Nocturnal Seizures for Elderly People with Epilepsy

Although epilepsy might not come to mind right away if you think about conditions affecting the elderly, a quarter of all people diagnosed with epilepsy are over 65. If one of your elderly loved ones does have epilepsy, or you are an older person with epilepsy yourself, it’s important to know the facts about seizures.

For example, while there’s a lot of information available about epileptic seizures that happen during waking hours, it’s key to remember that seizures in the night can happen as well. These are called nocturnal seizures or sleep seizures.

What happens during a sleep seizure, and how can it affect an elderly person? This guide will provide the answers.

What are epileptic seizures?

In order to understand what’s happening during nocturnal seizures, let’s review some basics about epilepsy.

Epileptic seizures occur when disorganised electrical activity happens in the brain. Since different parts of the brain control different body functions, the part of the brain you have seizures in will affect what you experience.

Seizures can be divided into different types, which have different symptoms. The type of seizure we most often think of in connection with epilepsy is a tonic-clonic seizure. An older person who has this type of seizure will lose consciousness, fall to the ground and experience uncontrolled, jerking movements.

However, there are various other kinds of seizures that are less dramatic to see. For example, focal seizures (previously called partial seizures) can be quite different. In this type of seizure, patients may keep some or all of their awareness of what’s going on around them. They might experience jerking movements, or just feel strange emotions, see strange things or wander blankly.

Elderly people are more likely to have focal seizures than tonic-clonic seizures, and they are more likely to have epilepsy in the temporal lobe. In brief, this means that older people’s epileptic seizures tend to be less like tonic-clonic seizures where a person is lying on the floor with jerking movements. Rather, elderly people’s epileptic seizures tend to manifest more along the lines of strange feelings, automatic movements and confusion. This is one reason why epilepsy in the elderly can be mistaken for dementia.

What are nocturnal seizures like?

An epileptic sleep seizure tends to happen more at the beginning or end of sleep rather than in the middle of the night. It usually lasts for just one or two minutes.

Seizures in the night can belong to any category of seizure. Tonic-clonic seizures are one possibility – these usually happen around the time the patient wakes up. The strong jerking movements and possible loss of bladder or bowel control during this type of seizure can be an indication that it has occurred.

But night-time, seizures can also manifest quite differently. Elderly people with epilepsy might find themselves out of bed and not knowing how they got there – and this can be the result of a seizure too.

If an elderly person who has epilepsy finds that they are extremely tired during the day, this can also be an indication that they have experienced seizures that interrupted their sleep.

One common type of epileptic sleep seizure is part of a specific epileptic syndrome – sleep-related hypomotor epilepsy, or SHE, which was previously called nocturnal frontal lobe epilepsy. In SHE, patients may make noises or violent movements, or they might wander around. However, as this syndrome is usually diagnosed in childhood, elderly people are less likely to have this type of epilepsy.

If you’re having epileptic seizures in the night, what can you do?

An elderly person who suspects they may be having night-time seizures should contact their doctor, who can recommend tests to determine whether this is the case. As it’s best to try to keep seizures as well controlled with medication as possible, your doctor may review your medication to see if these seizures can be reduced.

If you know that you are having nocturnal seizures and your medical team is working to address them, what else can you do?

One important step is to take your medication exactly as your doctor has prescribed. Missing doses of medication could lead to a sleep seizure.

Other steps that might help can depend on the type of seizure experienced.

Tonic-clonic seizures in the night

Some people who have tonic-clonic seizures during the night invest in an alarm that can detect the shaking and violent movement of a tonic-clonic seizure. As tonic-clonic nocturnal seizures carry a higher risk of death – although doctors are not completely certain why – some patients feel there is a greater need to alert a caregiver or family member to the seizure. However, as we’ve seen, the majority of older people with epilepsy will tend not to fall into this category of those who often have tonic-clonic seizures.

Other types of sleep seizure

What if an older person is having a different type of sleep seizure? In this case, health concerns might involve the risks of wandering unaware during the night and the dangers of confusion experienced the following day. Elderly people are more likely to experience longer periods of confusion after a seizure in any case, and night-time seizures can produce even more sleepiness during the next day because they interfere with the brain’s cycle of sleep and dreaming.

Therefore, in this situation it’s helpful to reduce the risks to an elderly person caused by night-time wandering, confusion and tiredness.

One step that’s always important for an elderly person’s home is to make sure that the floor is clear and not covered with obstacles that a person could trip on, such as wrinkled rugs. This could be important for a senior wandering unaware during the night or for an older person who is tired or confused during the day.

Another action that could be beneficial is wearing a personal alarm with automatic fall detection. This type of alarm doesn’t detect tonic-clonic seizures. Rather, it automatically detects when its wearer has fallen down. This could be important if a fall results from either unaware wandering or confusion and tiredness in an elderly person.

Personal alarms with 24/7 monitoring can also be a good option. With this type of alarm, an older person who is in bed and needs help can call for it with just the touch of a button.

How SureSafe alarms can play a part in keeping an older person with epilepsy safe

When an older person has epilepsy, there are more safety concerns to consider than what happens during a seizure – although of course that’s important too. Epilepsy medication, for example, can be a more difficult issue for elderly people because they may already be taking medication for other conditions that interacts with epilepsy medication. Since epilepsy can co-exist with dementia, dementia symptoms can also be a factor that must be considered when it comes to keeping an older person with epilepsy safe.

A personal alarm from SureSafe can help families to address some concerns related to epilepsy in an older relative. If there are concerns about wandering due to epileptic seizures during the night or day, a mobile alarm with GPS tracking can ensure an elderly loved one is never off the radar. Meanwhile, wrist alarms can also include medication reminders to ensure an elderly person with epilepsy takes their medicine at the right time – which helps to ward seizures off.

How else can personal alarms help elderly epilepsy patients to handle confusion, tiredness or wandering due to epileptic seizures? Try talking with our experts to learn more about what SureSafe’s personal alarms can do. You can call us on 0800 112 3201, reach out through our live chat or request a call back.