Epileptic seizures during sleep

Epilepsy is a complex neurological disorder that manifests itself in a range of forms, to the extent that it is more accurate to speak of “epilepsies” in the plural rather than singular.¹ One of these forms is sleep-related hypermotor epilepsy (SHE), formerly known as nocturnal epilepsy. Despite being a little-known form of epilepsy, it has a profound impact on the lives of those affected, also because it is often misdiagnosed.²

What is epilepsy?

Epilepsy is a neurological disease characterized by seizures that tend to spontaneously recur over time with varying and unpredictable frequency. There are many types of seizures and epileptic syndromes. In Italy, about 1 in 100 people have epilepsy.¹

When can an epileptic seizure occur?

Epilepsies can arise at any age, but the incidence peaks in early childhood and after age 75. Some causes of epilepsy are genetic, others are secondary to various types of brain lesions.¹

How can you recognize a seizure during sleep?

This type of epilepsy, once known as nocturnal epilepsy but now referred to as sleep-related hypermotor epilepsy (SHE), is a neurological disorder characterized by seizures during sleep, either during the day or at night.²

The diagnosis of sleep-related epilepsy is based on clinical observation. These seizures are most prevalent in childhood and tend to become less frequent with age.³

What happens to the body when a seizure occurs during sleep?

Sleep-related epilepsy manifests with convulsions, involuntary movements and the production of sound, sometimes even screaming.³

A seizure is generally preceded by specific symptoms, such as:³

How to handle a seizure?

First of all, it is essential to prevent falls and thereby the (sometimes serious) injury a sudden fall may cause.¹

If the person is already on the ground, place something soft under their head, so that during the seizure it will not bang repeatedly on a hard surface.¹ Once the convulsions are over (they generally last no more than 1 to 2 minutes), it is helpful to¹

• unfasten any clothing that may obstruct the flow of air in the airway¹
• turn the person’s head sideways and place the person on their side (the so-called recovery position) to facilitate the outflow of vomit or foamy saliva that sometimes occurs during a seizure, thus facilitating breathing¹
• get any dangerous objects out of the way if the person is moving⁴
• observe the person closely so that you can provide details of what happened⁴
• call an ambulance if the seizure lasts more than 5 minutes¹