Interviewer: Lifestyle changes you can bring to reduce the severity or the number of crises you have. Dr Sindhu Richards is a Deputy Professor of Neurology at the University of Utah Health. She specializes in the treatment of epilepsy.
Dr. Richards, what are some of the recommendations you give to someone who would like to make lifestyle changes or consider their lifestyle as a means of reducing the number or intensity of their crises?
# 1. Sleeping enough
Dr Richards: One of the greatest things that can affect the burden of crises is the quality of sleep. People with sleep deprivation are a big trigger for crises. We say we have an adequate sleep every night, try not to stay late, and have a regular sleep cycle will be really beneficial in terms of reducing the number of crises you have.
In correlation with this, one of the current diagnoses of patients affected epilepsy is obstructive sleep apnea. And that’s where they don’t sleep in good quality and may need a CPAP machine to do it.
So, the people who are treated to sleep apnea Also tend to have a lower crisis burden, just because when treated for sleep apnea, they sleep better quality. Even if they were sleeping with eight to nine o’clock per night, this quality is not excellent if they have untreated sleep apnea. It is therefore known to also worsen crises.
# 2. Drink alcohol in moderation
We also advise people on alcohol consumption. Thus, having an occasional glass here, or even a glass of wine per night, is quite well to do in patients who suffer from epilepsy. We are simply concerned about the excessive consumption of alcohol, as this is also more clearly linked to sleep deprivation. And then any significant alcohol consumption can really cause a crisis disorder itself. We therefore advise you against a moderate to severe amount of alcohol consumption, but having a drink here or there or even drinking socially, sometimes it is good if you suffer from epilepsy.
Another common thing that I am asked concerns food changes and if it can help with epilepsy. Thus, in terms of adult population, there is no really clear evidence in a kind of certain diets improving the frequency of crises.
# 3. An ketogenic diet can operate for pediatric epilepsy
In the pediatric population, certain types of crises respond to the ketogenic regime. So, if people with epilepsy really want to try a food measure to see if it reduces their frequency of crisis, it is generally the one I simply suggest because it has good proofs in the world of PEDs, but this is not the case in the adult world, but we know that this does no harm in terms of frequency of seizure. But in terms of reducing other sugars or any other, by removing any major food substance, we do not really recommend that in terms of epilepsy.
Interviewer: So, to be clear, as the diet may not have good proofs behind. Which means that I know that doctors really like to have these evidence that shows: “Yes, there is a direct link”. It is not necessarily – it could mean that it might not help someone. So, if you want to talk to your doctor to make sure that the ketogenic diet is correct for you or some of these other food adjustments, it would probably be the first step to make sure that it does not affect anything else. But with regard to epilepsy, that would not have an impact on this.
Dr Richard: Exactly. Yeah. It wouldn’t aggravate things. So yes, you need to make sure you check with your primary care doctor to see if it is an acceptable diet for you.
# 4. Be active and stay active
Interviewer: Are there any other things of lifestyle that someone could watch or adjust or adjust things in lifestyle that have been asked that we just don’t know.
Dr Richards: They are the big ones, I would say. We try, you know, patients with epilepsy, we want you to live the best normal life possible. So, continue to be active, as exercising, it’s very good in terms of medical problems, but it is also great for epilepsy because this is another question that we get.
We obviously do not want you to do a major exercise or activity where you would seriously injure yourself if you had to have a great crisis. So, some restrictions that we have in terms of this is that if you are going to swim, we say that you should have a supervisory in-head. If you are at a beach and there is a rescuer who looks at a lot of people, it is not acceptable in terms of supervision. You should have someone on the beach to look at you head-on directly. In this way, in case you have a crisis on the water, they could be careful and get out of there. So it’s a great thing.
# 5. Avoid risky activities
Driving is a great thing, obviously, which affects people’s lifestyles because if you had a crisis, you would lose knowledge, you would lose control of the car and not only you injure and the people of your car, but also other people on the road. It is therefore a really important precaution, we like to stress in patients with epilepsy. As a rule, we ask them if you know, they have a driver or take public transport. This is one of the most difficult lifestyle changes we find in patients with epilepsy, but it is important to follow. In this way, you and the others are safe.
Then, other activities, you know, we say in a way, use your judgment. If you had to have a crisis and it would cause serious damage to yourself or to others, you should simply be careful. So, as parachuting is not the one I usually recommend. You shouldn’t be scuba diving. So, things where, you know, if you had a crisis, it would be really dangerous for yourself or for others.
But the grown -ups we say to people are: no driving, no swimming alone, you should not be on heights and ladders, and you should not operate heavy machines. These are the large restrictions we give to people when diagnosed with epilepsy.
If you have an epilepsy diagnosis and have been tried on different drugs and you continue to have crises for at least more than a year, you must be seen in an epilepsy center and seen specifically by epileptologists.
We have complete care with neurosurgeonianRadiologists, neuropsychologists, nurses and social workers. You will therefore get a lot of resources that you will not get otherwise in terms of other options to treat your epilepsy.
Update: April 8, 2025
Originally published: May 12, 2021