Lack of Sleep and Epilepsy
Can sleep deprivation trigger a seizure?
Yes, it can. Seizures are very sensitive to sleep patterns. Some people have their first and only seizures after an "all-nighter" at college or after not sleeping well for long periods. If you have epilepsy, lack of "good sleep" makes most people more likely to have seizures. It can even increase the intensity and length of seizures. Some forms of epilepsy are especially prone to sleep problems.
Why does sleep deprivation provoke seizures?
Sleep can affect seizures in many different ways. During normal sleep-wake cycles, changes in the brain’s electrical and hormonal activity occur. These changes can be related to why some people have more seizures during sleep than others, and why not getting enough sleep can trigger seizures. Some people’s seizures are tied very closely with their sleep. They may have all of their seizures while sleeping, when falling asleep or waking up. For others, sleep may not be a common trigger, or the association is less clear. For example not getting enough sleep may trigger seizures only when other triggers are going on too.
What causes sleep problems?
Lot of things can affect a person’s sleep and make them more likely to have seizures. Here are a few factors to consider.
- Not getting enough sleep: There’s no magic number of hours of sleep that everyone should get. Some people do well on 5 hours a night, others need 8 to 10 hours or more. In general, at least 7-8 hours of sleep a night is considered good, but the quality of sleep also needs to be considered. If people sleep much less than this most of the time, they are likely sleep deprived and not getting good sleep.
- Not getting ‘good quality’ sleep: Good sleep means feeling rested when you wake up and have energy during the day. Lots of things can prevent you from getting good quality sleep, for example not getting enough sleep, waking up frequently, or having a very restless sleep.
- Having seizures at night: Seizures at night can wake people up or just disrupt their sleep so they aren’t getting a good quality of sleep. Their brains may be missing some of the important sleep cycles. As a result, someone who has lots of seizures at night may have trouble functioning during the day. They may also be chronically sleep deprived and have more seizures during the day too!
- Difficulty falling asleep: Sleep problems can arise from being unable to fall asleep, awakening frequently, or waking up too early. Seizures, moods, and medicine side effects can all cause insomnia.
- Moods: Difficulty sleeping is a common symptom of depression and anxiety. If sleep problems last longer than 2 weeks and/or other symptoms of mood problems are present, it’s time to sort this out by seeing your doctor or mental health specialist.
- Poor eating habits: Eating or drinking late at night, eating large amounts before sleep, drinking coffee or other drinks with caffeine, or drinking alcohol in the evening are just a few eating habits that can worsen sleep.
- Side effects of medications: Some seizure medications can make people sleepy. Others can make it harder to fall asleep. The times seizure medications are taken may also make a difference.
- Sleep disorders: Sometimes people can’t sleep because they have a sleep disorder, like sleep apnea, restless legs or other sleep problems. Sleep disorders can leave a person chronically sleep deprived and tired. It’s not unusual to see people with seizures also have sleep disorders.
How can I help improve my sleep?
- Exercise regularly. Look at the type and timing of exercise. Vigorous exercise is usually better earlier in the day.
- Use your bed for sleep and sex, not for activities that will keep you awake.
- Make sure your sleeping environment is quiet and dark.
- Try to keep consistent sleep hours. Keeping a regular wake up time is real helpful.
- Improve sleep habits before bed – look at when you exercise, don’t eat late at night, and turn off your electronics!
- Avoid caffeine at least 6 hours before bedtime. Limit alcoholic drinks at night.
- Take a warm shower before bed to help you relax.
- Stop working or doing stimulating activities before you go to bed. Try more relaxing activities instead.
- Consider meditation or a form of relaxing exercises before bedtime.
- If it takes you more than 30 minutes to fall asleep, get out of bed and do something relaxing or quiet for about 20 to 30 minutes until you get tired. Read something short, like a magazine article, but don't get engrossed in your favorite book! When you feel tired, go back to bed. If you still can’t sleep, get up after 30 minutes. Eventually your body will learn to sleep when you’re in bed.
- Visit Sleep and Epilepsy for other tips.
Can sleeping pills help with sleep?
If behavioral strategies don't work, over-the-counter sleeping aids such as melatonin or diphenhydramine may be relatively safe options. Yet, any sleeping pill (over-the-counter or prescription) should be used only under a doctor's advice. Don’t take sleeping pills for more than 2 or 3 weeks. Even with short-term use, they must be handled carefully. 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 big stress, 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. If you find yourself in this situation, talk to your epilepsy doctor.
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 try to slowly lower the amount you take. He or she may recommend a non-habit forming type of medicine that helps sleep. Or a medicine to treat the cause of the sleep problems may be suggested.
Do the same "rules" of sleep apply for children?
Children require more sleep than adults. The pediatrician can help you figure out how much sleep your child may need at different ages. They can also help you learn about common sleep problems in children and how to help them sleep better.
If seizures occur in children at night or the child is more tired than usual during the day, talk to the epilepsy doctor. If your child consistently has more seizures when he or she does not sleep enough, you will need to make a special effort to improve sleep habits and avoid things that cause sleep deprivation.
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