure as soon as they wake up and for the next several hours. Seizures at any time of the night can impair sleep, and seizures during the day might affect sleep for the following night as well. Seizures can disrupt sleep patterns for up to a week or more for some people.
Do anti-epileptic drugs affect sleep?
Anti-epileptic drugs (AEDs) might have negative effects for certain people, just like any other treatment. It is possible that AEDs can have varying effects on sleep, depending on the dosage. Several AEDs are sedatives and have been linked to fatigue. There are certain that can lead to sleep disturbances or insomnia. Some AEDs, on the other hand, can help with sleep quality by lengthening the period of deep sleep.
Seizures that start during sleep
Sleep seizures, also known as nocturnal seizures, can occur in persons with epilepsy while they are asleep, about to fall asleep or just waking up. Frontal lobe epilepsy is a kind of epilepsy in which seizures can occur both while a person is awake and while they are in REM sleep. Seizures in the frontal lobe frequently occur in ‘clusters,’ but are usually brief. Screams, jerks, unusual postures, and wandering in the middle of the night are all examples of nocturnal twitching.
‘Parasomnias’ are a type of sleep disorder in which strange events are associated with sleep. These include sleepwalking, night terrors, and other forms of sleepwalking (where a person suddenly wakes from sleep in a state of panic or fright). Some portions of the brain are awake, while other parts are sleeping. Unusual movements or sounds may be a symptom of parasomnia.
Parasomnia and seizures are two different things, and it can be hard to determine the difference between them at times. To aid in the process of diagnosis, having a written or video record of what transpires during the incident can be beneficial. Every time a seizure occurs, it may be easy to identify the beginning and end of the episode.
Parasomnias, on the other hand, don’t always follow a set pattern and often don’t terminate. Although narcolepsy is rare, it can cause uncontrollable impulses to sleep at any time of day or night, which can occasionally be mistaken for epilepsy in some patients. Some persons with narcolepsy, for example, suffer from cataplexy, a loss of muscle tone that affects the jaw, neck, and limbs, among other parts of the body. Slurred speech and blurry vision can also be signs of a seizure. Cataplexy can be provoked by strong emotions like laughing, wrath, or surprise.
Epilepsy and sleep disorders
When it comes to sleep disorders, some persons with epilepsy may also have sleep issues that are unrelated to their epilepsy. People with epilepsy are more likely to suffer from obstructive sleep apnoea (OSA), a condition in which they snore loudly and briefly stop breathing.
Low muscle tone in the area of the airway can be a contributing factor. Weight gain, a possible adverse effect of some AEDs, may be to blame for this. Obstructive sleep apnoea can cause seizures in certain persons, in addition to interrupting sleep.
Obstructive sleep apnoea can be diagnosed with a simple, non-invasive test that monitors oxygen levels in your blood overnight, which is painless and requires no anesthetic. For further information and a directory of NHS sleep clinics in the UK, go to sleep-apnoea-trust.org.
Tips for getting good sleep
You may be able to improve your quality of sleep by following a few simple guidelines.
- Instead of a caffeinated hot beverage before bed, try a milky beverage like almond milk (research suggests that reducing caffeine up to six hours before bed can increase the quality of sleep).
- Avoid late-night suppers and alcoholic beverages.
- Set a regular bedtime and a regular wake-up time.
- Keeping mobile devices like smartphones and tablets out of the bedroom will help you get a good night’s sleep.
- Prevent watching television or using a computer right before bedtime by relaxing instead.
- Keep your room at a reasonable temperature and as dark as possible to create a peaceful atmosphere.
- Make sure you have a supportive pillow and a comfortable bed.
- Restrain yourself to 15 minutes or fewer if you need a snooze during the day. This can aid in the maintenance of a regular sleep schedule.
- If you have problems with sleep your GP or consultant can refer you to a specialist sleep clinic.
Epilepsy Society is grateful to Dr Hugh Selsick, Royal London Hospital for Integrated Medicine, for his guidance on this information.
Epilepsy and the Brain
Nerve cells in the brain exchange information via electrical impulses. Neurotransmitters are the chemical messengers that carry these impulses throughout the body and are responsible for the transmission of these impulses. The brain’s electrical activity is generally well-regulated.
A person’s ideas, feelings, and actions are all affected when epilepsy causes aberrant electrical activity in the brain and brain connections. There are a wide variety of epilepsy and epileptic syndromes.
Epilepsy and Sleep
There has long been an association between sleep and epileptic seizures noticed by doctors and scientists. Doctors in the late 19th century realized that the majority of nocturnal seizures occur close to the time when a person is falling asleep and waking up.
Many key relationships between sleep and epilepsy are still being studied by researchers. To better understand how sleep affects seizure onset and frequency, more study is being done on the subject.
When two or more unprovoked seizures occur at least 24 hours apart, doctors consider a diagnosis of epilepsy. Even while epileptic seizures may be caused by medical problems, brain damage or aberrant brain development, most commonly the cause is unknown.
An electroencephalogram (EEG) is one of the tools a neurologist uses to evaluate a seizure patient (EEG). Doctors utilize EEGs to determine if abnormal electrical activity in the brain is originating from the entire brain or just a small area of it, as well as to pinpoint its exact location. EEGs are frequently used by neurologists to look for patterns of aberrant brain activity known as epileptiform abnormalities. A spike, a sharp wave, or a pattern of spikes and waves can all be signs of these aberrant brain waves.
Certain types of sleep, such as non-rapid eye movement (NREM) sleep, are more prone to epileptiform abnormalities. A portion of an EEG may be conducted while the patient sleeps so that anomalies in the brain’s electrical system can be detected.
Epileptic Seizures While Sleeping
At any hour of the day or night, epileptic seizures can occur. Exclusively about 20% of patients with epilepsy suffer seizure activity only while they are asleep, while 40% suffer seizure activity only when they are up, and 35% experience seizure activity both while awake and while sleeping.
It is possible that the electrical activity in different parts of the brain tends to synchronize during non-rapid eye movement sleep (NREM sleep). Seizures can occur as a result of too much or too hyper-synchronization. Another theory suggests that circadian rhythms and melatonin synthesis may be to blame.
In a number of different types of epilepsy, seizures can happen while you’re asleep.
- Nocturnal frontal lobe epilepsy (NFLE): Almost all NFLE patients have seizures during non-rapid eye movement (NREM) sleep. At any age, however, it is more frequent in children, this syndrome can arise. Seizures during the night may go unnoticed by persons with NFLE when they wake up.
- Benign epilepsy with centrotemporal spikes (BECTS): BECTS is the most frequent kind of epilepsy in children, and it often begins between the ages of 3 and 13. 70 percent of the seizures in children with this type of epilepsy occur when they are sleeping, frequently just as they are about to drift off to sleep or as they are about to get up in the morning.
- Panayiotopoulos syndrome: Between the ages of 3 and 6, this type of epilepsy is most common. Seizures affect 70 percent of children while they sleep and 13 percent after they wake up. Since most children with this illness have less than five seizures before they go into remission, this is good news.
Lennox-Gastaut syndrome, epilepsy with continuous spike-wave in sleep, and autosomal dominant frontal lobe epilepsy are all examples of epilepsies that are predominantly characterized by their occurrence during sleep (CSWS).
Epilepsy and Sleep Deprivation
People with epilepsy need to get the correct amount of sleep. Seizures in persons with epilepsy, including those who have never had seizures before, can be exacerbated by sleep deprivation, however, this isn’t true for everyone.
Neuronal excitability may play a role in why sleep loss may lead to seizures. Neurons in the brain are more prone to undergo big fluctuations in electrical activity when they are not getting enough sleep. People with epilepsy are more susceptible to seizures due to aberrant electrical activity.
Epilepsy and Sleep Disorders
A good night’s sleep is essential for both mental and physical well-being. People with epilepsy often suffer from sleep difficulties. Epilepsy is thought to be a contributing factor in a variety of sleep problems.
- Insomnia: It is not uncommon for patients with epilepsy to suffer from sleeplessness, with a prevalence of between 24% and 55%. Seizures during the night, medications and the impacts of worry and sadness can all contribute to insomnia in people with epilepsy.
- Obstructive sleep apnea: In obstructive sleep apnea (OSA), the upper airway collapses completely or partially while you sleep. As many as 30% of patients with epilepsy are affected by OSA, which is twice the rate of the general population. Snoring, frequent awakenings and difficulty sleeping can all be symptoms of sleep apnea.
The term “parasomnias” refers to a group of sleep disorders characterized by the occurrence of bizarre activities before, during, and after sleep. NREM-related parasomnias, REM-related parasomnias, and other parasomnias are the three main types of parasomnias.
The association between parasomnias and epilepsy is still a mystery to researchers. If you’ve been diagnosed with epilepsy, you’re more likely to be diagnosed with parasomnia than the other way around.
- NREM-related parasomnias: Sleepwalking, sleep terrors, and disorders of arousal are all included in this category. There are some forms of epilepsy that can be difficult to distinguish from sleep problems, such as nocturnal frontal lobe epilepsy. Up to one-third of individuals with nocturnal frontal lobe epilepsy have a family history of arousal disorders, making this distinction even more difficult.
- REM-related parasomnias: There are several types of REM-related parasomnias, including REM-related sleep behavior disorder. As many as 13% of elderly persons with epilepsy are suffering from this illness, which often goes unnoticed.
Epilepsy and Children
Adulthood is the culmination of all that a child experiences during childhood. During this period, sleep is crucial for everything from growth to learning and memory.
Children with epilepsy often have difficulty sleeping. Children with epilepsy, when compared to their unaffected siblings, were shown to have higher sleep disturbances and increased daytime sleepiness, according to studies.
In children with epilepsy, it is critical to address sleep disorders. 30 to 60 percent of children with epilepsy have sleep-related breathing abnormalities including OSA, and parasomnias are widespread in some kinds of childhood epilepsy.
In children with epilepsy, there are still many unanswered questions about how to enhance their sleep, although several researchers have found that parent-based therapies can help children with a variety of sleep disorders. Dialogue between parents and the child’s medical team can help parents of epileptic children devise a sleep-related treatment plan that will reduce seizures and limit long-term consequences.
Many people’s seizures can be reduced or eliminated with epilepsy treatment. Anticonvulsants and antiepileptics are the most widely prescribed drugs for treating epilepsy. Surgery and vagus nerve stimulation may be helpful in cases where medicine fails to control seizures.
There are other lifestyle adjustments that can assist people with epilepsy in better controlling their health and possibly lessen the occurrence of seizures. You may help yourself control epilepsy by ensuring you get adequate sleep and changing your diet.
Medications and Epilepsy
Epilepsy can cause sleep problems, but it’s frequently difficult for people with epilepsy to tell if they’re related to their medication or the physical and social repercussions of having epilepsy itself. Patients’ reactions to these drugs may differ from one another. Some drugs might make people sleepy, while others can make them more alert.
Antiepileptic medicines may be used to help people with sleep disorders. For example, doctors may prescribe antiepileptic medicines that promote sleepiness for insomniacs to take at night. Patients who complain of excessive daytime sleepiness may be prescribed stimulant antiepileptic medications.
For many persons with epilepsy, a better night’s rest and reduced frequency of seizures may be possible with the use of sleep medications. Melatonin’s effect on sleep quality in patients with epilepsy has not yet been shown. Consult a doctor before taking sleeping aids if you have epilepsy.
Tips for Better Sleep
The quality of life and mood of people with epilepsy can be negatively impacted by sleep deprivation. It’s actually one of the most common complaints among persons with epilepsy. Antiepileptic medicine side effects, nocturnal seizures, and social stigma all play a role in people with epilepsy’s sleep problems. Managing epilepsy, as well as the stress and worry associated with it, can cause sleep problems.
It’s important for people with epilepsy to be open and honest with their doctors about any sleep-related concerns they’re having. A doctor can be a good source of information on several topics:
- Ask about sleep disorders: Your doctor may be able to help you better manage your epilepsy by diagnosing an undiscovered sleep issue. Epilepsy seizures can be cut in half by treating sleep problems like OSA.
- Talk about side effects of medications: If antiepileptic medications are functioning and if they have any unanticipated side effects, doctors need to know about them. Inform your doctor of any side effects you have and any questions you may have about them.
- Discuss stress and anxiety: Living with epilepsy can have a profound impact on a person’s quality of life and be taxing on the body and the mind. A wide range of emotions and mood swings are quite natural. It may be helpful to discuss your feelings with a doctor, a support group, or a counselor. This group of experts can help you cope with stress and worry, which can disrupt your sleep.
With the help of their medical team, epilepsy patients can also benefit from better sleep hygiene while managing their sleep disorders. In order to get a good night’s sleep, it is important to practice good sleep hygiene. The following are a few ideas to help you sleep better:
- Schedule your sleep: Consistent sleep patterns help you obtain the quantity of sleep you require. Prioritize your sleep and make an effort to maintain a consistent sleep and wake-up schedule, even on the weekends.
- Make a nightly routine: In order to assist your body to prepare for sleep, you should establish a nighttime routine. For 30-60 minutes before going to bed, set a timer or a reminder on your phone or computer to turn off gadgets, dim the lights, and engage in some form of relaxation.
- Improve daytime habits: While we’re awake, the things we do can have a big impact on our sleep. Don’t drink alcohol, smoke cigarettes, or eat large meals before night, and get plenty of exercises and natural light during the day.
Can Sleep Deprivation Trigger A Seizure?
In theory, yes. Seizures are highly reliant on a person’s sleep schedule. A protracted period of sleep deprivation or a collegiate “all-nighter” may lead to a person’s first and only seizure. Most persons with epilepsy are more prone to experience seizures if they don’t get enough “good sleep.” Even the strength and duration of seizures can be increased by using this medication.. Epilepsy sufferers are more likely to experience sleep disturbances than others.
Why Does Sleep Deprivation Provoke Seizures?
There are numerous ways in which sleep might influence seizures. Neuronal and hormonal changes occur during typical sleep and waking cycles. These alterations may explain why some people have more seizures during sleep than others, and why not receiving enough sleep can lead to seizures. ” It’s possible that epilepsy sufferers’ seizures are strongly linked to the quality of their sleep. It is possible that they have all of their seizures while they are sleeping, either as they are going to sleep or as they awaken. Depending on the individual, sleep may or may not be a common cause. Seizures, for example, maybe triggered solely by a combination of factors, such as a lack of sleep.
What Causes Sleep Problems?
It’s possible for a person’s sleep to be disrupted by a variety of factors, all of which can lead to seizures. There are a few things to keep in mind.
- Not getting enough sleep: There isn’t a set number of hours that everyone should obtain in a night’s worth of sleep. Only 5 hours of sleep every night works for some people, while others require 8 to 10 hours or more. A decent night’s sleep is generally believed to be between seven and eight hours, but the quality of that sleep must also be taken into account. People who sleep significantly less than this are more than likely suffering from sleep deprivation and obtaining poor quality rest.
- Not getting ‘good quality’ sleep: Having a good night’s sleep means that you wake up feeling relaxed and energized for the remainder of the day. Insufficient sleep, frequent awakenings, and restless sleep are just a few of the factors that might cause you to miss out on a restful night’s slumber.
- Having seizures at night: At night, people may be awakened by seizures, or their sleep may be disrupted so that they do not receive a decent night’s rest. There is a possibility that their minds aren’t getting enough shut-eye. As a result, someone who experiences frequent nighttime seizures may find it difficult to carry on normal daily activities. Seizures are more common in the daytime if they suffer from chronic sleep deprivation.
- Difficulty falling asleep: Inability to fall asleep, frequent awakenings, or waking up too early are all possible causes of sleep disorders. It is possible to suffer from insomnia due to seizures, mood swings, and medication side effects.
- Moods: Depression and anxiety are frequently accompanied by insomnia, which is a typical symptom of both. You should visit a doctor or a mental health expert if you have sleep issues that have persisted for more than two weeks, or if you are experiencing other signs of depression.
- Poor eating habits: People who consume big amounts of food before bedtime, drink coffee or other caffeine-containing beverages, or consume alcohol in the evening are just a few eating habits that might cause sleep problems.
- Side effects of medications: Sleepiness is a side effect of some seizure medicines. When you’re with other people, it can be difficult to fall asleep. The times at which seizure drugs are given may also have an impact.
- Sleep disorders: Sleep apnea, restless legs syndrome, and other sleep disorders can keep people awake at night. Chronic sleep deprivation and exhaustion can result from sleep disorders. Seizures are frequently accompanied by sleep difficulties and vice versa.
How Can I Help Improve My Sleep?
- Regularly work out. The type and the time of exercise should be examined. Early in the day is often the best time to engage in strenuous physical activity.
- The bed should be reserved for sleeping and sex, not for things that keep you awake.
- Make sure your bedroom is peaceful and dark before you go to sleep.
- Consistency in the sleep schedule is key. It is quite beneficial to adhere to a consistent wake-up hour.
Improve your sleep patterns before going to bed by adjusting your workout and eating schedules, as well as turning off your electronic devices!
- Caffeine should be avoided at least six hours before night. Drinking alcohol late at night should be avoided.
- Relax by taking a warm shower before going to bed.
- Before you go to bed, put away your work or other stimulating activities. Instead, engage in more restorative pursuits.
- Before going to bed, try some sort of soothing exercise, such as meditation.
- After 30 minutes, get out of bed and do something soothing or quiet for around 20 to 30 minutes till you feel sleepy again. Don’t get sucked into your favorite book by reading something short like a magazine article! Go to bed if you’re exhausted. After 30 minutes, if you still can’t sleep, get up.
- Your body will eventually become accustomed to sleeping just when you are in bed.
- For more information, see Sleep and Epilepsy.
Can Sleeping Pills Help With Sleep?
Over-the-counter sleep aids like melatonin or diphenhydramine may be a safe choice if behavioral techniques fail. However, it is always best to follow a doctor’s orders when using a sleeping drug. If you’re taking sleeping aids for more than a couple of weeks, stop. Even when used for a short period of time, they must be handled with care. People who stop taking some types of sleeping drugs, notable benzodiazepines like temazepam (Restoril), may experience seizures.
Sleep deprivation can lead to a seizure if the person is under a lot of stress, such as the loss of a job or a romantic relationship. Your epilepsy doctor should be consulted if you find yourself in this position.
But I Just Can’t Sleep Without Sleeping Pills!
Getting off of sleeping drugs should be discussed with your doctor if you use them practically every night. He or she will most likely begin by gradually decreasing the amount you are taking. He or she may suggest a sleep aid that isn’t habit-forming. Another option is to prescribe a medication to address the underlying cause of insomnia.
Do The Same “Rules” Of Sleep Apply For Children?
Adults need more sleep than children do. At different ages, the pediatrician can assist you in determining how much sleep your child may require. Children’s sleep problems and solutions might be learned from them as well.
Talk to an epilepsy doctor if your child has nighttime seizures or is more exhausted than normal throughout the day. Make a special effort to improve your child’s sleep patterns and avoid items that deprive him or her of sleep if your child has a history of frequent seizures when he or she does not get enough sleep.