Can sleep deprivation trigger a seizure?

Yes, it can. Some people suffer a single seizure for the only time in their entire life after an "all-nighter" at college or after a prolonged period of poor sleep associated with a major life stress. If you have epilepsy, lack of proper sleep can increase your chances of having a seizure. It can even increase the intensity and length of seizures.

Why does sleep deprivation provoke seizures?

We don't know why sleep deprivation provokes seizures. The sleep-wake cycle is associated with prominent changes in brain electrical activity and hormonal activity, so seizures and the sleep-wake cycle are often clearly related. Some people with epilepsy have all of their seizures while sleeping and others have most of their seizures just as they are falling asleep or just after waking up. Of course, this effect doesn't apply to everyone; many people's seizures are randomly spread throughout the day and night.

To avoid sleep deprivation, how much sleep should I get?

"Adequate sleep" varies from person to person. A simple definition of adequate sleep is the amount that leaves you feeling refreshed the next day. For most adults with epilepsy, this usually means at least 7 hours a night. If you go to bed very late now and then, you probably can make up for it by sleeping late the next morning. For some people, however, this kind of disruption of their sleep-wake cycle (circadian rhythm) makes seizures more likely even if they sleep for the same number of hours.

What are some strategies for getting a good night's sleep?

• Make sure your sleeping environment is quiet and dark.
• Go to bed at least half an hour before trying to fall asleep.
• Read in bed instead of watching television (unless reading a good novel keeps you awake and TV puts you to sleep).
• Avoid caffeine for at least 6 hours before bedtime.
• Have no more than one alcoholic beverage a day.
• Exercise daily but do not exercise within a few hours of going to bed.

Can sleeping pills help with sleep difficulties?

Sleeping pills should be used only under a doctor's supervision and almost never for more than 2 or 3 weeks. Even with short-term use, they must be handled carefully, because stopping certain types of sleeping pills, especially the benzodiazepines such as triazolam (Halcion), clonazepam (Klonopin), and temazepam (Restoril), can trigger seizures in some people.

During a period of tremendous stress, however, such as loss of a job or a relationship, the careful use of sleeping pills for several nights can help to prevent a seizure caused by sleep deprivation.

But I just can't sleep without sleeping pills!

If you depend on sleeping pills almost every night, you should talk to your doctor about getting off of them. The doctor probably will suggest that you try to gradually reduce the amount you take. You may be able to substitute a non-habit-forming medication that promotes sleep. One example is diphenhydramine (Benadryl), but it can provoke seizures in some people with epilepsy. Melatonin is another over-the-counter product used to promote sleep. It appears to be safe for most people with epilepsy, but there are no good scientific studies.

Do the same "rules" of sleep apply for children?

Children require more sleep than adults. The pediatrician can advise you about how much sleep your child may need at different ages and can offer tips on helping to maintain a regular sleep routine. A good book on this subject is Solve Your Child's Sleep Problems by Richard Ferber, MD.

If your child consistently has more seizures when he or she does not sleep enough, you will need to make a special effort to recognize and avoid the things that cause your child to be sleep-deprived.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06