Another key factor in managing epilepsy is identifying and avoiding potential triggers of seizures. These are factors that are believed to increase the risk of having a seizure. It may or may not be related to the underlying cause of the epilepsy. Triggers for seizures vary from person to person, and some people may not have any identifiable triggers.

Potential triggers of seizures that patients with epilepsy may wish to avoid include:

• Lack of sleep. One of the most common triggers of seizures in patients with epilepsy is sleep deprivation, although the reason for this is unclear. The relationship between epilepsy and sleep is complex. Getting too much or too little sleep can make people more susceptible to seizures. However, getting adequate sleep can be difficult if seizures occur at night or if side effects of seizure medications cause sleep disturbances. Despite these difficulties, many people find that regulating their sleep patterns (i.e., going to sleep at the same time every night, avoiding caffeine before bedtime) helps to control their seizures.
  
  
• High stress. Stress appears to be linked to an increased likelihood of seizures in people with epilepsy, although scientists are still working to understand the nature of this relationship. When stress cannot be avoided, patients with epilepsy are advised to take certain actions that help them to relax. This may include deep breathing, massage and listening to soft music. A positive attitude and a sense of humor can also help reduce the effects of stress, and the likelihood that it may trigger seizures in people with epilepsy.
  
  
• Lack of physical activity. Regular exercise appears to lessen the incidence of seizures in patients with epilepsy. The reason for this is unclear, although it may have to do with the ability of physical fitness to improve sleep and help reduce stress. It is important to note that not all activities may be appropriate or advisable for individuals with epilepsy. For example, certain sports (e.g., swimming, mountain climbing) may be hazardous to individuals with poorly controlled seizures.
  
  
• Poor nutrition. Diet appears to play a role in triggering seizures among some patients with epilepsy. In these cases, a ketogenic (low-carbohydrate, low-protein and high-fat) diet may help, although patients should talk to their physician before making any significant changes to their diet.
  
  
• Alcohol and drugs. The amount of alcohol that can trigger a seizure may vary from person to person. Generally, people with epilepsy are advised not to consume large amounts of alcohol. However, for some people, one alcoholic drink could trigger a seizure. A more significant concern for some patients is that alcohol can interact with some types of seizure medications, making the medication ineffective or increasing its side effects. In addition, many illegal drugs (e.g., cocaine, ecstasy) lower a person’s seizure threshold, making people with epilepsy more susceptible to recurrent seizures. In some cases, seizures occur after a person stops drinking or taking drugs.
  
  
• Exposure to flickering light. A small proportion of people who have recurrent generalized seizures are particularly sensitive to light (photosensitive). Television screens, computer games and strobe lights are common sources of flickering light, although the amount of light stimulation needed to trigger a seizure can vary from person to person. Studies indicate that lights that flash between five and 30 times per second are most likely to trigger seizures in people who are photosensitive.
  
  Patients with photosensitivity are encouraged to be aware of any potential light triggers (e.g., a flickering light bulb over a desk) and to adjust or avoid these environments. The use of sunglasses when outdoors may help limit exposure to sunlight that may be seen as flickering as it passes over certain objects (e.g., tree branches, street signs).
  
  
• Certain physical stimuli. In some cases, certain sounds or sensations may trigger seizures in patients with epilepsy. This may include sounds such as loud ringing, some voices or certain types of music. Sudden movement, such as being jostled on an escalator, or sensations such as heat, may also sometimes provoke seizures.
  
  
• Certain hormonal activity and hormone medications. Seizures appear to occur more frequently among women with epilepsy during menstruation or ovulation. In addition, certain hormone medications may also trigger seizures.