Epilepsy Talk

The Nightmare of Nocturnal Seizures | May 22, 2019

According to an article in Journal of Neurology, Neurosurgery & Psychiatry, if more than 90 percent of your seizures occur while sleeping, you are said to have sleep seizures.

The article also notes that an estimated 7.5 percent to 45 percent of people who have epilepsy have some form of sleep seizures.

Since seizures occur in sleep during the night, it’s often hard to diagnose them, except for unusual movements at night, confusion upon awakening, bed wetting or falling out of bed.

However, these symptoms are also a kind of parasomnia — an umbrella term for a group of sleep disorders that include night terrors, sleepwalking, teeth grinding, and restless leg syndrome.

It’s believed that sleep seizures are triggered by changes in the electrical activity in your brain during the stages of sleeping and awakening. Most nocturnal seizures occur in stage 1 and stage 2, which are the stages of lighter sleep.

And nocturnal awakenings are sometimes confused with insomnia. Epilepsy patients are often unaware of the seizures that occur while they sleep.

They may suffer for years from daytime fatigue and concentration problems without ever knowing why.

In contrast, panic attacks typically occur within three hours of sleep onset and are most commonly seen in the transition from stage 2 to stage 3 sleep.

And after these night terrors, which are accompanied by screaming and intense fear, the person falls back to sleep and sometimes has no recollection of the episode when awakening in the morning, except in some cases, waking with a bitten tongue or a disordered bed.

Other people can recall the episode in the morning and this frequently leads to dread and anticipation of another attack.

Nocturnal seizures are associated with certain types of epilepsy, including:

Juvenile myoclonic
Awakening grand mal
Benign rolandic (also called benign focal epilepsy of childhood)
Electrical status epilepticus of sleep
Landau-Kleffner syndrome (LKS)
Frontal onset seizures

Doctors evaluate a number of factors to diagnose epilepsy and determine the type. Factors include:
The type of seizures you have
The age when you began having seizures
Family history of epilepsy

To diagnose epilepsy, doctors may use:
Images of electrical activity in your brain recorded by an electroencephalogram (EEG)
The structure of your brain as shown in a computed tomography (CT) scan or magnetic resonance imaging (MRI)
A record or diary of your seizure activity

Sleep studies (Polysomnography) with expanded EEG aids can indicate the difference between seizures and parasomnias.

If being observed in a sleep lab, there is a decrease in rapid eye movement (REM) and an increase in the lighter stages of sleep, according to the article “Nocturnal Seizures,” by Carl W. Bazil, MD, PhD.

It doesn’t take the fear away, but it can help diagnose and treat the nightmare of nocturnal seizures.


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  1. ThankYou for the information ! 🙂

    Liked by 1 person

    Comment by maryleeparker — May 22, 2019 @ 9:44 AM

  2. Hope you found it helpful!


    Comment by Phylis Feiner Johnson — May 22, 2019 @ 9:51 AM

  3. Thank you Phylis for addressing these complex and emotional issues associated with epilepsy. Nocturnal seizures, with almost all of the symptoms you list, I have experienced. After years of study at Vanderbilt, including multiple surgeries, I am at the point that a combination of generic Lamictal and Klonopin are the solution to controlling the sleep seizures. The side effects are a lack of clarity and slowness during the day. My neurologists – quite honestly and kindly – have said that they have done their job and the decision to come down or off the medications is mine. But I can drive. Thanks again. I’m sure you have helped others who suffer from nocturnal seizures.

    Liked by 1 person

    Comment by George — May 22, 2019 @ 11:09 AM

  4. Well, we seem to be on the same med mix!

    Generic Lamictal and Klonopin…


    Comment by Phylis Feiner Johnson — May 22, 2019 @ 11:12 AM

  5. I have been having night seizures for the last couple years and they are progressively getting worse. Even though my meds have been changed. This is good information to take to my doctor in which I’m seeing this morning. Thank You

    Liked by 1 person

    Comment by Nicole — May 22, 2019 @ 11:54 AM

    • Nicole, I hope it will be helpful for you.

      Good luck.


      Comment by Phylis Feiner Johnson — May 22, 2019 @ 1:28 PM

    • I keep having these short strange feelings and I don’t know what to do about them. I’ve had two for the day now. Im a little scared because I not my license taken away on the 11th because I had a seizure in drive thru, and hit a parked car with no one inside praise God. This illness has ruined my life.

      Liked by 1 person

      Comment by jjayp75 — September 27, 2019 @ 5:54 PM

      • I would guess they’re absence seizures and I suggest you stay off the road.

        I drove my mother’s car around a cement pillar when I was younger.

        And even though my seizures are 99% controlled, I recently drove my car into the back wall of the garage. 😦


        Comment by Phylis Feiner Johnson — September 27, 2019 @ 6:35 PM

  6. Phylis,
    Thanks for the interesting article & helpful information I can relate too.
    In the very beginning, most of my seizures kept happing in my sleep, therefore I knew nothing about my seizures & I refused to believe I was having seizures & can NOT understand WHY I was waking up in hospital ERs all over the city, until my family & my employer insisted I take medical leave of work & see a Doctor.
    Thanks to Stanford University hospital videotapping two of my grandmal seizures in a week & in my SLEEP, I learned the hard way that I’ve become epileptic 20 years ago, watching my own seizures on video tape.
    And the most shocking part of the whole ordeal was I didn’t even knew WHAT, WHERE, WHEN, WHY,,, is it happening to me & have no control to stop it nor have any memory of the whole episode, beyond the painful bite at the edge of my tongue.
    Having no recollection of the seizures, it was very difficult to figure it out of what’s going with me & around me.
    Waking up in confusion & disorientation, my soundings looked very strange & unfamiliar.
    But collecting more information from my family, coworkers, doctors & this forum before & after my seizures, gradually I’ve learned to FEEL the auras that are associated to my seizures & quickly make myself seat or lay down in safe position & places & finally figured out WHY the edge of my tongue is hurting.
    As soon as soon as the post seizures confusion & disorientation are over, tracing & keeping track of my auras & carefully recording the post seizure recovery process made the whole nightmare more manageable than I started with.
    And thanks to your devoted hardwork providing resourceful information to Epilepsy patients & all members of this helpful forum sharing their experience about Epilepsy, I now know more about my own seizures than I started with, finally accepting to live with Epilepsy.
    Keep up the great work, you are doing a whole lot of good more than you will ever come to know.

    Liked by 1 person

    Comment by BahreNegash Eritrea — May 22, 2019 @ 12:10 PM

    • What a scary thing. Having seizures without a clue. Except waking up with a bitten tongue. And SEEING them on videotape!

      Thank goodness you recognized your auras. And it was brilliant to record everything, so you’ll know and be warned in the future.


      Comment by Phylis Feiner Johnson — May 22, 2019 @ 1:41 PM

  7. I have had seizures in my sleep for over 10 years now.my neurologist said it was do to my sexual abuse from age 5 to 14 by my father.my daughter’s where both raped one of them by my stepson.and my brain couldn’t take it all in.she put me on lamictal and briviac now.I’ve been on alot more.but thank got this combination of medince has been working,in also have gran mai seizures.and I was recently diagnosed with ping pong seizures

    Liked by 1 person

    Comment by Angela carter — May 22, 2019 @ 2:01 PM

  8. It sounds like PTSD to me.

    Anyone can get PTSD at any age.

    Going through trauma is not rare. About 6 out of every 10 (or 60%) of men and 5 of every 10 (or 50%) of women experience at least one trauma in their lives.

    Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.

    It can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, car accidents, train wrecks, plane crashes, bombings, attack, injury, or natural disasters such as floods or earthquakes.

    People most likely to develop PTSD are those that:

    Were directly exposed to the trauma as a victim or a witness…
    Were seriously hurt during the event…
    Went through a trauma that was long-lasting or very severe…
    Believed that they were in danger…
    Believed that a family member was in danger…
    Had a severe reaction during the event and feeling apart from their surroundings…
    Felt helpless during the trauma and were not able to help themselves or a loved one.

    You are also more likely to develop PTSD if you:

    Had an earlier life-threatening event or trauma, such as being abused as a child…
    Have another mental health problem…
    Have family members who have had mental health problems…
    Have little support from family and friends…
    Have recently lost a loved one, especially if it was not expected…
    Have had recent, stressful life changes.

    PTSD can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma.


    Comment by Phylis Feiner Johnson — May 22, 2019 @ 3:31 PM

  9. There is a big overlap between this article and the one you did about medical cannabis.
    Even for those of us who are not seeking out the feeling of being stoned, cannabis can be a very useful nighttime medicine which then doesn’t interfere with your functioning at all during the day (unlike most AEDs). You can take it only at bedtime and it helps you sleep peacefully through the night and then you wake up and go about your day with all your faculties intact.
    I found medical cannabis particularly useful when I was titrating off of one of my meds. It seemed to cushion the transition.

    Liked by 1 person

    Comment by paleobird — May 22, 2019 @ 3:59 PM

    • I have friends who have said the same.

      As a sleep aid, it’s the best. Deep sleep, with no hangovers.



      Comment by Phylis Feiner Johnson — May 22, 2019 @ 4:05 PM

    • I have nocturnal night time in my sleep for 38 yrs or more . So, I am treated with sleep med. along with taking my epilepsy and also take melatonin and CBD pot all helps me sleep and seizure controlled . Luckily on study drug too ! Knock on wood I have been 3 yrs 9mths seizure free. All together works for me but everybody different!!! Also do good exercise & yoga! Do the Walk, too it all works!💜💜💜😊


      Comment by JOY STEWART — June 1, 2019 @ 10:03 PM

  10. The Catch 22 of nocturnal seizures is that the worry and anxiety of anticipating a possible seizure can keep you from getting a good restful night’s sleep. Sleep deprivation can actually cause seizures. Cannabis is very helpful in breaking this vicious cycle and turning it around.

    Liked by 1 person

    Comment by paleobird — May 22, 2019 @ 4:21 PM

  11. You got that right.

    Anxiety = seizures.

    Lack of sleep = seizures.

    Anxiety + lack of sleep = seizures. 😦


    Comment by Phylis Feiner Johnson — May 22, 2019 @ 4:24 PM

  12. Thank you for yet another extremely interesting article.

    Liked by 1 person

    Comment by Douglas Lee-Murray — May 23, 2019 @ 11:12 AM

  13. Hope it was of help, Douglas.


    Comment by Phylis Feiner Johnson — May 23, 2019 @ 12:34 PM

  14. I have had seizures in my sleep off and on, caused by a childhood accident. I noticed their occurrence was often at times of stress. I would wake with headaches.
    I need a dependable method for awareness of seizures, now that I live alone. I used to try to record night events for information for me and my doctor, but that was cumbersome. Can anyone recommend a good app to do this, or another method? Many products seem useful for seizures involving movement, but say specifically not for complex partial seizures. Any suggestions are appreciated. Take care!

    Liked by 1 person

    Comment by Mary — May 25, 2019 @ 4:31 PM

  15. I don’t know if this article will help, but you can give it a look:

    Top-Rated Seizure Monitors


    There are also several smart phone monitors which might do the trick:

    NEW! Apple Seizalarm — A user-friendly iPhone and Apple Watch app which allow those with epilepsy and other seizure disorders to alert emergency contacts automatically when seizure-like motion is detected or manually if they need immediate help or think they might need help soon. Detects seizure-like motion, requests immediate help, seizure monitoring control, GPS location tracking, and event log tracking. http://seizalarm.com/

    Embrace — Created to track your activity, stress and overall body balance, enabling people who live with Epilepsy to get an alert when an unusual event happens such as a convulsive seizure, warning them and their loved ones. https://www.empatica.com/product-embrace

    The SmartWatch — A motion detecting and alerting wristwatch that can detect seizures and alert caregivers within seven to 10 seconds. http://www.smart-monitor.com/
    For details and pricing information, please call 1-888-334-5045.

    Epilepsy Detector Application — An accelerometer based mobile phone application that uses advanced signal processing to detect epileptic seizures. It runs on most mobile phones that support SMS messaging, movement detection and GPS position location. http://www.epdetect.com/

    SAMi — A night vision monitor used to monitor and record abnormal sleep movements. Runs on an iOS device such as an iPhone or iPod Touch. http://www.samialert.com/

    Hope this helps, Mary.


    Comment by Phylis Feiner Johnson — May 25, 2019 @ 5:03 PM

  16. From: gentryh:

    I’ve been using a security camera with night vision and motion detection to capture my nocturnal “events”. $50 from best buy. Here’s an example.


    Liked by 1 person

    Comment by Phylis Feiner Johnson — May 27, 2019 @ 10:25 AM

  17. Thank you for the information very helpful

    Liked by 1 person

    Comment by Simone — May 22, 2020 @ 2:24 AM

  18. How timely is your post Phylis. I just had another nocturnal seizure last night. I can’t figure out anything that was new or different before I went to bed. I had just talked to my epileptologist yesterday asking if a sleep study would give us any useful info. My regular Internal Med md is a sleep medicine specialist also. I have a previously scheduled appt. with him soon. So I’ll ask him what he has to say. That should be interesting. One of the hard things with my nocturnal sz’s is that I have no memory of them. So my husband has to tell me all the details. He says, “I hate being the bearer of bad news” It certainly is hard on him also since he’s the one that experiences watching them. Thanks for all your good info. Cindy

    Liked by 1 person

    Comment by Cindy Fiser — September 29, 2020 @ 10:41 AM

    • Great that you’re having a sleep study. That should help to verify your nighttime “activity” so you can get a firm diagnosis and the appropriate medication.

      I’m sorry that you’re going through this, Cindy. But glad there’s a resolution in sight.


      Comment by Phylis Feiner Johnson — September 29, 2020 @ 11:22 AM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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