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Fatigue is more than just feeling tired. It’s a persistent, draining exhaustion that can affect every part of life. For people living with epilepsy, fatigue is one of the most common and frustrating symptoms. It can show up after seizures, as a side effect of medication, or even as part of a cycle with depression and poor sleep.
If you often feel low on energy, you’re not alone. Understanding what causes fatigue in epilepsy and learning practical ways to manage it may help you feel more in control and find more energy.
Fatigue consists of chronic or overwhelming feelings of exhaustion, tiredness, or weakness. It’s much more common in people living with epilepsy than in the general population. In fact, one study found that people with epilepsy experience fatigue up to 4.1 times more often compared to those without epilepsy.
Fatigue in epilepsy is often caused by a combination of physical, emotional, and neurological factors. Below are some reasons that can cause a person with epilepsy to experience fatigue.
Depression affects about one-third of people with epilepsy, and its symptoms are different in everyone. In fact, having epilepsy can increase the risk of developing depression, and having depression can increase the risk of developing epilepsy. In a 2025 study, epilepsy research found that 47.1 percent of people with epilepsy had fatigue that could be due to depression.
This fatigue may sometimes trigger epileptic seizures. A cycle can develop, with depression causing fatigue, which contributes to seizures. These seizures then cause more fatigue, which contributes to depression, and so on. Talk to your doctor about how to treat depression to break this cycle.
MyEpilepsyTeam members sometimes discuss their struggles with depression. “I never thought I would ever have to deal with depression,” wrote one member. “With epilepsy, depression is a daily battle.”
Another important risk factor for developing fatigue when living with epilepsy is poor sleep or sleep impairment. In particular, nocturnal seizures, or seizures that happen while a person is sleeping, can affect their sleep quality.
A person is considered to have nocturnal seizures if more than 90 percent of their seizures happen during sleep. This pattern is found in about 12 percent of people with epilepsy.
Any type of epilepsy, including generalized and focal seizure types, can occur as nocturnal seizures. Nocturnal seizures tend to happen during the first, lighter stages of sleep or when waking up.
One MyEpilepsyTeam member described nighttime seizures as a source of fatigue. “I recently had several nocturnal seizures, and I am now very exhausted,” they said. “It will take three days for my body to get back to normal. It takes so much out of you.”
Another member described how nocturnal seizures interrupt their sleep rhythm and cause fatigue the next day: “Does anyone else ever have a seizure in their sleep and find it hard to fall back asleep? Then during the day, it can completely take your energy away.”
There are several stages to a seizure:
Research shows that fatigue is worse after a seizure than during one. People report higher fatigue scores and lower energy in the postictal (after-seizure) phase than in the ictal (during-seizure) phase. In other words, the recovery period after a seizure is a time of intense fatigue.
Many members reported needing to sleep due to intense fatigue during this phase. “I always go to sleep after a seizure,” wrote one member. “It’s often compared to running a marathon. Your muscles are weak, everything hurts, and you are plain tired.”
Some anti-seizure medications (sometimes referred to as antiepileptic drugs, AEDs) are known to cause fatigue or sleep disturbances as side effects. Sometimes, combining different types of drugs can result in dizziness and fatigue. This may mean adjusting your medication or treatment plan to help ease your symptoms. Never make changes to your current treatment plan without talking to your doctor first.
One member responded to another’s question about medication-related fatigue: “When I took one AED, I experienced fatigue, anxiety, fear, anger, and mood swings.” They also offered some advice: “When side effects become unmanageable, it’s time to talk to your neurologist and ask for a drug that has fewer side effects.”
Some medications you may take for other health conditions can also raise the risk for seizures.
Recent studies have looked into whether low levels of vitamin D are linked to fatigue in people with drug-resistant or hard-to-treat epilepsy. The relationship isn’t well understood yet, so more research is still needed. If you’re worried you might be low on certain nutrients, ask your doctor about testing and whether you should take supplements.
Managing fatigue with epilepsy can be challenging because its different causes can be interrelated. Try the following tips to better manage your fatigue.
Keeping a seizure diary or using an app to track your symptoms can be helpful. Note seizure activity, sleep quality, medication timing, and your mood. This information can help you and your healthcare team spot any patterns and adjust treatment as needed.
The British Epilepsy Association published a study that measured fatigue and depression using the Epworth Sleepiness Scale and the Beck Depression Inventory. The results highlighted the importance of managing depression for better fatigue, epilepsy, and seizure management.
Antidepressant medicine may help treat depression. Psychotherapy (talk therapy) and other types of counseling may also be beneficial. Healthy daily habits can help reduce depression symptoms.
One MyEpilepsyTeam member swore by exercise to help depression: “I took a six-mile run this afternoon to help with my depression.”
Another said they rely on a support animal: “Our therapy cat is super sweet and loves to cuddle with me and my wife. She helps alleviate my stress, anxiety, and depression.”
Eating a regular, healthy diet and snacks can help to keep up energy levels and fight off excessive daytime sleepiness. Maintaining a healthy weight and staying hydrated throughout the day may also help boost energy levels.
One member found that following a routine and avoiding seizure triggers had the biggest impact on managing fatigue. “Eat healthily, get eight to ten hours of sleep a night, no alcohol, take medication daily and at the same time every day, and take care of your mental health,” they wrote. “In general, avoid the typical triggers.”
Another member added, “I gave up caffeine after my last seizure and started eating breakfast every morning. Breakfast gives me energy, and I haven’t had a seizure since I started that. Going on six months seizure-free.”
One member lamented the cycle of fatigue, lack of sleep, and seizures: “My husband has a very hard time getting to sleep and staying asleep. When he has a bad night of sleep, he usually has a seizure. Then, he is so exhausted he sleeps almost all day and can’t get to sleep at night, and such is this vicious cycle.”
Following good sleep habits can help you sleep better. Some tips for better sleep with epilepsy include:
According to one MyEpilepsyTeam member, a referral to a sleep clinic might help: “I had a good visit with the sleep clinic on Zoom. If you guys are having trouble sleeping, you should ask for a referral to a sleep clinic. He really took the time to give me tips to improve my sleep without medication.”
While it may seem counterintuitive, gentle physical activity like walking can actually lead to better rest and boost energy. Start small and build up gradually. Even 15 minutes a day can make a difference. Try to finish your workout at least three hours before you want to go to bed.
A MyEpilepsyTeam member suggested yoga for better rest: “Yoga helps you notice what’s happening in your body and helps you gently let go of stress. It helps you learn how to breathe deeply and evenly and what positions are best to help your body rest.”
If epilepsy is making you feel fatigued, talk with your doctor. Together, you can find the best ways to improve your well-being and quality of life. Complementary therapies are treatments used alongside standard care, such as mindfulness or yoga. Your healthcare provider may adjust your epilepsy treatment plan or add complementary therapies to help reduce fatigue.
Fatigue may be part of living with epilepsy, but it doesn’t have to control your life. By understanding causes and making small changes, you can start to feel more energized.
Read about ways to participate in Epilepsy Awareness Month.
On MyEpilepsyTeam, people share their experiences with epilepsy, get advice, and find support from others who understand.
What’s helped you feel more energized while living with epilepsy? Let others know in the comments below.
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Most of the time people who get seizures usually don't know when they have a seizure. Unless though someone who sees you having one.
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