Although epileptic seizures can sometimes happen randomly and without warning, many people find that certain factors — known as triggers — can make their seizures more likely to happen. These triggers vary widely from person to person. Possible seizure triggers can include a specific sight or sound, a substance, or a physical condition, such as having low blood sugar.

It’s important to remember that triggers don’t cause epilepsy. Epilepsy can stem from causes such as genetics, illness, or brain injury. Instead, triggers are circumstances that put your brain into a state that makes seizures more likely to happen. Identifying and understanding your own seizure triggers is a key step in managing epilepsy.

Read on to learn about 10 common seizure triggers and practical tips on how you can avoid them.

A seizure trigger can be a specific sight or sound, a substance, or a physical condition, such as having low blood sugar.

Common Seizure Triggers

Because everyone’s brain and body are different, what triggers seizures for one person may not affect someone else. Here are 10 of the most common seizure triggers.

1. Missed Medication

Skipping doses of anti-seizure medications (ASMs) is one of the most common seizure triggers. ASMs work by preventing seizure activity in the brain, but they’re only effective when taken as prescribed. Missing a dose or taking the wrong dose can lower medication levels in your bloodstream and trigger seizures.

2. Stress

Emotional or psychological stress — including anxiety, anger, depression, or other intense emotions— is another common seizure trigger. Stress can also indirectly contribute to other triggers, such as lack of sleep.

3. Inadequate Sleep

Lack of sleep is one of the most common triggers for epileptic seizures. Lack of sleep can happen for many reasons:

• A change in schedule
• Insomnia
• Medication side effects
• Poor sleep quality
• Consumption of alcohol or caffeine
• Seizures that happen during sleep

4. Alcohol

Drinking alcohol consumption can raise the risk of seizures. Some people with epilepsy can tolerate small amounts of alcohol, but others may have seizures after just one drink. Binge drinking — drinking until you’re intoxicated — is a very common trigger. Seizures related to alcohol can happen a few hours after drinking and up to 48 hours after heavy drinking stops. Alcohol can also interfere with how your anti-seizure medications work and worsen sleep quality, which can make seizures more likely.

5. Caffeine, Nicotine, and Other Substances

Caffeine and nicotine are stimulants that — especially at higher doses or in susceptible individuals — may lower the seizure threshold, making seizures more likely. Common sources of caffeine include coffee, tea, soda, and chocolate, though individual responses and risk vary.

When taken in large amounts, caffeine and other stimulants can make the brain more excitable. Recreational, illicit drugs such as cocaine, amphetamines, and MDMA (ecstasy or molly) can also trigger seizures in people with epilepsy.

Some medications, including certain over-the-counter options, may increase your seizure risk or interact with your antiseizure medications. Always check with your healthcare provider or pharmacist before starting a new medication or supplement to make sure it won’t interfere with your epilepsy medication.

6. Flashing Lights

Flashing lights and certain visual patterns — like contrasting colors or alternating patterns of different colors — can trigger seizures in some people with photosensitive epilepsy. The frequency and type of flashing light that triggers seizures varies from person to person. Sometimes, high-contrast geometric patterns can also trigger these types of seizures.

7. Low Blood Sugar

Hypoglycemia (low blood sugar) can also trigger seizures. Skipping meals or eating at irregular times can cause blood sugar levels to rise and fall, increasing seizure risk.

8. Time of Day

Some people have seizures at specific times of day or night, including while they’re sleeping.

9. Hormonal Changes

During a normal menstrual cycle, levels of the hormones estrogen and progesterone rise and fall. These hormone shifts can be a seizure trigger.

One MyEpilepsyTeam member shared, “I started my period when I was 12, and I had my first seizure that same day. The seizures would last until my period stopped, then they would start all over again next month.”

10. Fever and Illness

High fever from an infection or illness can cause febrile seizures. Children are more likely to experience febrile seizures than adults. Having a febrile seizure in childhood does not necessarily mean the child has or will develop epilepsy.

If you have an upset stomach or are vomiting due to illness, it may be difficult to take or seizure medications and keep them down.

Read more about what to do if you vomit a dose of ASM.

How To Identify Your Seizure Triggers

Identifying your personal triggers is the first step toward avoiding them. Tracking what tends to bring on your seizures can also help your neurologist or other healthcare provider fine-tune your diagnosis and determine the best epilepsy treatment options for you.

Try keeping a seizure diary to help you find patterns. If you can’t record your seizures yourself, ask a family member or caregiver to help you track them. Each entry should include:

• The time of day your seizure happened
• What you were doing beforehand
• When you last took your medication
• What you ate or drank recently
• How much sleep you had

Try keeping a seizure diary to help you find patterns. Share this information with your doctor.

Share your notes regularly with your doctor. The more details you collect, the easier it will be to uncover your personal triggers.

How To Avoid Seizure Triggers

Once you know what tends to trigger your seizures, you can take steps to avoid or minimize those triggers.

1. Take Your Medication as Prescribed

Always take your prescribed anti-seizure medication exactly as directed — the right dose at the right time. Never adjust the dosage or stop taking any antiepileptic medication without consulting your doctor.

To help you stay consistent:

• Use a pillbox to keep track of daily doses.
• Keep a calendar to track your doses.
• Set alarms or reminders on your phone.
• Use an app designed to help manage your medications.

Read about what to do if you accidentally take an ASM twice.

2. Manage Stress

Stress can trigger seizures, so finding ways to manage it is an important part of epilepsy care. While you can’t always control what causes emotional or psychological stress, you can work on identifying stressors and reducing their impact on your mind and body.

Helpful stress management techniques include:

• Practicing relaxation methods such as meditation or deep breathing
• Getting regular exercise
• Keeping a healthy sleep routine

If stress or anxiety feels overwhelming, consider talking with a psychologist, counselor, or therapist. Professional support can help you develop coping strategies and improve your overall well-being.

3. Prioritize Sleep

A good night’s rest is essential for brain health — especially if you’re living with epilepsy. Good sleep hygiene can include going to bed and waking up at the same time every day, avoiding screens or bright lights in bed, and avoiding caffeine, other stimulants, alcohol, and large meals before bedtime.

Some common triggers can be avoided by keeping to a schedule that helps you take your anti-seizure medication on time and get regular sleep.

4. Limit Alcohol

Avoiding alcohol is the safest way to prevent alcohol-triggered seizures. Drinking heavily or binge drinking raises seizure risk. If you drink regularly, quitting suddenly can also cause withdrawal-related seizures.

If you’re worried you may be dependent on alcohol, talk with your doctor before stopping to make sure you do so safely.

5. Avoid Caffeine, Nicotine, and Other Substances

If caffeine or nicotine trigger your seizures, cutting back or eliminating them may help reduce your risk. It’s also best to stay away from recreational or illicit drugs, such as cocaine or amphetamines, which can directly cause seizures.

6. Avoid Flashing Lights

If you have photosensitive epilepsy, talk with your doctor about what specific types of flashing lights or visual patterns may trigger seizures for you. Your doctor may use a test called an electroencephalogram (EEG) to help identify these specific triggers.

If it’s not possible to completely avoid light triggers, you can sometimes lower your risk of having a seizure by covering one eye or turning away from the light source.

7. Modify Eating Habits

Maintaining a healthy, balanced diet supports overall well-being and may help reduce seizure risk. Try to avoid foods or habits that trigger seizures for you, and prevent low blood sugar by eating regular, balanced meals.

For some people, a ketogenic diet, or keto diet — a high-fat, low-carbohydrate eating plan — can help control seizures, especially when antiepilepsy medication doesn’t work. However, this is a very restrictive diet that requires medical supervision. Consult your doctor before making major dietary changes, including starting a ketogenic diet.

8. Plan Around Your Menstrual Cycle

Certain hormonal birth control methods may help prevent seizure triggers by stabilizing hormone levels. Your doctor may also adjust your dose of anti-seizure medication or recommend additional medications at specific times during your cycle to help prevent seizures.

9. Treat at the First Sign of Illness

Although it’s not possible to simply avoid getting sick, taking care of yourself early can help reduce the risk of seizure activity. At the first sign of fever, infection, or another illness:

• Stay hydrated and get plenty of rest.
• Eat nourishing foods and continue taking your medications as prescribed.
• Check with your doctor or pharmacist about possible drug interactions, especially with antibiotics or new medications.
• Seek medical care if your symptoms don’t improve or if you can’t keep your medications down.

Talk With Others Who Understand

On MyEpilepsyTeam, people share their experiences with epilepsy, get advice, and find support from others who understand.

What’s the most surprising seizure trigger you’ve discovered? Let others know in the comments below.