Seizures can occur during sleep. These events, known as nocturnal seizures, are a specific type of seizure activity that manifests when an individual is in a sleep state. Understanding nocturnal seizures is important for identifying and managing them effectively. Gaining knowledge about them can help individuals and their families navigate this condition.
Understanding Nocturnal Seizures
Nocturnal seizures are classified by the timing of seizure activity, not as a distinct type of epilepsy. Many different seizure types can manifest during sleep, with generalized tonic-clonic seizures being a common example. These involve muscle stiffening (tonic phase) followed by rhythmic jerking movements (clonic phase).
Focal seizures, which originate in a specific brain area, can also occur during sleep. Frontal lobe epilepsy, for instance, is frequently associated with nocturnal seizures and may involve complex movements or vocalizations. Benign epilepsy with centrotemporal spikes (BECTS), also known as Rolandic epilepsy, predominantly affects children and typically manifests as focal seizures during sleep, often involving the face and mouth. These focal seizures can sometimes spread and become generalized, resembling a tonic-clonic seizure.
Recognizing Signs of a Sleep Seizure
Recognizing the signs of a sleep seizure can be challenging, as the affected individual is often unaware of the event. A person might wake up feeling confused or disoriented, which can persist for several minutes or longer. Headaches are also a common post-seizure symptom.
Physical indicators may also be present upon waking. These can include a bitten tongue, especially on the sides, or unexplained injuries from falling out of bed or striking nearby objects during the seizure. Muscle soreness or stiffness, resembling intense physical exertion, is another frequent complaint. Bedwetting, medically known as enuresis, can also be a sign, particularly if it is a new or recurring issue for an adult. A bed partner or family member might observe the seizure directly, noticing jerking movements, unusual vocalizations, or periods of difficulty breathing during the night.
Why Seizures Happen During Sleep
Seizures during sleep are linked to dynamic changes in brain activity throughout the sleep-wake cycle. Sleep involves distinct stages, each characterized by specific brain wave patterns. Non-rapid eye movement (NREM) sleep, particularly deeper stages, can alter neuronal excitability, making some individuals more prone to seizure activity.
During deep NREM sleep, synchronized neuronal firing can create an environment conducive to the abnormal electrical discharges characteristic of a seizure. Transitions between sleep stages, or between wakefulness and sleep, can also trigger seizures in susceptible individuals by lowering the seizure threshold. Additionally, sleep deprivation can significantly reduce the seizure threshold, making seizures more likely to occur.
What to Do If You Suspect Sleep Seizures
If you suspect you or someone you know might be experiencing sleep seizures, consult a healthcare professional. A neurologist, a doctor specializing in brain and nervous system disorders, is the most appropriate specialist to evaluate such concerns. They will likely begin by taking a detailed medical history, including any observations of nighttime events.
The diagnostic process often involves tests to monitor brain activity. An electroencephalogram (EEG) is a common tool, and a sleep EEG, which records brain waves during sleep, is useful for identifying seizure activity that occurs predominantly at night. Brain imaging techniques like magnetic resonance imaging (MRI) may also be performed to look for structural abnormalities. Treatment often includes anti-seizure medications (ASMs) to stabilize brain activity and reduce seizure likelihood. Maintaining a consistent sleep schedule and avoiding sleep deprivation are important lifestyle measures that can help manage seizure triggers. For individuals diagnosed with nocturnal seizures, safety measures during sleep, such as using a low bed or padding surrounding areas, may be recommended to prevent injuries.