Epilepsy during sleep. Causes and symptoms of nocturnal epilepsy

Epilepsy is a chronic disease manifested by convulsive seizures, vomiting, loss of consciousness and other equally dangerous symptoms. It is considered a neurological disease and is treated by neurologists. Attacks occur both during the day and at night. But when they disturb a person only during sleep, then the disease is called “nocturnal epilepsy”. 

Epileptic syndrome most often occurs in children 6-7 years old, as well as young people under 35 years of age. A characteristic feature of the disease is that it can pass on its own without special treatment. This is due to age-related changes in the nervous system.

Causes of nocturnal epilepsy

Genetic predisposition is one of the main causes of the disease. Children with parents with epilepsy are more likely to develop seizures.

The development of the disease is facilitated by:

• head trauma;
• overexcitation of the nervous system;
• taking alcoholic beverages;
• sleep disturbance.

Sleep is an integral part of human life, thanks to which the nervous system and the body fully rest. When an epileptic sufferer sleeps less than they should, it will lead to more frequent seizures. Provoking factors: night shifts, walks, night awakenings, late bedtime. The nervous system is depleted and the brain cells become vulnerable.

More frequent attacks can be caused by sudden changes in time zones. People with epilepsy need to be careful about travel. A sharp alarm clock is a seemingly insignificant factor in the life of every person, but for epileptics it can be dangerous (a sharp awakening provokes an attack). 

Symptoms of nocturnal epilepsy

A seizure that occurs only during sleep is a symptom of nocturnal epilepsy. Sometimes it disturbs the patient and during the day’s rest.

Sleep epilepsy is characterized by: 

• sudden unreasonable awakenings;
• convulsive conditions;
• nausea and vomiting;
• dysarthria ;
• severe headaches;
• a person creates unusual sounds that resemble a squelch;
• trembling;
• skewed eyes, sometimes faces.

The patient in a dream can get on all fours, making movements with his legs, reminiscent of riding a bicycle.

 Seizures in nocturnal epilepsy last from a few seconds to 2–5 minutes. Children, as a rule, do not remember those events that happened at night during sleep. But some people retain memory, they can describe their feelings.

Indirect symptoms that are important to pay attention to:

• there are traces of blood on the pillow;
• there are abrasions and bruises on the body of unknown origin;
• tongue bitten;
• muscle pain;
• wet bed (involuntary urination);
• man wakes up on the floor.

Classification of nocturnal epileptic seizures in medicine

1. Parasomnias . Symptoms:

• involuntary shuddering of the lower extremities at the moment when a person falls asleep;
• short-term immobility at the moment of awakening.

1. Sleepwalking. Symptoms:

• walking in a dream;
• nightmares;
• incontinence during sleep.

Children are more susceptible to sleepwalking. Usually, with age, it goes away on its own, but sometimes it does not stop and continues in adults. When a person walks in a dream, there is a possibility of injury, because at this moment he does not control his movements. Another symptom of sleepwalking is aggression during awakening. Neither children nor adults remember anything that happened to them at night during sleep.

1. Bed-wetting. In medicine, this symptom is isolated in a separate form (if no more signs are observed). The brain cannot control the state of the bladder at the time of its filling, so it is emptied voluntarily, so that the patient does not even have time to wake up at this moment. Nocturnal incontinence is typical for children under the age of 14 (mostly boys). Involuntary urination occurs approximately 4 hours after falling asleep. 

Not to be confused with epilepsy!

There are some symptoms that are not related to this disease. Children, sometimes adults, wake up at night because of fears, nightmares. They are confused with epileptic seizures. Some children sit down and cry in their sleep, while they do not react to the joys of their parents, but there are no convulsions. The child, after a few minutes, calms down, goes to bed further.

Some people experience muscle twitching when falling asleep. The body relaxes in preparation for sleep, and this provokes “benign sleep myoclonus .” It does not pose any danger and does not require treatment.

First aid

The goal is to protect the patient from possible injury . It is necessary to provide a soft surface for the person during an attack, which should be flat. For this, you can use a blanket, clothes. If the patient is dressed in pajamas, then, if possible, it should be removed so that the body is not constrained. The head is turned to one side so that the vomit is freely released and does not enter the respiratory tract.

Until the attack is over, you should hold the limbs, but you cannot counteract the seizures. To prevent biting your tongue and protect your teeth from possible fractures, you should insert soft tissue (such as a handkerchief) into your mouth whenever possible.   

During an attack, loved ones who are trying to help should know that it is strictly forbidden to unclench closed teeth! Forcibly unclenching the jaw can damage the teeth, and there is also the possibility of injury to the person helping.

Diagnosis of epilepsy

If a person has symptoms that are alarming, then you should immediately consult a doctor. Parents notice the changes that occur during sleep in their children immediately, but with adults it is not so easy (especially if there is no one around at night).

Before prescribing treatment, the doctor must make a diagnosis. To do this, you need to carry out:

• sleep deprivation test;
• night EEG monitoring.

Epilepsy treatment

Nocturnal epilepsy is considered the mildest form of the disease, its treatment does not cause any particular difficulties. But if the patient does not take antiepileptic drugs, then there is a risk of developing seizures in the daytime. The dosage of the drug is prescribed depending on the intensity of the seizures. 

Treatment also implies compliance with a number of rules:

1. If the drugs prescribed by the doctor cause drowsiness in the daytime, insomnia at night, then in such cases the doctor should be notified of this. He will prescribe another drug.
2. Develop a regular habit of going to bed at the same time. If a person does not get enough sleep at night, then there is a risk of an attack during the day.
3. Taking sedatives, caffeine aggravates the situation.
4. A child with nocturnal epilepsy should have a raised bed. You can also lay something soft near the bed.
5. Children with this condition should not sleep on a bunk bed.
6. Avoid using high pillows, which increase the risk of suffocation.

Correctly selected treatment improves the quality of a person’s life. If the disease concerns a child, then his parents will be able to calmly rest without worrying about their baby at night.