When you’re living with epilepsy, sleep can feel like both an ally and an enemy. Some nights, your rest is peaceful and healing; other nights, it’s fragmented, restless, or interrupted by seizures. And the truth is: epilepsy and sleep are deeply intertwined. Sleep (or lack thereof) can influence seizure activity, and seizures (or epilepsy-related factors) can disrupt sleep. Understanding this relationship is key to managing both sides better; learning how to actually rest is just as critical as medication or doctor checkups.
The Two-Way Street: How Sleep & Epilepsy Affect Each Other
Sleep Can Trigger Seizures
One of the clearest connections between epilepsy and sleep is that sleep deprivation is a well-known trigger for seizures. In fact, a review article stated: “Sleep deprivation is a common trigger of seizures in many persons with epilepsy” (Reddy et al., 2018). When your brain is overly tired, its neurons become more excitable, lowering the threshold for seizure activity.
More precisely, different stages of sleep matter too. The brain cycles between non-rapid eye movement (NREM) and rapid eye movement (REM). Some types of epilepsy show increased electrical activity during NREM sleep, especially in deep sleep or transitions between stages (Kim et al., 2023). Meanwhile, REM sleep tends to be more protective in some cases. Sleep architecture matters.
A recent study by Stirling et al. (2023) even found that bed and wake times (i.e. consistency) are more strongly linked to seizure risk than just how many hours someone sleeps. This suggests that regular sleep schedules might be as protective as getting “enough hours.”
Epilepsy Disrupts Sleep Quality
On the flip side, epilepsy itself can damage your sleep. Seizures during the night (nocturnal seizures) can cause awakenings or fragmented sleep, which degrade overall sleep quality. Some forms of epilepsy are especially active during sleep periods. The SleepMedRes review notes that “excessive daytime sleepiness and fatigue can result from epilepsy and the sedating effects of antiseizure medications” (Kim et al., 2023).
Medications, too, complicate things. Anti-seizure drugs (ASDs) can have side effects such as drowsiness, insomnia, or disruptions in sleep cycles. Some medications act as sedatives, others may interfere with REM sleep or worsen sleep disorders like sleep apnea (SleepMedRes, 2023).
Sleep disorders, too, are more common in people with epilepsy. Insomnia, obstructive sleep apnea (OSA), restless legs syndrome, or circadian rhythm disturbances are some examples of these conditions. A study of children with epilepsy found that over half had reported sleep concerns; 45% had frequent nighttime awakenings, and more than a third struggled to fall asleep (Michigan Medicine, 2022).
Additionally, a recent U.S. study found that epilepsy is significantly associated with sleep disturbances (odds ratio ~3.67). Interestingly, depression partially mediated that relationship. This would mean that moods and mental health also play a role (Wen et al., 2024). In other words: epilepsy → sleep problems → depression → more sleep problems.
Why Poor Sleep Makes Everything Harder
When your sleep is disrupted or low quality, multiple parts of your life suffer—not just the risk of seizures.
– Cognition & Memory: Sleep helps consolidate memory. Disrupted sleep can impair learning, attention, and memory retention.
– Mood & Mental Health: Sleep and mood are tightly linked. Poor sleep raises the risk of anxiety, depression, and irritability.
– Energy & Fatigue: Fragmented or insufficient sleep leads to daytime sleepiness, fatigue, and lack of motivation.
– Seizure Control: If sleep disruption is making seizures more likely, bypassing or weakening medication effectiveness, the cycle intensifies.
It’s a vicious feedback loop: seizures worsen sleep; bad sleep makes more seizures likely; more seizures worsen sleep further, etc.
How to Actually Rest (Strategies With Evidence)
1. Prioritize Sleep Consistency
Because timing matters so much, go to bed and wake up at the same time every day, even on weekends. The AES Companion Guide for sleep & epilepsy emphasizes consistent timing as a foundational strategy (AES, 2024).
2. Optimize Sleep Hygiene
Good sleep hygiene helps your brain and body know when it’s time to sleep. Some tips:
- Make your bedroom dark, quiet, and cool.
- Use blackout curtains, white noise machines, or fans if necessary (Epilepsy.com).
- Limit screen time (devices emit blue light which suppresses melatonin).
- Avoid doing stressful things in bed and study or phone use should be outside the sleep space.
- Be cautious with naps. They can throw off your “sleep pressure” (Epilepsy.com, “How to Get Enough Sleep”).
3. Relaxation & Wind-Down Routine
Your brain needs cues to shift from “active” to “rest.” Try:
– Deep breathing, progressive muscle relaxation, or guided meditation.
– Read a light book (not stressful) or listen to calm music.
– A warm (not hot) bath before bed.
– Avoid caffeine or stimulants in the evening.
4. Review (and Adjust) Medication
Talk openly with your neurologist about how your anti-seizure meds might be affecting sleep. Sometimes shifting timing, switching drugs, or lowering evening doses (if safe) can help (SleepFoundation). Be careful: never change meds without medical advice.
5. Screen for Sleep Disorders
Loud snoring, waking up gasping, feeling extremely tired during the day, or restless legs are all red flags. Sleep apnea or other disorders might be worsening both your sleep and seizures. Consult a sleep specialist. The AES guide encourages routine sleep assessments in those with epilepsy.
6. Use a Sleep Diary
Track your sleep: bedtime, wake time, awakenings, daytime naps, how rested you feel. Over weeks you might spot patterns. For example, days when you slept poorly and seizures flared, or nights you felt “off” after bad rest. You can bring this to your neurologist or epilepsy team.
7. Light Exposure & Routine
Expose yourself to bright daylight in the morning (helps set your circadian clock). Avoid bright overhead lighting at night, especially late evening. Some studies suggest insomnia and circadian misalignment are risk factors for epilepsy (Li et al., 2025).
Why It Matters
This stuff isn’t just theory. For many people with epilepsy, sleep feels like a battleground: one night okay, the next night a disaster. I’ve heard from peers that after a bad night, they feel foggy, anxious, and almost like they’re walking through the day underwater.
What helped one person wasn’t just a tweak in medication. It was finally treating sleep apnea they didn’t know they had. Another said that once they locked in a stricter bedtime schedule, they noticed fewer nighttime “brain weirdnesses.”
Sleep might not control everything, but it’s often the easiest (and most ignored) lever we have. Paying attention to rest, tweaking routines, and advocating for better sleep care can sometimes make as much difference as changing meds.
Conclusion
Epilepsy and sleep are bound together in a dynamic, relentless dance. One influences the other in both directions. But that also means change is possible. Better sleep habits, addressing sleep disorders, being attentive to medications, and prioritizing rest don’t magically cure epilepsy, but they give your brain a fighting chance.
References
– Krutoshinskaya, Y. (2024). The Reciprocal Relationship between Sleep and Epilepsy. PMC.
– Lanigar, S. et al. (2017). Sleep and Epilepsy: A Complex Interplay. PMC.
– Reddy, D. S. et al. (2018). Neuroendocrine Aspects of Improving Sleep in Epilepsy. PMC.
– Stirling, R. E. et al. (2023). Bed and wake times are more important for identifying seizure risk than sleep duration. Brain.
– Wen, Q. et al. (2024). The association between epilepsy and sleep disturbance in US adults: the mediating effect of depression. BMC Public Health.
– Kim, K. M. et al. (2023). Sleep and epilepsy: a review of interrelationship and drug effects. SleepMedRes.
– Epilepsy.com. “How to Get Enough Sleep.”
– Epilepsy.com. “Epilepsy Sleep Hygiene.”
– AES (2024). The Critical Role of Healthy Sleep Habits for People with Epilepsy.