A lack of sleep can affect our memories and judgement. It can also affect our mood and how well our immune system works. Some people have specific triggers for their seizures, for example a lack of sleep. In some types of epilepsy seizures can happen as someone is waking up and within the next few hours. For some people the effects of having a seizure can upset their sleep pattern for several days afterwards. As with all medications, anti-epileptic drugs AEDs can cause side effects for some people.
AEDs may have different effects on sleep, and this can vary from person to person, depending on the dose. Some AEDs are classed as sedatives and can cause tiredness. Some can cause insomnia or disrupted sleep. However some AEDs can help to improve the quality of sleep by increasing the length of deep sleep.
Frontal lobe epilepsy is a type of epilepsy where seizures can commonly happen during periods of NREM sleep as well as when awake. They can include sudden jerking movements, strange postures or movements of the arms or legs, loud cries or screams and wandering about during sleep.
These can include confused behaviour during sleep, sleepwalking or night terrors where a person suddenly wakes from sleep in a state of panic or fright. This may happen when some parts of the brain are awake and others are asleep. Some parasomnias include making unusual movements or sounds.
Sometimes it can be difficult to tell whether someone is having seizures or if what happens to them is part of a parasomnia.
It can be helpful to keep a record or video recording of what happens during the event to help with diagnosis. Seizures often follow a similar pattern each time they happen and it may be clear to see when a seizure starts and when it stops. However, parasomnias do not necessarily follow a pattern and often have no clear end. Some symptoms of narcolepsy a rare condition causing uncontrollable urges to fall asleep, at any time of the day are sometimes mistaken for epilepsy. For example, some people with narcolepsy develop cataplexy, a loss of muscle tone often affecting the jaw, neck and limbs.
Symptoms can also include slurred speech or blurred vision and some people may collapse. An episode of cataplexy may be triggered by emotions such as laughter, anger or surprise. One of the epilepsies most specifically related to sleep is called "awakening grand mal" epilepsy. If you have this kind of epilepsy, you have generalized tonic-clonic "grand mal" seizures , but they occur only just before or just after you wake up.
The seizures typically happen in the morning, but they can also occur when you wake up from a nap. Usually seizure medicines can control these seizures, but you should be cautious anyway during the times of greatest seizure risk. Don't operate machinery or be a caregiver for small children immediately after waking up. Many other types of epilepsy include seizures that usually, but not always, happen upon awakening. Juvenile myoclonic epilepsy JME usually begins in the teenage years.
People with JME have rapid, isolated jerks of muscles similar to what most people experience as they fall asleep , called "myoclonus. If you have JME, you also may have grand mal seizures, usually early in the morning. Seizure medicines typically can control the seizures of JME. Other seizure types tend to occur during sleep rather than upon awakening.
Frontal lobe seizures are a type of partial epilepsy that begins in the frontal lobe, the part of the brain behind the forehead.
Frontal lobe seizures are brief generally not more than 2 minutes and sometimes violent. They usually or always happen during sleep and can be followed by brief confusion. Seizure medicines tend to work better in controlling them if they occur only during sleep. Children also can have forms of epilepsy in which seizures are restricted to periods of sleep.
The most common type is called benign rolandic epilepsy BRE , named after the brain region in which it starts. Jerking of the face, limbs, or both on one side almost always begins during sleep. The child usually wakes up and is alert.
Usually an electroencephalogram EEG will be helpful to confirm the diagnosis. It is important to find out whether the child really has BRE, because it is always outgrown. Treatment is not always recommended, particularly if the seizures are rare and occur only during sleep.
If seizure medicines are used, they are quite effective, typically at a very small dose. Even though seizures are usually unpredictable, we know that some things make them more likely.
Many sorts of physical or emotional stress, including illness and lack of sleep, can increase the chance of seizures. So people with epilepsy are usually told to avoid sleep deprivation, as well as substances like alcohol that interfere with normal sleep. A doctor who believes you may have epilepsy will often recommend an electroencephalogram EEG to confirm the diagnosis and learn more about your specific type of seizures. Because certain abnormalities are only seen during sleep, it is important for you to sleep during the study.
Therefore, you may be asked to come to the test sleep-deprived. Although this is contrary to the usual recommendation, it will make the test more accurate and complete. It also may increase the likelihood that the test will show any abnormal activity. Daytime drowsiness is not unusual for people with epilepsy. If you find it troublesome, you should ask your doctor to investigate. It may be related to persistent seizures or to seizure medicines.
Or it may just be the same kind of drowsiness that affects many Americans these days because their sleep is inadequate or is disrupted by things like noise, alcohol, or caffeine. Having epilepsy does not protect you from also having an unrelated sleep problem.
If you do have a sleep disorder, it can worsen your epilepsy and your epilepsy can worsen your sleep. You can therefore develop a cycle of worsening seizures and worsening sleep, which can make it difficult to treat either problem.
If you have epilepsy, you should pay particular attention to the conditions of your sleep and possible disruptions. The most troublesome sleep disorder in people with epilepsy is sleep apnea, in which breathing stops briefly during sleep.
It is most common in people who are overweight. As sleep deepens, the airway relaxes too much and becomes blocked. The brain recognizes the resulting lack of oxygen, and the person wakes up usually with a loud snore and begins to breathe again. Often the person does not remember waking up, but this cycle is repeated all night long and normal sleep is never achieved. Therefore the person is drowsy most of the time and may be at risk of falling asleep during activities like driving.
It's especially important to recognize and treat sleep apnea if you have epilepsy. The lack of sleep can make your seizures worse. So can the lack of oxygen getting to your brain during sleep. You may continue to have seizures particularly during sleep even if you take seizure medicines that would otherwise be effective.
Both your drowsiness and seizures should improve if the sleep apnea is treated. Seizures usually last only a minute or two. Most people recover rapidly and can function pretty normally within 10 or 15 minutes.
Recovering from a generalized seizure may take a bit longer. But a substantial number of people with epilepsy find that they do not function at their best for a day or more after a seizure. This group includes many people who have seizures during their sleep.
In some ways, seizures during sleep are less disruptive. Included in this category are:. Partial seizures, also called focal or localized seizures, are limited to one hemisphere of the brain. Partial seizures can affect behavior, consciousness, and responsiveness.
They also can include involuntary movements. The report also noted that an estimated 7. People with nocturnal-only seizures can develop seizures while awake. One study from showed that about one-third of people with sleep-only seizures can develop seizures while awake even after being seizure-free for many years.
Most nocturnal seizures occur in stage 1 and stage 2 , which are moments of lighter sleep. Nocturnal seizures can also occur upon waking. Both focal and generalized seizures can occur during sleep.
Nocturnal seizures disrupt sleep. They also affect concentration and performance at work or school. Nocturnal seizures are also associated with an increased risk for Sudden Unexpected Death in Epilepsy, which is a rare cause of death in people with epilepsy. Lack of sleep is also one of the most common triggers for seizures. Other triggers include stress and fever.
Seizures and epilepsy are more common in infants and children than any other age group. However, children who have epilepsy often stop having seizures by the time they reach adulthood. Parents of new infants sometimes confuse a condition called benign neonatal sleep myoclonus with epilepsy. Infants experiencing myoclonus have involuntary jerking that often looks like a seizure. Plus, myoclonus is rarely serious.
For example, hiccups and jerking in sleep are forms of myoclonus. It can be tricky to diagnose nocturnal seizures because of when they occur. Sleep seizures can also be confused with parasomnia, an umbrella term for a group of sleep disorders. These disorders include:.
To determine which form of epilepsy you may have, you doctor will evaluate a number of factors, including:. If you suspect that your infant or child is having nighttime seizures, consult with your doctor. You can monitor your child by:. Talk to your doctor if you believe that you or your child is experiencing seizures while sleeping.
Medication is the first-line treatment for epilepsy.
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