Epilepsy Awareness Day – How Sleep Affects Epilepsy

Almost 40,000 people in Ireland have Epilepsy. It is the fourth most common neurological disorder with it affecting 50 million people worldwide. Interestingly Epilepsy can affect the same part of the brain that regulates your sleep and according to The National Sleep Foundation, getting healthy sleep is a necessity for people with Epilepsy.

What is Epilepsy

Epilepsy is a neurological disorder which affects the brain. The abnormal neurological firing may cause a sensory disturbance with strange sensations and making sounds and vision overwhelming, violent shaking or unconsciousness. Seizures are often associated with Epilepsy although a person may not have active seizures. A seizure is a brief and temporary disturbance of brain function. A person can have a seizure without necessarily having Epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy.  EEG’s and brain scans are common ways to diagnose Epilepsy.

What Causes Seizures

We are made of salt and water and therefore good conductors of electricity. Our neurological system relies on this electricity supply to work optimally. However, too much electrical activity can cause symptoms of violent shaking or unconsciousness and it can also appear as a blank stare like daydreaming. They can also be caused by brain injury or extremely low blood sugar.

Sleep and Epilepsy Connection

Sleep and Epilepsy are very much connected. While we are awake during the day and resting the brain is not very active. At night time when we are sleeping the brain activity varies throughout each sleep cycle and can become more active at night than it is during the day. This is especially true during our active phase of sleep, REM sleep or dream sleep. These changes in electrical activity may trigger nocturnal or night time seizures. Nocturnal seizures can wake a person up feeling confused, not being aware that they just had a seizure. They may mistakenly think they have insomnia from these repeated wake ups and often feel very tired during the day with problems concentrating. This may go on for years without ever knowing why. Sleep is controlled by the sleep/wake cycle and circadian cycles, which is regulated in the brain. The electrical charges involved with seizures are also located in the brain, therefore it would make sense that the two are connected.

People with Epilepsy have a double-edged sword problem with Epilepsy causing sleep disturbances and the lack of sleep aggravating epileptic seizures.

Sleep Apneoa

People with Epilepsy are at a higher risk of Sleep Apneoa. In fact, approximately one third of people with Epilepsy had Sleep Apneoa according to a study by University of Michigan and that these people were more likely to have seizures at night.

Obesity is another risk factor of Sleep Apneoa and the drugs mainly used to treat Epilepsy, Anti-Epileptic-Drugs or AEDs, can cause weight gain. 70% of people have their seizures controlled by medication.

Vagus Nerve Stimulation

Vagus nerve stimulation (VNS) is a technique used to treat epilepsy. It involves implanting a pacemaker-like device that generates pulses of electricity to stimulate the vagus nerve. According to Mayo Clinic, About one-third of people with epilepsy don’t fully respond to anti-seizure drugs. Vagus nerve stimulation may be an option to reduce the frequency of seizures in people who haven’t achieved control with medications. Vagal nerve stimulation has a variety of effects on sleep and wakefulness, which include: improved daytime alertness and the structure of your sleep at night. 

Children and Epilepsy

10,000 children in Ireland have Epilepsy. Sleep is especially crucial for children with Epilepsy. They are still developing themselves and really need that deep restorative and repairing sleep. Sleep deprivation causes problems at school with lack of concentration, problems with learning and behavioural difficulties and it can also result with increased risk for attention-deficit/hyperactivity disorder (ADHD). Parents themselves will have reduced sleep too, checking on their children during the night. A study by West Virginia University looked at the sleep habits of 50 parents of children (5 years old and younger) who had been diagnosed with epilepsy revealed that parents spent an average of 4 hours sleeping during the night; awaking at least 3 times to check on their children. 

Tips to get a better night sleep with Epilepsy

  • Set a sleep schedule and stick to it. Go to bed and wake up at the same time every day. Listen to your body. If you find yourself feeling drowsy on a consistent basis earlier than you have gone to sleep before, adjust your bedtime accordingly.
  • Get sunshine first thing in the morning to help reset your circadian clock and sync you into the natural daily rhythms.
  • Exercise and eat well. Do not drink alcohol or coffee especially in the evening or eat for at least 3 hours before you go to sleep.
  • Check your medications. Ask your doctor if you can take your medicine earlier in the day if it is interfering with your sleep or to rule out that it is interfering with your sleep.
  • Sleep Apneoa – If you are concerned you may have Sleep Apneoa, ask your doctor to refer you to a sleep specialist where you can get a sleep lab test done, called a polysomnogram, were sleep technicians will monitor your brainwaves and heart rate etc., to detect Sleep Apneoa and also nocturnal seizures.
  • Create bedtime rituals. A relaxing bath with magnesium flakes or soothing music, stress and relaxation management techniques like mindfulness meditation, and any repeated, calming action can help you get to sleep quicker.

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