Nocturnal seizures are neurological events that occur during sleep. While not every seizure leads to significant harm, nocturnal seizures carry specific risks. This article explores these risks, provides guidance on how to respond, and outlines when medical advice should be sought.
What Are Nocturnal Seizures?
Nocturnal seizures are epileptic seizures that happen when a person is asleep, falling asleep, or waking up. These events stem from unusual electrical activity in the brain, causing a temporary loss of control over some brain functions. Most nocturnal seizures are tonic-clonic seizures, previously known as grand mal seizures.
These seizures can manifest in various ways, including sudden rigidity, jerking, twitching, or vocalizations like crying out. Other signs can include bedwetting, biting the tongue, or falling out of bed. Often, individuals may not remember the seizure, waking up confused, tired, or with unexplained headaches or bruises.
The brain’s electrical activity naturally changes during different sleep stages, particularly during non-rapid eye movement (NREM) sleep, when most nocturnal seizures occur. This altered brain state can trigger seizures in susceptible individuals.
The Dangers and Risks
Nocturnal seizures present several dangers and risks. Physical injury is an immediate concern, occurring if the person falls out of bed, strikes nearby furniture, or bites their tongue during involuntary movements. Forceful muscle contractions can lead to sprains, fractures, or other trauma.
Breathing difficulties are another risk. The airway can become obstructed, or there may be temporary cessation of breathing (apnea). This can lead to low blood oxygen levels, affecting the brain and other organs.
A prolonged seizure, or a series of seizures without full recovery, is known as status epilepticus, a medical emergency. This is a particular concern with nocturnal seizures due to potential for delayed recognition.
Sudden Unexpected Death in Epilepsy (SUDEP) is a rare but serious risk associated with epilepsy, especially when seizures are not well-controlled. Nocturnal seizures are linked to SUDEP, with respiratory or cardiac issues following a seizure potentially contributing. Proper management can significantly reduce SUDEP likelihood.
Beyond physical dangers, nocturnal seizures disrupt sleep quality. Frequent seizures fragment sleep, leading to chronic sleep deprivation, daytime fatigue, and impaired cognitive function. This ongoing disturbance affects daily life and overall well-being.
What to Do During a Nocturnal Seizure
Responding appropriately during a nocturnal seizure can minimize harm. If you witness someone having a nocturnal seizure, gently roll them onto their side after the seizure activity has stopped. This position helps keep the airway clear and prevents choking.
Time the seizure from beginning to end. Clear the immediate area around the person to remove objects that could cause injury. Placing a soft, flat object, such as a folded jacket or small pillow, under their head offers protection.
Loosening any tight clothing around the neck, like a collar or tie, can assist with breathing. Avoid restraining the person or attempting to stop their movements. Never place anything in their mouth, as this can cause injury to their teeth or jaw, or lead to choking.
After the seizure, stay with them until they regain consciousness. They may be confused, drowsy, or disoriented. Providing reassurance can be helpful. Documenting the event, including its duration and observed symptoms, is beneficial for medical consultation.
When to Seek Professional Help and Management
Recognizing when to seek medical attention for nocturnal seizures is important. Call emergency services immediately if:
A seizure lasts longer than five minutes.
Repeated seizures occur without regaining consciousness between them.
The person experiences difficulty breathing after the seizure.
The seizure results in injury.
It is a first-time seizure.
The seizure occurs in water.
Any suspected nocturnal seizure warrants a medical evaluation. A doctor can help confirm a diagnosis, often using an electroencephalogram (EEG) to measure brain activity. Many people with nocturnal seizures may not be aware they are having them.
Management focuses on reducing seizure frequency and risks. This involves confirming the seizure type, identifying triggers like sleep deprivation, and adhering to prescribed medication. Lifestyle adjustments, including consistent sleep patterns, are often recommended. Proper medical management can reduce nocturnal seizures and their dangers, improving overall well-being.