What is the Connection Between Sleep and Epilepsy?

Sleep and epilepsy are closely linked. Sleep disorders and epilepsy can sometimes feed off each other to create a cyclical medical problem that is very hard to resolve. Some forms of epilepsy are specifically associated with sleep, and epilepsy seizures are closely linked to sleeping and waking patterns on the part of the patient. Understanding the connection between sleep and epilepsy is important for patients, as it will help them control their seizures more effectively.

Epilepsy involves seizures caused by abnormal electrical activity in the brain. In some people, these seizures only happen during sleep. People may struggle with insomnia, daytime sleepiness, and fatigue for an extended period of time before epilepsy is identified as the cause. The connection between sleep and epilepsy can also manifest in the form of conditions where people have seizures when they wake up.

If someone with a history of epilepsy experiences sleep deprivation, the number and severity of seizures can increase. In fact, this is used to advantage in medical evaluation of patients with suspected epilepsy, as they may be asked not to sleep before an electroencephalogram (EEG) test to increase the probability that abnormal brain activity will develop during the test. Likewise, seizures can make it hard for people to sleep, causing sleep deprivation and, in turn, triggering worse seizures.

Sleep and epilepsy can also be seen linked in the incidence of sleep apnea. In sleep apnea, people stop breathing for short periods of time while they are asleep. People with epilepsy are far more likely to experience apnea. Since apnea can lead to sleep disorders, the sleep disorder can make the seizures worse, leading to more apnea and worse sleep. Patients with suspected sleep disorders will often be asked to spend time at a sleep clinic so they can be evaluated, and their time at the sleep clinic may reveal that epilepsy is the underlying cause of the problem.

Because of the link between sleep and epilepsy, people with epilepsy are often advised to get enough sleep and to avoid doing things that may jeopardize sound sleep, like drinking caffeine before bed, disrupting sleep schedules, and maintaining noisy bedrooms. Sound sleep can help control seizures and in some cases, people only experience seizures after extreme sleep deprivation, making it relatively easy to avoid seizures in the future simply by taking care to get enough sleep at night. Epilepsy patients may also be separately evaluated for sleep disorders to see if a separate sleep disorder is contributing to the patient's epilepsy and making it harder to control.