Answer by John W. Miller, MD, PhD
Although many people with epilepsy find that their seizures are affected by sleep, different individuals have very different patterns. Some only have seizures during sleep; some only have them when they are awake.
It’s also not unusual for seizures to be stronger if they happen during sleep. People with some types of epilepsy often have seizures right after they wake up in the morning. With most types of epilepsy, lack of sleep or poor sleep can trigger seizures.
There are great differences in the electrical and chemical activity of different brain regions during wakefulness, quiet sleep, and dreaming sleep, and these differences must explain why a person’s state of arousal or sleep can trigger seizures. However, the relationship between sleep and seizures is so variable in different people, that researchers do not have answers that apply to everyone with epilepsy.
The most important thing is to understand how sleep affects your epilepsy. It is important to get enough sleep. If you have a sleep problem, such as insomnia (trouble falling or staying asleep) or sleep apnea, treating the sleep problem may help to control your seizures. If you have to get up early in the morning, be sure to go to bed early enough to get a good night’s sleep. If you find that your seizures typically happen at certain times of night or day, you should be extra careful at those times. Talk to you doctor so that you can understand how sleep affects your seizures, and what you can do about it.