The Link Between Epilepsy and Sleep Apnea

Epilepsy is a neurological disorder where sudden bursts of electrical activity in the brain will cause seizures. It has long been appreciated that the quality of sleep can impact seizures, with sleep disorders such as insomnia and obstructive sleep apnea common among people diagnosed with epilepsy.

The Link With Sleep

Some people diagnosed with epilepsy have seizures when they sleep, while others may have seizures either during the day or at night. Indeed, sleep plays an important role in diagnosing this neurological disorder, although more research is needed to pinpoint the reasons why sleep can affect the number of seizures a person may experience.

One potential theory is excessive electrical activity in different parts of the brain overnight may be the cause of the seizures. Another area of interest is the role the body’s circadian rhythm and production of the sleep hormone melatonin may have on seizures.

What does seem clear is that a lack of sleep can increase the number of seizures for some people. Consistently poor nights of sleep, which are further interrupted by seizures, can lead to sleep deprivation and fatigue. Excessive daytime sleepiness is one of the more common issues reported by people who suffer with epileptic seizures, with the negative effect this has on their quality of life, including mood and concentration levels.

The link between epileptic seizures and sleep can feel like a vicious circle. On the one hand a lack of sleep can increase frequency of seizures, while anxiety over seizures can hinder sleep. It is also an issue for children as well as adults. Sleep is crucial in a child’s development, but children with epilepsy have been seen to find it harder to fall asleep and stay asleep, as well as being more at risk of having a sleep disorder.

The Effect of Sleep Disorders

Several disorders are linked to epileptic seizures, including obstructive sleep apnea. This is the most common form of sleep apnea, with the upper airways collapsing as you sleep, resulting in breathing difficulties. The brain awakes the body for air and these sleep interruptions can occur frequently through the night – hundreds of times, in some cases.

Among those who experience epileptic fits, up to 40% may also suffer with obstructive sleep apnea. In children this figure can be 60%. The frequent awakenings resulting from sleep apnea increase the risk of sleep deprivation, a condition which can increase the frequency of epileptic seizures for some people.

Diagnosis and Treatment

Epilepsy is often treated with medications called anticonvulsants and antiepileptics. Sleep disorders like obstructive sleep apnea can also be treated once diagnosed, offering the chance of consistent nights of improved sleep and reducing the risk of sleep deprivation and daytime fatigue.

Unfortunately, many instances of sleep apnea remain undiagnosed. The main symptoms of obstructive sleep apnea are:

  • frequent awakenings during the night
  • loud snoring
  • excessive daytime fatigue
  • morning headaches
  • poor concentration
  • increased irritability

Anyone who is experiencing sleeping difficulties should consult with their doctor who may recommend a sleep test if the symptoms suggest a sleep disorder. Diagnosis is key to working out a treatment plan for your sleep disorder.

One study by Nancy Foldvary-Schaefer DO, MS, a professor of medicine at the Cleveland Clinic, looked at how using positive airway pressure (PAP) therapy to treat obstructive sleep apnea impacted on the frequency of epileptic seizures. This study found that those who used PAP to treat their sleep apnea were more likely to see a 50% decrease in seizures compared to those who remained untreated.

This research once again suggests the importance of diagnosis for sleep apnea, as only after diagnosis can an effective treatment plan be recommended. By improving sleep many could find they reduce the frequency of their seizures. However, more research is needed to look at whether this applies to children, as well as all the various types of epilepsy.

Improving Your Sleep

As a lack of sleep may increase the frequency of seizures for some, as well as impact on your overall quality of life, finding ways to improve sleep are important. This applies to those both with sleep disorders and those without a diagnosed disorder. There are a number of ways to improve your sleep hygiene, including:

  • Develop a night-time routine which sees you go to bed at the same time each night and get up at the same time the next morning. Look to turn off screens between 30 to 60 minutes before going to bed.
  • Introduce some form of relaxation prior to bed, which could be having a bath, reading or meditation.
  • Ensure your bedroom is quiet, dark and has a comfortable temperature as well as a comfortable mattress. The room should be primed to aid sleep.
  • Develop good habits during the day, including regular exercise, a balanced diet and natural sunlight. You should avoid smoking and also avoid alcohol, caffeine and meals close to bedtime.

People who experience epileptic seizures will also be advised to make lifestyle changes. Healthier lifestyles can help reduce the frequency of seizures as well as help promote better sleep. Some people may look at sleep aids, but so far research into the likes of melatonin to improve sleep quality have proved inconclusive.

Two or more unprovoked seizures -- which are at least 24 hours apart -- form the basis of an epilepsy diagnosis. The condition can be caused by a brain injury or an abnormal development of the brain. Other medical conditions and genetics can also play a role. 

A sleep disorder like obstructive sleep apnea may also contribute to increased frequency of seizures through sleep deprivation. Sleep has a strong bi-directional link to epileptic seizures, and studies show that treating a sleep disorder or improving your sleep can have a positive influence on the number of seizures suffered.

If you have symptoms of sleep apnea, speak with one of our SleepQuest Sleep Care Specialists to learn if you might benefit from sleep testing. Our primary goal, as always, is to help you get the restorative sleep your body requires for overall good health – and a long life.