How are sleep and epilepsy connected?

We all know that we think more clearly, react more quickly, and generally perform better after a good night's sleep. And while a good night’s sleep plays a key role in the overall well-being and health of all people it is even more vital in people with epilepsy. 

One reason why is because a lack of sleep or poor quality of sleep can in turn increase frequency of seizures. The reasons why sleep deprivation provokes seizures are unclear, but here are a few thoughts. 

  • We know that the sleep-wake cycle is associated with prominent changes in brain electrical activity, so seizures and the sleep-wake cycle are often clearly related.
  • We also know that most types of seizures are affected by sleep, although the degree varies greatly from type to type and patient to patient.
  • There are hormonal changes during sleep that could possibly be related to seizures.
  • Finally, the effects of seizures and seizure medicines on the quality of your sleep can make the relationship even more complicated.

In this section we will explore all the different aspects of the sleep-epilepsy connection. Let’s get started with an introductory look at how sleep and epilepsy are connected.

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Several studies have confirmed that sleepiness and sleep disorders are common in persons with epilepsy.

  • Patients with partial epilepsy have twice the incidence of drowsiness as people who do not have epilepsy, and this significantly worsens quality of life. Much of this may be related to sleep apnea that is frequently undiagnosed.
  • Children with epilepsy have higher scores for poor quality sleep, anxiety about sleep, and disordered breathing. Children with epilepsy show more sleep problems than did controls, and these were associated with seizure frequency, age, paroxysmal activity on EEG, duration of illness, and behavioral problems.
  • Patients taking anticonvulsants known to disrupt sleep (phenobarbital, phenytoin, carbamazepine, or valproic acid) have increased drowsiness compared to epilepsy patients who are not taking anticonvulsants.
  • Other possible reasons for disrupted sleep fall into several categories, including the effects of seizures, insufficient sleep, inadequate sleep hygiene, and coincident sleep disorders.

 

 

Authored by: Carl Bazil, MD | Joseph I. Sirven, MD
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 8/2013
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