Epilepsy and Sleep

You can get a good night’s sleep with all sorts of tips, tricks, and treatments. But if you have epilepsy, you may have to navigate a few extra hurdles. The good news is that you have lots of options for medical care, social support, and sleep tips to help you not only manage your epilepsy symptoms but get a good night’s rest, too.

Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.

What Is Epilepsy?

Epilepsy is one of the most common neurological disorders in the world — it causes recurring seizures that come from brief disruptions in electrical brain activity. (1)

About two-thirds of the time, the underlying cause of a person’s epilepsy is unknown. In other cases, though, epilepsy can develop because of a stroke, brain tumor, brain infection, genetic disorder, brain injury, or a neurological disease like Alzheimer’s. (2) No matter the cause, epilepsy itself can’t be spread from person to person. (3)

If your epilepsy is caused by a brain infection, that infection may have been contagious, but the resulting seizures are not. “Seizures in and of themselves are not something that can be transmitted or swapped between people,” Dr. Danielle Kelvas, MD, tells Sleepopolis. 

Even though you can have a seizure without a precipitating trigger, they can be triggered by stress, sleep deprivation, not eating enough, alcohol/drug use, and skipping seizure medications. (4) This may all feel a bit heavy, but hang in there — we’re going to talk about some types of epilepsy and how it affects your sleep, but then we’ll tell you what you can do about it.

Epilepsy Types

Epilepsy describes over 30 types of seizure disorders. (5) In 2017, the International League Against Epilepsy (ILAE) decided to update the classification of epilepsy types. Now, experts sort out epilepsy type by looking at three factors: (6)

1. Seizure type: Seizures can look like staring into space (absence), falling on the ground, looking dazed and confused, or rhythmic muscle jerks (tonic-clonic). (7)
2. Epilepsy type: After your provider figures out your seizure type, they can diagnose an epilepsy type: focal, generalized, combined, or unknown. This is determined by where in the brain your seizures start. (8)
3. Epilepsy syndrome: This final step in diagnosis narrows your epilepsy down to a specific syndrome based on factors like what types of seizures you have and how old you were when they started. Your provider may also prescribe a test called an electroencephalogram (EEG) which records your brain activity. (8)

With this in mind, it’s important to seek medical attention immediately the first time you have a seizure — a medical provider can work with you to discover what type of epilepsy you have and decide which medical treatment is necessary to prevent seizures in the future. 

We know that reading about epilepsy, especially if you’re just beginning to learn about it, can be pretty scary. Keep in mind that many types of epilepsy fade over time, and plenty of people learn how to manage their symptoms with treatment. (1)

Epilepsy and Sleep

Sleep is closely entwined with epilepsy. How well you sleep can influence how often you have seizures, how long they last, and when they happen. (10) People with epilepsy may also have seizures while they sleep. 

Dylan Di Girolamo, a teacher in London, Canada, was diagnosed with epilepsy at 23. “Sometimes I have [seizures] in my sleep and wake up with a sore mouth and/or [feel] a bit groggy,” Di Girolamo says.

One possible reason for epilepsy’s connection to sleep may be how it affects your circadian rhythm (internal clock). Some studies on animals have confirmed this correlation, and in July 2024, a small study found the same results in a human trial. (11) (12)

Let’s take a closer look at how epilepsy and sleep are interlinked.

Epileptic Seizures and Sleep

Whether your seizures happen during the day or night, they can all affect your sleep. Like the medications you take to prevent them, seizures themselves can disrupt your sleep architecture, which is how much time you spend in each sleep stage. (13)(14)

When seizures wake you or interrupt your sleep stages, you can wake up the next day not feeling very refreshed, says Dr. Benjamin Emanuel, DO, Associate Professor of Neurology at USC – Keck School of Medicine. 

With some types of epilepsy, seizures mostly happen during the lightest sleep stage. (13) Others cause seizures most often one to two hours after waking up. (10) Clearly, not all types of epilepsy will have the same relationship with sleep, but the epilepsy syndromes below are linked especially closely with sleep. Fair warning: they have some intense names, but we’ll break it down for you! (15)(16)

• Benign rolandic epilepsy (BRE): The most common form of epilepsy in children, BRE causes seizures at night or soon after waking. Children usually grow out of BRE during adolescence. (17)
• Developmental/epileptic encephalopathy with spike-wave activation in sleep (DEE-SWAS):  This type of epilepsy is rare and shows up in children between two and 12 years old. DEE-SWAS can cause some developmental delays, but symptoms and seizures often fade during the teenage years. (18)
• Sleep-related hypermotor epilepsy (SHE): This epilepsy type can begin anywhere from age one to 60. SHE seizures can involve a lot of limb movement and are sometimes confused with movement disorders. These seizures don’t last long but can happen up to eight times a night. SHE has no cure yet, but can be managed with medications. (19)
• Panayiotopoulos Syndrome (PS): Most common in early childhood (between ages three to six), PS seizures may not look like much at all. Children can feel sick or get pale. Other times they may vomit, have blurry vision, or have rhythmic muscle jerks (tonic-clonic seizures). These seizures can last up to two hours in some children. Almost all kids outgrow PS seizures two to three years after their first. (20)

Sleep Deprivation

Missing out on sleep can make the next day tough on anyone, but when you have epilepsy, sleep deprivation may cause seizures by triggering disorganized electrical activity in your brain. (10) (21) Di Girolamo finds that lack of sleep combined with stress, anxiety, and hormones increases her seizures. 

Sleep deprivation isn’t just about how much sleep you get; quality plays a big part, too. Even if you sleep seven to nine hours, like experts say you should, you can still be sleep deprived if your sleep is broken up or you don’t get enough time in deep sleep. (10) (13)

Epilepsy and Sleep Disorders

A lot of people with epilepsy also have one or more sleep disorders. (16) Even though seizures and epilepsy medications can affect your snoozing, sleep disorders may also play a big part. (13)

• Obstructive Sleep Apnea (OSA): This sleep disorder shows up a lot with epilepsy. (13) Depending on age and epilepsy type, up to 70 percent of people with epilepsy also have sleep apnea. Thankfully, several treatment options, including CPAP therapy, can help treat OSA and make your seizures less frequent. (22)
• Insomnia: If you have trouble falling asleep or staying asleep more than three nights a week for over three months, you may be diagnosed with chronic  insomnia. (23) Insomnia affects 24 to 50 percent of people with epilepsy. Because it steals your sleep, this sleep disorder can lead to more seizures. Insomnia can be caused by epilepsy itself, but it can also be caused by health conditions, or could be a medication side effect. (22)
• Parasomnias: Parasomnias are unpleasant experiences that occur during sleep, and the most common are sleep walking, talking in your sleep, nightmares, teeth grinding (bruxism), and night terrors. (24) Sometimes parasomnias and epileptic seizures can look so similar, they get confused for one another. (13)

Epilepsy in Children

Many types of epilepsy start when you’re a baby or child. (25) Because some seizures manifest more subtly, you may not recognize them right away. For example, as your baby grows, you may notice periods of staring—that may seem typical enough on its own. Or perhaps, after they start talking, you’ll notice they don’t make much sense for a few minutes. (26) If you’re regularly noticing some behaviors that feel a bit out of the ordinary for your child, it never hurts to talk to their healthcare provider and get it checked out. 

The care plan for a child with epilepsy can look a little different than a plan for adults, says Emanuel. Children are more sensitive to epilepsy medication, and their dose will be based on their weight. (27) “Children may also be more sensitive to triggers like lack of sleep, flashing lights, or a change in treatment,” Emanuel says.

How Epilepsy Affects Sleep In Children

A kid’s sleep doesn’t look the same as an adult’s. (5) For example, adult sleep cycles last about 90 to 100 minutes each, but sleep cycles in children and infants are closer to 60 minutes long. (13) Sleep deprivation can also hit kids differently because they solidify what they learned during the day differently than adults. (5) 

One large study review found that children with epilepsy get an average of 34 minutes less sleep per night than their peers. When these kids didn’t sleep enough or had low-quality sleep, they got sleepy during the day, which wasn’t great for learning. (28) Stick with us, though — we’re about to tell you what you can to help your child in this area.

Special Considerations for Sleep in Children with Epilepsy

Sometimes, kids with epilepsy also have to deal with extra emotional, behavioral, social, and academic difficulties. (5) If your child is having issues in one or more of these areas, it’s important to know you have some options. 

Your child’s healthcare provider can help you figure out which treatments and strategies are right for them. You may not be able to stop every seizure, but you can give them the tools to learn, address their mental health, and get good sleep. These organizations can give you some parental support:

• Epilepsy Foundation Individual and Family Services
• Parent to Parent USA
• Center for Parent Information and Resources
• Family Voices

Di Girolamo wants parents to know that epilepsy doesn’t have to control them or their child’s life. “Life can still be lived to the fullest. Children can persevere and if they don’t grow out of it, they can still have a career and independence in the future. It’s better to spread awareness than let it control your life.”

Getting Diagnosed

Before you can get busy supporting your child or yourself on an epilepsy journey, you need a diagnosis. One seizure doesn’t automatically equal epilepsy — seizures can also be caused by low blood sugars or alcohol and drug withdrawal. (2) “From an infectious disease perspective, high fevers can [also] cause seizures,” says Kelvas.

Your primary care provider will rule out these possibilities before they consider epilepsy. After two seizures with no other explanation, your provider or specialist can begin an epilepsy diagnosis workup: (4)

• Medical history: Your provider will ask all about your health history and seizures. (29)
• Neurological exam: This exam checks to see if your muscles, reflexes, and senses are firing on all cylinders. Your provider may watch you walk a few steps, tap on your knee to make your leg jump, and ask you questions to test your memory. (30)
• Electroencephalogram (EEG): This safe and painless test measures your brain waves through 10-24 tiny electrode stickers all over your scalp. It takes 60 to 90 minutes and can detect those surges of electricity your brain likes to have just before a seizure. (31)(32)
• Brain imaging: A magnetic resonance imaging (MRI) test is the recommended imaging exam for epilepsy because it can show a lot of tiny details. This test can sometimes find the cause of your seizures and may help rule out some other problems. (33)

Di Girolamo encourages everyone to take any recurring symptoms seriously. She had symptoms like nausea and confusion for years before her own diagnosis, which came much later. You know your body best — don’t hesitate to advocate for your health!

Epilepsy Treatment  

Once you have an epilepsy diagnosis in hand, you can start to think about treatment. Seizure medications are often the first step in treatment, and your provider can recommend the best choice for your specific epilepsy syndrome. Some medicines can be taken daily to prevent seizures, while others can be used during a seizure to stop it faster. (34) 

But medicine isn’t the only option. Your provider may also recommend: (34)

• Epilepsy surgery: When your seizures start in one tiny part of your brain, removing that part can prevent seizures from ever starting. 
• Seizure devices: These tiny gadgets send electrical signals to your brain. Depending on the device, they can stop seizures or prevent them from happening. (35)
• Dietary therapies: Although it doesn’t work for everyone, some diets can help control your seizures, such as ketogenic, modified Atkins, low glycemic, and medium-chain triglyceride (MCT) options. (36)
• Alternative therapies: Some with epilepsy may have better sleep and less stress from complementary approaches like medical cannabis and mindfulness or yoga practices. Always be sure to check with your provider before you try any new alternative therapy.

Epilepsy Treatment and Sleep

While some treatments may work great for your epilepsy, they can also interfere with your sleep. Some epilepsy medications make you sleepy, while others make it hard to drift off. (37) 

Benzodiazepines and phenytoin may make you spend too much time in light sleep and not enough in deep sleep. This combination can leave you feeling like you didn’t get much rest at all. (13) 

It’s important for your provider to look at the big picture. If you have other medical issues like pain, migraines, mental health disorders, or sleep disorders, your medication options may change, so be sure to paint a comprehensive picture. (13) If your treatment isn’t working for you, let your provider know — they can help you try out some different options.

Tips for Getting Better Sleep with Epilepsy

If you have epilepsy and notice your sleep could use a little help, we’ve got some tips for you. “Anything that improves sleep in general can improve sleep for people with epilepsy,” says Emanuel. 

Getting to bed and waking up at the same time can help anyone get better sleep. (12) Some other good sleep hygiene habits can help you get better sleep more often: (38)

• Create a regular bedtime routine.
• Get some exercise during the day.
• Try mindfulness or meditation.
• Avoid caffeine and alcohol later in the day.
• Keep meals/snacks on the light side close to bedtime – heavy meals can keep you up.
• Get out in the sunshine during the day and avoid blue light (from screens) too close to bedtime.

If you find some other habits that help you sleep better, do it!

Resources for People with Epilepsy

Even when epilepsy responds well to treatment, it’s easy and normal to feel some emotional overwhelm. Seizures often zap your energy no matter when they happen. (39) 

“Having [a seizure] shortly before bed ups anxiety,” says Di Girolamo, “and therefore I end up staying up longer because I’m scared as they are usually pretty clustered.” Understandably, it’s common to have anxiety and other mental health issues along with epilepsy. (40)

Anyone with epilepsy needs and deserves support from their friends, family, community, healthcare team, and others with the condition. These organizations can get you started with support groups, helplines, and heaps of information. 

• Epilepsy Alliance America
• Epilepsy Foundation
• Empowering Epilepsy

Financial Support

Navigating the financial twists and turns of epilepsy care can feel like a bumpy ride. Many of the resources above offer financial assistance for medical bills, transportation assistance, and lots of other help in the money department.

FAQs

The Last Word From Sleepopolis

When epilepsy tries to dampen your sweet dreams, you can fight back. With help from your healthcare provider, you can use medical treatments and good sleep hygiene to get back on track. If you’re feeling isolated because of your diagnosis, reach out to one of the many groups that want to help. You don’t have to go through this alone.

Sources

Abby McCoy

Abby McCoy is an RN of 16 years who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She has practiced nursing all over the world from San Fransisco, CA to Tharaka, Kenya. Abby loves spending time with her husband, four kids, and their cat named Cat.