Hesperian Health Guides
Sleeping well with epilepsy
HealthWiki > Epilepsy and Seizures > Chapter 6: Living well with epilepsy > Sleeping well with epilepsy
Sleep or lack of sleep does not cause epilepsy. But sleep problems and being tired can trigger seizures for a person with epilepsy. There are many ways sleep can be disturbed.
Contents
SIGNS
Disturbed sleep
- Not sleeping long enough
- Waking up frequently
- Not having a regular sleep pattern (by working nights, changing shifts, traveling, or the demands of a newborn)
- Not being able to fall or stay asleep (insomnia)
Managing disturbed sleep
Make your bedroom comfortable, neither too hot nor too cold. Cool temperatures help many people sleep better. In hot, dry weather, sprinkle a few droplets of water on your bed or wear a damp shirt to help keep yourself cool. Use light cotton bedding and sleep with a fan or air cooler turned on. In cold weather, cover ears, head, hands, and feet with warm clothing and blankets.
If you like massage, a gentle massage to your hands, legs, and feet with sesame or coconut oil (or no oil at all) can help you relax before sleep.
Avoid drinking alcohol. Reducing or stopping the use of alcohol when taking antiseizure medicines is often necessary. Combining alcohol and most antiseizure medicines can disturb sleep.
Limit screen time before bed. If possible, turn off your phone screen, television, or other screens at least 1 hour before bedtime. Screens in the bedroom can make it harder to fall asleep and get good rest.
Go to bed and get up at around the same time every day. The brain can train itself to go to sleep and stop sleeping at the same time.
Stay physically active every day. A daily dose of physical activity helps us grow tired and rest well at night.
Take your daily antiseizure medicine. Take your antiseizure medicine at the same time every day. Ask your health worker how you can avoid waking up in the middle of the night to take it.
Use gentle alarms. If you use an alarm on your phone or other electronic device, choose a pleasant sound to wake you more naturally.
Make sleeping comfortable while traveling If you have trouble sleeping while traveling, bring something that reminds you of home, perhaps a small pillow. Stick to your regular sleep routine as best you can.
Take naps. If you do not sleep well at night, a short nap during the day can help you feel more rested. Napping for 20 to 30 minutes not too late in the day is best—it will not interfere with your sleep at night.
Yoga pose to relax and get ready for sleep
Yoga can improve our minds, our bodies, and our epilepsy. It can also help the body prepare for sleep. The traditional resting pose in yoga is called corpse pose, or Savasana. To get into this relaxation pose:
- Lie on your back on the floor or a bed, arms at your sides and palms facing up. Close your eyes and relax your shoulders and jaw. Take a few deep breaths.
- Hug your knees to your chest and take a deep breath in. Breathe out as you stretch out your legs without lifting any part of your body. Do this 3 to 5 times.
- Lie flat without stretching, your body fully relaxed.
- If any part of your body feels tight or painful, take a deep breath and, in your mind, breathe out into that part of the body.
- Silently count from 1 to 4 as you breathe in, and then again as you breathe out.
- Counting helps you focus on your breath.
- Keep breathing and let yourself drift into sleep.
Seizures during sleep
Some people have seizures during sleep which they may or may not be aware of. They may learn about them from others who observe unusual movements, sounds, or behaviors as they sleep.
SIGNS
Seizures during sleep
- Yelling or crying sounds
- Strong movements of arms and legs
- Random movements from side to side
- Waking for no obvious reason more than once a night
Identifying sleep seizures
Seizures during sleep can be difficult to discover or describe because the people around the person having seizures may also be sleeping or may not be fully awake. To collect information:
Make a video. Filming while a person sleeps can capture their movements during a seizure. This will help identify the seizure type. Aim a mobile phone or other camera so the person’s whole body can be seen.
Ask questions. Getting a detailed description of a person’s sleep seizures from someone who observed the seizures can help identify the seizure type.
As with other seizures, identifying the seizure type can help determine what medicine might best control the seizures. For more information about seizures during sleep, see Chapter 3.
Manta’s sleep seizures
I was in my second year of university, writing papers and studying hard for final exams. I only had a few hours of sleep for 3 days and I was beyond tired. I took a nap, and that’s when I had my first seizure.
My roommate was studying in our room and saw me moving in bed. She did not say much about what she saw, except that it seemed to last only a few seconds.
We called my parents, and they told me to go to a hospital. After a brief exam, the health worker sent me home. I was still so tired. I went to bed but woke up again with jerking movements.
I was so frightened I went back to the hospital. This time I saw a brain specialist who asked me questions about what happened and took a brain scan.
The doctor said I had all the signs of epilepsy and that there seemed to be a connection between my seizures and sleep. She asked me to keep a diary and write about my seizures as soon as they happened.
Keeping the diary helped me learn that my seizures are more frequent when I am tired and almost always happen while I am sleeping or right upon waking. The doctor gave me an antiseizure medicine for epilepsy. It helps. But the most important thing for me is to get enough sleep.
Preventing injuries from sleep seizures
Remove sharp objects or other dangerous things from near the bed.
Sleep close to the floor on a low bed or mattress. Place pillows or pads next to the bed to cushion a fall.
Share a bedroom. Have someone nearby who knows how to help you if a seizure happens.
Sleep with a little light. Waking up in a dark room might increase confusion after a seizure—light can help you know where you are. It can also help a caregiver be more alert to your seizure and act quickly.
Use a firm pillow that will not prevent you from breathing if you are lying face down during or after a seizure.
Avoid sleeping on your stomach. This increases the risk of inhaling vomit or other fluids during a seizure, causing breathing problems. Sleep on your side or back to allow for easier breathing.
If possible, sleep in a room on the ground floor. Not all seizures during sleep happen while a person is still in bed. Some people get up and move around during a seizure, which can lead to falls or injuries. If you cannot sleep on the ground floor, at least keep your sleeping area away from stairs.
Effects of antiseizure medicines on sleep
Side effects from antiseizure medicine often affect sleep. Some medicines:
- cause people to sleep more and may make people feel tired during the day.
- do the opposite and cause difficulty sleeping (insomnia).
- cause strange dreams or nightmares.
- cause anxiety, which can lead to sleepless nights and tiredness.
Sleep usually improves over time as the body gets used to the medicine. If the side effects of an antiseizure medicine are too strong, talk with a health worker to see if a different dose or medicine might work. People with frightening dreams may also find it helpful to talk about them with a friend, family member, or health worker.
The ways medicines affect sleep differ from person to person. Antiseizure medicines that are known to have more effects on sleep include phenobarbital, levetiracetam, and valproic acid.