Sleep, Stress and Seizure Control: Key Advice From a Leading Epilepsy Expert

In an interview with The Educated Patient, Dileep Nair, M.D., section head of adult epilepsy and director of intraoperative neurophysiologic monitoring at Cleveland Clinic, clears up some of the biggest misconceptions about seizures and epilepsy. He explains that seizures come in many forms — not just the dramatic shaking that most people picture. Some seizures may only involve a momentary blank stare, brief unresponsiveness, a sudden unusual sensation or repetitive movements. Although seizures may look intense, they are rarely painful, and many people don’t remember them afterward.

Nair emphasizes that epilepsy is a brain condition caused by electrical disturbances, not a mental or psychiatric disorder. Epilepsy has many possible causes, including genetics, brain injury, scarring or other structural changes. He also explains the important distinction between epileptic seizures and nonepileptic events, which may look similar but are caused by psychological or physical factors rather than electrical activity in the brain.

Another myth is that people with epilepsy are limited in life or intelligence. In fact, most people with epilepsy live full, successful lives, especially when their seizures are well controlled with treatment.

Nair also discusses common seizure triggers, including stress, missed medications and lack of sleep. Medication adherence is one of the most important parts of treatment, even for those who do not have frequent seizures. Sleep, he stresses, is critical for brain health. Poor sleep can worsen seizures and has been linked to mental health issues, immune problems and even dementia.

For people whose seizures are not well controlled with medication, Nair highlights that there are many other effective treatment choices — including epilepsy surgery, which has been proven safe and highly effective for appropriate candidates. He encourages patients who have tried two or more antiseizure medications without good control to seek evaluation at an epilepsy center, where specialists can determine whether advanced therapies are right for them. His message to patients is simple: Be your own advocate and ask for specialized care if seizures continue.