Epilepsy Talk

Ever Had a Seizure in Your Sleep? | February 13, 2021

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 sleep seizures.

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  1. Great topic, Phylis. Yes, I have had a seizure in my sleep – hundreds of them, in fact. They are the tonic clonic category. I would be very curious as to what others in the group have experienced. I was so desperate to get them under control – not only for me but for my spouse – that I underwent multiple brain surgeries and am still taking Lamotrigine and Clonazepam. Something is still happening. And now one neurologist tells me that I have Periodic Limb Movements of Sleep, while another one is unconvinced and wants me to have a Home EEG done. I’m going to have a Home EEG done to try to get a better grasp on what is happening and work with the neurologists to work on a treatment plan.

    Liked by 1 person

    Comment by George Choyce — February 13, 2021 @ 11:30 AM

    • Oh George, just when you think you have everything solved, wham!

      Here’s what I gleaned from WebMd:

      Therapy does not cure Period Limb Movement, but relieves symptoms. Note that many of the medications used to treat PLMD are the same as those used to treat restless legs syndrome.

      Benzodiazepines: These drugs suppress muscle contractions. They are also sedatives and help you sleep through the movements. Clonazepam (Klonopin), in particular, has been shown to reduce the total number of periodic limb movements per hour. It is probably the most widely used drug to treat PLMD.

      Dopaminergic agents: These drugs increased the levels of an important neurotransmitter (brain chemical) called dopamine, which is important in regulating muscle movements. These medications seem to improve the condition in some people but not in others. Widely used examples are a levodopa/carbidopa combination (Sinemet) and pergolide (Permax).

      Anticonvulsant agents: These medications reduce muscle contractions in some people. The most widely used anticonvulsant in PLMD is gabapentin (Neurontin).

      GABA agonists: These agents inhibit release of certain neurotransmitters that stimulate muscle contractions. The result is relaxation of contractions. The most widely used of these agents in PLMD is baclofen (Lioresal).


      I’m glad you’re being so proactive and positive and if not one of these, I hope you find a resolution soon.


      Comment by Phylis Feiner Johnson — February 13, 2021 @ 11:40 AM

      • Thanks, Phylis for your comments. They were both encouraging and informative. And descriptive! “Wham” is a good choice of wording. Trying to be “proactive and positive” is also the best way for me to live because I’ve tried the alternative. Ugh! I’ll keep on keeping on. There are just too many of us, unfortunately, who give up when we have been diagnosed with intractable seizures. Epilepsy can be so cruel. Thanks for giving us this forum where we can find comfort and companionship with others who are undergoing the same, if not similar, conditions.

        Liked by 1 person

        Comment by George Choyce — February 13, 2021 @ 12:30 PM

  2. Reblogged this on Disablities & Mental Health Issues and commented:
    I don’t know about my Focal or absence seizures but yes my last generl seizure was in my sleep in 1996

    Liked by 1 person

    Comment by Kenneth — February 13, 2021 @ 12:22 PM

  3. I had 35 years of nothing but sleep seizures.

    Liked by 1 person

    Comment by paleobird — February 13, 2021 @ 2:41 PM

  4. I was always told I had many seizures when I was about 12 to 17 years old.

    Liked by 1 person

    Comment by lanceminnis — February 13, 2021 @ 5:22 PM

  5. My son who is now 20 years old started off with absence seizures and then when he his his teens it was full seizures “only” during his sleep. He took Trileptal for 10 years but that began to affect his sodium levels and the last 3 years has taken Phenytek which has controlled them.The seizures he had in his sleep were horrifying and I am grateful he does not remember them.

    Liked by 1 person

    Comment by Tami — February 13, 2021 @ 7:45 PM

  6. Quick info–focal seizures, diagnosed at age 30 (2 years ago), lamotrigine 200mg twice a day. Controls bad ones but I still space out all the time.

    So I’ve been staying up too late for the last, uh, 10 months, and the last month I’ve been pushing it to 230am. The other night I was listening to music and was all wired so I shut it off and made myself settle in. I was dozing and at 250am or so I woke up feeling like a band was wrapped around my eyes and head and my head was being ripped off. I sat up and tried to get up but I was afraid I’d faint. It really felt like an iron band was there and someone just twisting and ripping at the top of my head. I was scared if I fainted I’d die. I was so scared that I was actually gonna go get one of my parents, but through sheer willpower I calmed myself down enough to fall asleep. I woke up at around 8 or 830am with a blinding headache. I took Advil with coffee and that helped.

    Do you think this could be one? It felt so much like my really bad ones back in the day.

    Liked by 1 person

    Comment by Hetty Eliot — February 13, 2021 @ 11:49 PM

    • Hetty, to me it sounds like a blinding migraine, but I’m no doc.

      I looked up “Migralepsy,” — a migraine triggered seizure which occurs during or within 1 hour of a typical migraine aura attack.

      This is just a pure guess on my part. If you want to read more about it, go to What Is Migralepsy?

      Just as an aside, I take the same dose of lamotrigine, twice a day and it used to make me crazy/hyper. I finally settled down when I changed my bedtime dose to 6:00PM. Otherwise, I was a basket case.


      Comment by Phylis Feiner Johnson — February 14, 2021 @ 2:47 AM

  7. Thanks for all the info Phyllis. I have nocturnal seizures and have had for years. Unfortunately they remain uncontrolled despite meds, surgeries and diets. But still working on it. One of my surgeries did get rid of my absence seizures so that’s a victory! Anyway it’s always nice to learn something new or review stuff that I forgot about. Plus being able to read through others comments is helpful too. Happy Valentine’s Day

    Liked by 1 person

    Comment by Cindy Fiser — February 14, 2021 @ 12:22 PM

  8. Sorry you’re still having nocturnal seizures, despite all you’ve done.

    I agree, it’s enlightening to hear other people’s experiences and what they have to say.

    Thanks for your contributions.

    Happy Valentine’s Day to you!


    Comment by Phylis Feiner Johnson — February 14, 2021 @ 12:53 PM

  9. Has anyone tried or know anything about using the Muse headband to detect possible nighttime seizures?

    Liked by 1 person

    Comment by Sue — February 14, 2021 @ 1:51 PM

  10. I may have had more but the only seizure in my sleep that I know about is the one I had the last day of my VEEG. I had only one the first five days but that last day I had the two worst seizures I ever had and they told me I had a third in my sleep. I must say though I was glad I had it or they were going to set up another week of VEEG.

    Liked by 1 person

    Comment by Ed Lugge — February 14, 2021 @ 8:10 PM

  11. And you don’t remember having had any other seizures in your sleep? Wow. What happened next?


    Comment by Phylis Feiner Johnson — February 14, 2021 @ 10:40 PM

  12. One time i woke up on the floor shivering, searching for my blankets. I felt the floor and carpet and get up feeling like i’ve been hit by a truck, wondering if anyone got the license plate number. I find my way into the bathroom and i looked horrible, than get back to bed. Since then i’ve had nerve damage in my finger tips on my right hand.

    Liked by 1 person

    Comment by Zolt — February 15, 2021 @ 12:29 PM

  13. Oh Zolt, how horrible. Have you had any more seizures like this?


    Comment by Phylis Feiner Johnson — February 15, 2021 @ 12:32 PM

  14. Whew. Glad the first one was the only one. It was bad enough.


    Comment by Phylis Feiner Johnson — February 15, 2021 @ 6:01 PM

  15. Yes, I have had most of my seizures in my sleep!

    Liked by 1 person

    Comment by rduncanheart — March 29, 2021 @ 11:56 PM

    • Studies have shown that 10-45% of people with epilepsy have seizures that occur predominantly or exclusively during sleep, whereas 34% have seizures upon awakening and 21% have diffuse seizures (while both awake and asleep).

      So, you’re not alone. 😦

      Liked by 1 person

      Comment by Phylis Feiner Johnson — March 30, 2021 @ 9:16 AM

      • I’ve gone 2.5 yrs since I had my last seizure, thank God! I am on two different meds now and since I started my most recent med, haven’t had one since. I have a wonderful Neurologist for which I am incredibly thankful!

        Liked by 1 person

        Comment by rduncanheart — March 30, 2021 @ 9:24 AM

  16. YAY! You made my day!


    Comment by Phylis Feiner Johnson — March 30, 2021 @ 10:12 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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