A Complex Interplay Exists Between Sleep and Seizures

Epilepsy Can Bring About Sleep Seizures

man in dark room sleeping
Rod Morata/The Image Bank/Getty Images

Epilepsy is a disorder of recurrent seizures that may consist of subtle changes in outward attention or even physical convulsions. Epilepsy episodes can be a scary thing for those experiencing them and those witnessing them.

For those that suffer from epilepsy, the struggle doesn't always stop with conscience seizures. Approximately 15% to 30% of all individuals that suffer from epilepsy will also suffer from sleep seizures at some point, either exclusively or predominately.


Sleep, or the lack of it, seems to be directly associated with increased changes in the electrical activity of the brain that are typically characteristic of seizures. These changes in electrical activity can be measured with an EEG. These changes, or epileptiform discharges, often occur during NREM sleep and especially during slow-wave sleep. It seems that during REM, or Rap Eye Movement sleep, the stage when dreaming occurs, these discharges are suppressed and the abnormal electrical activity affects less of the brain.

What Epilepsy Disorders Are Associated with Sleep Seizures?

There are a handful of specific epilepsy disorders that are closely related to sleep seizures. These epilepsy disorders include:

  • Frontal lobe epilepsy
  • Temporal lobe epilepsy
  • Juvenile myoclonic epilepsy
  • Benign childhood epilepsy with centrotemporal spikes
  • Epilepsy with generalized tonic-clonic seizures on awakening

What Are the Consequences of Sleep Seizures?

There can be some serious consequences of sleep seizures.

When seizures do happen to occur at night, they can lead directly to increased awakenings and in turn the fragmentation of sleep. This leads to more of the night being spent in lighter sleep stages and a decreased overall amount of deep REM sleep. As a result, a person who has sleep seizures may experience excessive daytime sleepiness since they did not get as much solid, deep sleep as necessary throughout the evening.

Conversely, sleep deprivation can profoundly affect one's tendency to have seizures. Not getting enough sleep lowers a person's seizure threshold, meaning that it becomes much easier to have seizures. In this situation, individuals that get less sleep become more prone to potential seizures. Since this occurs because of an increase in the frequency of the abnormal electrical discharges in the brain, sleep deprivation is often used as a way to diagnose epilepsy.

Curiously, individuals with medically refractory epilepsy -- meaning that they continue to have seizures, despite optimal medication compliance -- frequently have sleep apnea, in up to 30% of cases. They are more likely to have seizures compared to individuals with a similar epilepsy disorder but without sleep apnea. The good news is that treatment of the sleep apnea tends to lead to better seizure control.

How Can Epilepsy Medications Affect Sleep?

Medications that are commonly used to treat epilepsy may also cause sleep changes. Some may cause excessive daytime sleepiness as a side effect. They include benzodiazepines, carbamazepine, phenobarbital, topiramate, and gabapentin.

Other antiepileptic medications, such as felbamate, may cause insomnia.

It is important to recognize sleep disruption or excessive sleepiness as potential side effects of these medications and bring these issues to the attention of your doctor, as this could cause other issues. 

View Article Sources
  • Mowzoon, N et al. "Neurology of Sleep Disorders." Neurology Board Review: An Illustrated Guide. 2007; 744.