Woman With Epilepsy Sleeping.

How to Sleep Better With Epilepsy (7 Ways)

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This article was written by Dr. Calvin Young who has a Ph.D. in behavioral neuroscience from the University of Calgary to ensure that the content is factually accurate and unique.

If you have epilepsy, then you may find that you’re having seizures at night that are affecting your sleep – or you’re suffering from insomnia, anxiety, and/or depression caused by having epilepsy that’s negatively impacting your sleep.

So how do you get better sleep when you have epilepsy?

To get better sleep with epilepsy: talk to your doctor about taking antiepileptic medication like levetiracetam, tiagabine, pregabalin, or clobazam that could improve sleep, and try CBT, a ketogenic diet, and good sleep hygiene to reduce seizures and improve sleep quality.

The rest of this article expands on these points to give you 7 practical ways to sleep better with epilepsy.

However, you should always consult with your doctor or another suitably qualified medical professional first to ensure that the treatment plan is safe and effective for you.

Related: see my guide to getting to sleep with intrusive OCD thoughts if you have a racing mind at night to get better sleep now.

7 Ways to Sleep Better With Epilepsy

One of the most common triggers for epileptic seizures is the lack of sleep.

In fact, clinicians would use sleep disruption as a way to trigger seizures to confirm the presence and location of the seizure foci for diagnostic and treatment purposes.

There are many direct and indirect reasons why you may not be getting the best sleep while suffering from epilepsy.

For example, you may be napping throughout the day after seizures, having seizures during your sleep, becoming anxious and depressed about having epilepsy, or receiving treatments that interfere with your sleep.

People who suffer from epilepsy do tend to have higher rates of sleep disorders such as insomnia, sleep apnea, and parasomnia (e.g. sleepwalking).

Insomnia is perhaps the most significant sleep disorder related to epilepsy, affecting 50-75% of epileptic patients with a positive correlation with the severity of depression and is a predictor of a poorer quality of life.

You may be suffering from a sleep disorder independent of your epilepsy.

To complicate things even further, any of the reasons mentioned above may interact with each other so being able to sleep better with epilepsy depends on the main reason causing sleep problems in the first place.

Therefore, it is essential for you to consult your physician about the sleep problems you may have, so you can work together to find the best way to sleep better.

Improving your sleep should improve your mood, seizure threshold, energy levels, cognitive abilities, and quality of life in general.

Below are 7 ways that you can sleep better when you have epilepsy:

1: Take Antiepileptic Medication That Improves Sleep

One of the most effective ways to get better sleep when you have epilepsy is to talk to your doctor to ensure that you’re taking the right type and amount of antiepileptic medication – with levetiracetam, tiagabine, and pregabalin potentially helping you to sleep longer, whilst clobazam could help you fall asleep faster.

In most cases, seizures are controlled by medication.

Since seizures are characterized by “out-of-control” brain activity, many of the medication used to treat epilepsy are sedative in nature; however, not all medication works in the same way.

Different medications act on different stages of sleep differently.

For example, antiepileptic drugs such as phenobarbital and levetiracetam reduce rapid eye movement (REM) sleep but gabapentin does the opposite.

Levetiracetam, tiagabine, and pregabalin increase slow-wave (non-REM; NREM) sleep but clobazam decreases it.

All these medications (except for gabapentin) make you sleep longer, with clobazam also making you fall asleep faster.

Particular types of seizures may be more common at night and occur at specific sleep stages.

If you have trouble sleeping or suffer from nighttime seizures, you may need to consult with your doctor to strike a balance between seizure control and sleep issues.

2: Try CBT and Mindfulness to Control Stressors

Cognitive behavioral therapy (CBT) can be used to treat epilepsy and sleep disorders (particularly insomnia) by identifying and reducing the impact of stressors –a major trigger for seizures in many – that can lessen the sleep burden caused by seizures during the day.

Being stressed about not getting enough sleep could lead to a vicious cycle of more stress, more seizures, and less sleep.

Therefore, mindfulness training is also helpful for relaxation and lessens the impact of anxiety and depression on sleep.

Try the 20 minute guided mindfulness meditation below to help you sleep:

20 Minute Mindfulness Meditation for Being Present / Mindful Movement

3: Eat a Low Sugar Ketogenic Diet to Control Seizures

When and what to eat and drink has a general impact on the quality of sleep regardless of susceptibility to seizures.

Specifically, ketogenic diets (high in fat, low in sugars) limit the intake and use of sugars – the preferred source of energy for the brain.

A ketogenic diet should improve your sleep through the better control of seizures.

The video below explain more about how following a ketogenic diet can potentially help treat epilepsy:

Ketogenic Diet as Treatment for Epilepsy

In general, a healthy diet is important for sleep.

Studies have indicated that a lack of nutrients like calcium and magnesium – and a host of vitamins – are correlated with an increased incidence of sleep disturbances.

In addition to avoiding too much sugar intake for seizure control, lower sugar intake also helps you to stay asleep.

There are various other diets, usually consisting of whole plant-based foods rich in fiber which have been found to improve sleep.

These diets are generally compatible with epilepsy as being low in sugar and high in nutrients/vitamins are the main features.

It is extremely important to have a balanced and adequate diet to meet your individual nutritional needs.

Consultation with professionals is essential to make sure you are getting all the nutrients you need, especially with underlying health conditions like epilepsy.

3.1: Avoid Stimulants and Alcohol Before Bed

Sugar, chocolate, caffeine, tobacco, and other forms of stimulants before bed should be avoided for good sleep hygiene – especially for people suffering from epilepsy since these compounds provide the fuel for seizures.

While the consumption of alcohol in moderation is usually safe, its impact on sleep cycle disruption may exacerbate sleep-related problems associated with epilepsy – so it should be avoided.

4: Avoid Screens to Control Seizures and Improve Sleep

Flashing – or sometimes a combination of various visual inputs – is known to trigger seizures, especially in younger people.

Furthermore, screen time before bed has been shown to negatively impact sleep.

Given the reciprocal relationship between sleep and epilepsy, avoiding screens 1-2 hours before bedtime can be highly beneficial.

While reducing screen time may not be practical for some (e.g. work commitments), there are several things you can do to reduce the risk of seizures and better sleep:

  • Have a balanced brightness/contrast between the screen and the ambient lighting conditions.
  • Establish a good working/viewing distance (aim for a viewing distance of 1.5 to 2.5 times the diagonal screen measurement – source).
  • Take regular breaks.
  • Invest in a pair of glasses that reduce glare with blue light filtering when using devices (I use the orange glasses show below when working for long periods, but you can also use an app like F.lux to reduce eye strain).
Orange Glasses for Blocking Blue Light
Orange Glasses for Blocking Blue Light

Particularly, screen time activities that are interactive do appear to negatively impact sleep more – presumably due to cognitive or emotional engagement, be it gaming or messaging friends and family.

The best practice is to eliminate the use of any devices/screens in the bedroom, and certainly avoid their usage just before going to bed.

5: Treat Mental Health Issues to Improve Sleep

In many cases, people suffering from epilepsy have sleep problems not directly related to the cause of seizures themselves.

Having epilepsy is stressful, and often the stress leads to mood disorders such as depression, as well as anxiety – both are known to be associated with poorer sleep.

It is important to address these mental health issues, as they are not only important for your sleep health but also improving your general outlook and quality of life.

CBT, mindfulness training, and general relaxation-based exercises before bed can help you relax for a better night’s sleep in general, and help you build resilience against anxiety and depression.

People suffering from epilepsy are almost twice as likely to experience mood disorders, particularly depression.

There might be a direct biological link between the two, especially if epilepsy results from some form of head trauma.

Similar to the relationship between epilepsy and sleep, the relationship between depression and sleep is reciprocal; the lack of sleep can increase the risk of becoming clinically depressed, and being depressed can exacerbate sleep disorders – particularly insomnia.

Feeling down or anxious about a life event is normal and adaptive.

However, if the feeling persists and starts to impact normal functioning in life, it is best to consult a health professional to resolve the issue.

Given the three-way interaction between epilepsy, mood/anxiety disorders, and sleep, being proactive about your mental health would greatly benefit both epilepsy and sleep outcomes.

6: Establish Good Sleep Habits

Having good sleep hygiene is perhaps the most actionable set of recommendations to improve sleep when you have epilepsy since it is all about establishing better habits on your own and is not dependent on medical diagnoses and treatments.

Not consuming stimulants, staying away from screens, and relaxing before bed have been covered above.

The physical setup and usage of the bedroom is the other side of the equation – you should consider:

i) Set Up the Bedroom so it’s Dark and Quiet

Light is the most powerful cue for your body’s internal clock which modulates everything from when you feel hungry, energy level fluctuations throughout the day, and sleep/wake cycles.

While it is obvious falling asleep is harder under bright lights and constant noise, many of us do not put an effort into optimizing light and sound levels – invest in a pair of earplugs and/or eye masks if it is not possible to light and soundproof your bedroom.

Blackout curtains are also a great option to make sure you stay asleep until you need to wake up in the summer.

And definitely read my article that shows you 19 ways to make your bedroom pitch black for better sleep here.

ii) Keep the Room Temperature at 18°C (64°F)

The best temperature to sleep at is ~18°C (~64°F).

It is nice to be warm and comfortable sleeping with a hot water bottle, electric blanket, or a down duvet, but at night the body is trying to cool down as you go to sleep.

Staying too warm will make falling asleep harder.

Also, note that prolonged exposure to hot/warm temperature and the subsequent mild dehydration due to increased respiration are both potential seizure triggers for some.

Keep warm, but do not overdo it as being too warm will affect your ability to fall asleep and may trigger seizures.

iii) Only Use the Bedroom for Sleeping

Train your brain to realize that when you’re in your bedroom it’s time to sleep.

So reading books, doing work on the computer, or watching television should all be avoided in the bedroom.

Once your brain is conditioned to the idea that the bedroom is for sleeping, the very act of stepping into your bedroom should prepare your body for a good night’s sleep by lowering your metabolism, body temperature, and a host of other physiological changes your body needs to transition into sleep mode.

iv) Have a Regular Sleep Schedule

Cut down on the naps, although understandably sometimes it may feel necessary after intense seizures.

Try and have the same daily sleep schedule throughout the whole week, including weekends.

Make sure you have enough but not too much sleep, and a consistent wake-up time.

Like conditioning your body’s reaction to your bedroom, when you adhere to a regular sleep schedule, your body will be ready to sleep when you need to and wake when you ought to.

This means shift work should be avoided, if possible.

7: Avoid Triggers to Control Seizures

Seizures do occur ‘spontaneously’ but most of the time there are specific stimuli that trigger seizures.

Incidentally, many of the recommendations for a good night’s sleep are also relevant to seizure control, namely light exposure, food choices, and stress management.

This is no surprise as a major physiological response of the brain during a seizure is increased arousal/excitability.

Although not everyone has the same seizure triggers and not everyone responds to all triggers, having a good strategy to deal with arousal, whatever the cause, would be highly synergistic in managing seizures and sleep.

Guide to Epilepsy and Sleep

Below is a short guide that explains what epilepsy is and how it affects sleep.

Epilepsy Has Several Potential Root Causes

Epilepsy is a treatable neurological disorder characterized by seizures.

The cause of epilepsy can be genetic, physical trauma, or other forms of serious health conditions.

Seizures come in many different forms and many are triggered by an external stimulus.

Epilepsy Negatively Affects Sleep in Multiple Ways

The impact of epilepsy on sleep is multifaceted as anxiety and depression associated with having epilepsy can have an indirect impact on sleep, as well as a direct consequence of “tiredness” associated with “out-of-control” brain activities.

Sleep and epilepsy are intricated related – some only have seizures when they sleep, and the lack of sleep triggers seizures in many patients.

Seizures are uncontrolled, runaway brain activation which can trigger full-on motor responses (i.e. tonic-clonic seizures).

After the seizure (post-ictal period), people often report being tired or drowsy and may take a nap, which can be disruptive to sleep schedules for good sleep hygiene.

If you are having seizures during sleep, seizures have a direct impact on sleep and the functions it serves.

Brain activities during sleep are fairly stable and stereotypical, unlike when you are awake, making it possible to tell what kind of sleep you are in.

Slow-wave sleep is believed to reflect an “upkeep” phase to clear out waste and reset connections, whereas rapid eye movement sleep may reflect offline memory consolidation.

So when seizures occur during sleep, there is a disruption of all these background upkeep processes, resulting in downstream effects on mood, cognition, and energy levels.

7-8 Hours of Sleep is the Minimum for Epileptic Patients

In the general population, there is a large variability in how many hours of sleep is needed by an individual; patients suffering from epilepsy are no different.

Regardless, it is known that seizures result in the feeling of “tiredness” and that not enough sleep may trigger seizures.

A general recommendation is made to sleep 7-8 hours a day if you have epilepsy – this would be a good starting point for adults but the younger you are, the more sleep you would need.

There Are No Specific Sleep Aids For Epilepsy

Insomnia and other sleep disorders may be associated with the indirect consequences of having epilepsy – namely anxiety and depression.

Since epilepsy is treatable but not curable, there is little which can be done for “nocturnal seizures” other than the treatment you are already receiving.

While there is no specific sleep aid for epilepsy, the usual recommendations of avoiding stimulants (e.g. caffeine), cutting down screen time, and having time to wind-down before bed are all effective for better sleep. 

Use a Seizure Alarm to Detect Nocturnal Seizures

There are “seizure alarms” ranging from relatively simple movement detectors attached to the body (in the form of a watch), infrared cameras that detect motion in the dark, to systems with movement and sound sensors that can be fitted to a bed that can alert carers when seizures are happening at night for appropriate actions to be taken.

Full-on tonic-clonic seizures involve strong and intense muscle contraction, but the person may not be aware that they are having a seizure despite the vigorous motor response.

Many report signs of tongue-biting, vomiting and muscle aches, and disturbances items around the bed (e.g. bedside lamp) to be indications of when you may have had a seizure during sleep.

The gold standard of seizure detection is the use of an electroencephalogram (EEG), where surface electrodes over the scalp are used to detect electrical activities of the brain.

This would be the most clinically relevant and reliable way to detect and confirm seizure activity.

Conclusion: Use a Combination of Treatments

To sleep better when you have epilepsy, you should first talk to your doctor about adjusting your antiepileptic medication to favor better sleep and ask them to treat any adjacent issues such as depression or anxiety that may be causing insomnia and/or making your epilepsy worse.

Beyond this, you should also consider trying CBT, mindfulness, a low sugar diet, and improving sleep hygiene to help you get better sleep.

Up next: discover if DayQuil can keep you awake and 5 ways to get to sleep after taking it.

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Medical Disclaimer

No part of this article or website provides medical advice – always consult with your doctor for guidance specific to your condition and needs for the best and safest outcome.

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