Seizures and teens: stress, sleep, & seizures

Exceptional Parent, The, July, 2007 by Patricia Osborne Shafer

Most parents are used to erratic sleep patterns and mood swings in their teenagers. When these occur in an adolescent with seizures, however, the parent may wonder if sleep and mood problems are related to seizures. Sorting out the cause and effects of sleep in an adolescent with seizures can be confusing. Since stress can be a contributor to both sleep problems and seizures and ways of managing stress and sleep may be similar, these topics are often addressed together in this age group. This article provides an overview of the role of sleep and stress in adolescents with seizures and ways to monitor and modify your teen's lifestyle as part of seizure management.

Importance of sleep: Sleep and stress are both integral parts of life. Sleep is critical for our brains and body to work properly. During sleep, nerve cells actively work to make connections, form memories, help us learn, and provide necessary rest and repairs for the body. The importance of sleep can be understood by looking at what happens when people don't sleep well. For example, sleep deprivation can affect memory and learning, physical performance, growth, and hormone function. Sleep important for our ability to cope with pain and stress. When sleep is disrupted, people may feel irritable, tired, depressed, or overwhelmed. A person's usual ways of coping may not be as effective, judgment may be impaired, and decision-making affected.

What is enough sleep? Sleep needs vary as we age. Teenagers typically need 9 hours of sleep a night as compared to 10 to 12 hours of sleep for young children and 7 to 8 hours for adults. Normal sleep has five different stages, including periods of drowsiness, beginning to fall asleep, deep sleep, and REM sleep, or the time when dreaming occurs most often. When people have broken or interrupted sleep, the brain doesn't progress through the normal sleep stages, and the critical work of sleep not complete. Constant sleep deprivation can occur even if the person feels like they are sleeping enough. When we sleep also important to the quality of sleep and whether a person getting enough. Hormones regulate sleep so people usually get tired at night and awaken when it's light out. When people sleep during the day or with lights on, sleep-wake cycles are affected, and people are at risk for sleep deprivation.

A typical teen sleeps too little on weekdays and too much on weekends. As a child enters adolescence, their body clocks change, and they stay awake later. While they may study, work, or play late in the evening, typical school hours still require teens to get up early. As a result, most teens don't get enough sleep during the week and then try to catch up on the weekends. These changing sleep times and periods of too little sleep often lead to chronic sleep deprivation.

Sleep and seizures: Some forms of seizures tend to occur more often at night or in early morning hours. For example, a common form of seizures in adolescents, benign rolandic epilepsy, typically consists of seizures that occur only at night. They tend to go away on their own, and in some people, seizure medications may not even be needed. However, if seizures occur frequently, interfere with daytime function, or also occur during the day, medications would be recommended. In other types of epilepsy, seizures may occur more often during drowsy periods such as upon falling asleep or upon awakening, as well as during the day.

Sleep deprivation can also make seizures more likely to occur in an adolescent with seizures. Teens can be sleep deprived by not getting enough sleep, sleeping at irregular times, or having interrupted sleep from seizures at night. Additionally, teens with disrupted sleep could have a sleep disorder, such as sleep apnea. Since sleep disorders can worsen seizure control in teens with epilepsy, it's important to look carefully at sleep patterns and causes of sleep disturbances.

Importance of stress: Stress is defined differently by everyone. Most commonly, we think of stress as a physical, mental, or emotional tension or problem. Our bodies respond to stress with certain physical, emotional, and hormonal changes. If stress occurs repeatedly over a period of time, the body's usual responses may not work. Stress builds up and can lead to unhealthy symptoms and illness. New illnesses or health problems can arise, or existing problems can worsen.

Stress and seizures: Many people feel that stress may affect their seizures, yet proving this is hard to do. Some people note that seizures occur after many little stresses or 'hassles;' others report that seizures tend to occur only before or after a major stress. Physical stresses may affect some people, while the buildup of emotional stress, either positive or negative, can affect other people. Stress is also a common cause of sleep problems. Teens who feel stress may have trouble talking about what bothers them but may feel tired, sleep too much, or have difficulty sleeping. Difficulty managing stress can lead to emotional problems such as anxiety or depression that don't go away on their own. Thus, sleep problems can be a sign of mood problems, or stress and mood problems can arise from poor sleep!