What to know about anxiety seizures during sleep

It is common to feel anxious every now and then. However, anxiety can feel more intense for some people and affect their day-to-day lives, which is known as an anxiety disorder.

As anxiety can cause you to feel restless or on edge, your body is more likely to have heightened adrenaline levels. This can make it difficult to fall asleep and trigger your fight or flight response as you are trying to wind down.

For some people, stress can result in seizures even if you do not have epilepsy. This is known as a psychogenic nonepileptic seizure (PNES), which can cause your body to shake uncontrollably. Stress-induced seizures can occur at any time, including during sleep.

What can cause an anxiety-induced seizure?

The cause of an anxiety-induced seizure can differ for each individual. One theory is that as anxiety can result in physical symptoms such as hyperventilation, this can decrease blood carbon dioxide levels and cause seizures. Some research studies suggest that the brain functions responsible for seizures can also cause anxiety.

You may experience a seizure when awake or asleep. There are several possible reasons why you may experience a seizure.

This includes:

• Sleep deprivation: Anxiety can often lead to sleep deprivation, which increases the risk of developing seizures, such as reflex seizures during sleep.
• Stress hormone elevation: Anxiety activates the brain pathways responsible for the production of stress hormones. When your body releases more stress hormones, this can trigger seizures.

Treatment options for anxiety-induced seizures

There are treatment options available for managing PNES in sleep, such as lifestyle measures or taking prescription medication.

Medication options

If you have PNES, it may be beneficial to treat the root cause of your seizures, such as the anxiety itself.

Here are several common types of anxiety medications:

• selective norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor) and duloxetine (Cymbalta).
• benzodiazepines, such as diazepam (Valium), and Clonazepam (Klonopin).
• selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)

A healthcare professional may also prescribe anti-seizure medications if your seizures are due to epilepsy to help stabilize the electrical impulses in your brain. Here are some examples of anti-seizure medications:

• carbamazepine (Tegretol)
• gabapentin (Neurontin)
• diazepam (Valium)
• ethosuximide (Zarontin)
• topiramate (Topamax)

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Lifestyle measures

Certain lifestyle measures can help to effectively reduce the risk of PNES during sleep.

• Improving sleep quality and duration: Effective sleep hygiene practices are one of the best ways to improve sleep quality. Simple behaviors such as sticking to a consistent sleep schedule and sleeping in a comfortable environment can possibly reduce the risk of seizures during sleep.
• Cognitive-Behavioral Therapy (CBT): CBT is a popular psychological therapy that teaches you how to manage anxiety triggers and strengthen coping skills necessary to handle anxiety.
• Relaxation Techniques: Deep breathing exercises, mindfulness, and yoga can help decrease stress and anxiety levels.
• Speaking with loved ones: Emotional support from close family members and friends can help individuals cope with anxiety.

How can anxiety-induced seizures be prevented?

Prevention of anxiety-induced seizures typically requires a collaborative approach in addition to stress reduction techniques. Care from a team of healthcare professionals, such as mental health professionals, can ensure you receive proper medication adjustments and follow-up care.

The following prevention strategies may also help people with PNES:  

• Stress Reduction: A 2017 review by researchers at the University of Cincinnati Epilepsy Center highlighted the association between stress and seizures. The researchers further noted that stress reduction techniques, like mindfulness or psychotherapy, could be therapeutic for those at risk of PNES.
• Cannabidiol (CBD): A 2019 study suggested the potential of CBD to decrease the risk and frequency of seizures in some people. More research is needed to fully validate its safety and efficacy for people with PNES.
• Psychological Interventions: Psychological therapy, such as cognitive behavioral therapy (CBT), can support those who experience high stress levels and decrease their risk of developing PNES.

Preventing anxiety-induced seizures involves a personalized approach that fits an individual’s unique health condition and needs. Speaking with a doctor can further help you to identify the most suitable prevention strategies.

When to speak with a doctor

If you find that you have seizures during sleep, consider speaking with a healthcare professional. They can work with you to put together a suitable treatment plan.

Generally, individuals who experience a lot of stress are at risk of PNES. A healthcare professional can help you identify ways to lower your stress levels and improve your sleep quality.

Summary

Anxiety-induced seizures in sleep are common in individuals who experience high stress levels. Due to the connection between the brain regions that manage stress and anxiety, stress can induce changes that can affect a person’s anxiety levels. 

If you are experiencing seizures during sleep, it can be helpful to speak with a healthcare professional who can put together an effective treatment plan based on your needs. This may include anti-seizure or anxiety medications, as well as lifestyle measures such as stress reduction and improved sleep hygiene.

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