Sleep and Epilepsy

Headshot of Mithri Junna. - Clinician's Corner

by Dr. Mithri Junna, M.D., Mayo Clinic  

Sleep and epilepsy have an intimate association. During the sleeping period, the brain’s electrical activity changes as it cycles through various sleep stages. There are certain periods of sleep during which some individuals may be more prone to experience seizures. In others, seizures tend to occur more often during sleep-wake transitions. Some people may be more susceptible to the effects of sleep deprivation and, consequently, may experience more frequent or prolonged seizures following a night of sleep deprivation. Reductions in sleep quantity and/or quality can occur under a range of circumstances. 

Inadequate sleep hygiene and insomnia

The amount of sleep needed by each person can vary, though in general, most adults require between seven and eight hours of sleep, best when achieved in a consolidated fashion. Difficulties initiating and maintaining sleep can result from a variety of reasons. Engaging in stimulating activities either outside or inside the bedroom may impair one’s capacity to fall asleep in a timely manner. A disruptive bedroom environment can also create similar problems. Substances such as caffeine may reduce one’s ability to initiate sleep, and others, such as alcohol, may lessen one’s ability to maintain sleep. Seizures themselves can also cause unexplained nocturnal awakenings. Mood disorders, which occur more frequently in those with epilepsy, can be associated with sleep disruption. Drug side effects must also be considered, as certain anti-seizure medications can lead to insomnia.

Obstructive sleep apnea

People with epilepsy are known to have a high incidence of obstructive sleep apnea, a condition in which pauses in the breathing occur during sleep due to airway obstruction. Symptoms of this disorder can include snoring, cessation of breathing, unexplained nighttime awakenings and daytime sleepiness.  These individuals are more likely to experience nocturnal seizures, and therefore, appropriate sleep evaluation and treatment for the condition should be pursued.

How to achieve healthy sleep

  • Maintain a regular sleep-wake schedule and target seven to eight hours of total sleep time per day
  • Avoid stimulating activities prior to bedtime
  • Ensure that the bedroom environment is not disruptive and used only for sleeping or sexual activity
  • Avoid caffeine and alcohol during evening and night hours
  • Avoid eating too close to bedtime
  • Exercise daily
  • Seek psychiatric evaluation if mood symptoms are present
  • Seek sleep evaluation if sleep apnea or additional sleep disorders are suspected

Comprehensive Care for Individuals with Epilepsy

At Mayo Clinic, the world’s most highly specialized epilepsy experts care for more than 7,000 adults and children with epilepsy every year. By seeking new knowledge through cutting-edge research and groundbreaking clinical trials, our experts improve diagnosis and treatments for epilepsy patients. They take the time necessary to listen, understand symptoms and concerns, and design a personalized treatment plan so each patient gets exactly the care they need.

To learn more and request an appointment, visit MayoClinic.org/epilepsy.