How to Sleep Better if You Have Epilepsy

Getting a good night’s sleep is important for everyone, but it’s even more critical if you’re one of the 2.3 million adults in the United States who has epilepsy. The reason: Seizures can keep you from getting the quality sleep that you need, which can cause you to have more seizures. It’s a vicious cycle, especially for people who don’t realize that their seizures are affecting the amount and quality of their sleep.

Why the close relationship between sleep and epilepsy? Seizure disorders like epilepsy cause a “misfiring” of activity in your brain, the very organ that regulates your sleep. So when your brain is malfunctioning because of your seizures, your sleep suffers. And when your sleep suffers, your brain becomes more vulnerable to these misfirings that cause seizures in the first place.

What’s more, some seizures, such as benign Rolandic (benign focal epilepsy of childhood) and frontal lobe seizures, actually occur while you’re asleep. Others, such as like juvenile myoclonic and awakening grand mal seizures, happen as you’re waking up. Either way, your sleep is affected. You may even experience sleep disturbances on nights when you don’t experience any seizures.

Another complicating factor: Seizure medications might be making you extra-tired or even changing the quality of your sleep. Some commonly prescribed treatments, such as clonazepam, phenobarbital, and valproate, can have sedating effects, which means they may make you sleepier than normal. Many of the newer seizure medicines are less likely to have these sedative effects, so talk with your doctor about switching if you think your medication is leaving you more tired than usual.

Smart Sleep Strategies for More ZZZs

Making adjustments to your medication, avoiding known seizure triggers, and working closely with your doctor on your treatment strategy are important first steps. But according to sleep specialist Shalini Paruthi, MD, the codirector of the St. Luke’s Sleep Medicine and Research Center in Chesterfield, Missouri, there are more steps you can take to help you rest easy and wake up refreshed. Start with these tips.

• Get enough shut-eye. It sounds obvious, but the fact is, most of us just don’t sleep enough. A poll conducted in 2014 by the National Sleep Foundation found that about 45 percent of Americans say that poor or insufficient sleep interferes with their daily activities at least once a week. The average adult needs 7 to 9 hours of sleep a night to function at their best, while teenagers 14 to 17 need 8 to 10 hours, and children 6 to 13 need 9 to 11 hours. If you’re sleep-deprived, your brain will be more irritated, which can lead to more seizures. So first things first, get more sleep.
• Develop a sleep schedule. Go to bed and wake up at the same time each day, and time your naps so they don’t interfere with your bedtime.
• Treat any underlying sleep problems. A review published in September 2018 in Epilepsy Research found that people with epilepsy are more likely to have sleep disorders, such as obstructive sleep apnea, restless legs syndrome, and insomnia. That makes having a sleep disorder a double whammy, because if your brain is affected by a sleep disorder all night long, that can provoke more seizures. Know the signs: Feeling excessively tired during the day, snoring while you sleep, or waking up often during the night can signal a sleep disorder. Your doctor might recommend that you see a sleep medicine specialist who can perform certain tests to see exactly what’s affecting your sleep. If you are diagnosed with a sleep disorder, taking steps to control it can help calm brain activity and improve your epilepsy.
• Develop healthy sleep habits. Create an environment that’s conducive to sleep. Keep your bedroom dark and quiet, and turn off all electronics, including TVs, cell phones, handheld video games, tablets, and computers, because they emit light, which decreases melatonin, the hormone produced by your brain that helps you sleep. Establishing a simple bedtime routine that you follow every night — whether it’s a soak in the tub or a few minutes of deep breathing — can also help teach your mind and body when it’s time to go to sleep.

Dr. Paruthi admits that doing this kind of habit retraining can be hard at first, but you’ll soon reap the benefits and restful results. “Many people forget that getting to sleep involves positive, good behaviors," she says. "To be a good sleeper, you have to actually practice your short, 15-minute bedtime routine every night. And practice makes perfect.”