Sleep Disorders During Pregnancy: Seizures and Sleepwalking Concerns

The wife is pregnant with her second child and experiences symptoms during sleep similar to seizures (unconsciousness, neck stiffness, eyes open, and drooling or vomiting gastric acid) as well as sleepwalking symptoms?

Hello Doctor: My wife is currently about 5 weeks pregnant with our second child, and our first child is about 1.5 years old (born via cesarean section).
During her first pregnancy, she occasionally experienced sleepwalking at night.
This time, during her second pregnancy, she experienced symptoms similar to seizures (unconsciousness, neck stiffness, eyes open, and drooling or vomiting stomach acid) early in the morning on January 3rd.
My wife has never had seizures before, nor is there a family history of such conditions.
Is this a normal occurrence during pregnancy that will resolve postpartum, or are there any precautions we should take to reduce the likelihood of these symptoms? Thank you.

Mr. Wang, 30~39 year old female. Ask Date: 2019/01/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My wife is currently about 5 weeks pregnant with our second child, while our first child is about 1.5 years old (born via cesarean section).
During her first pregnancy, she occasionally experienced sleepwalking at night.
This time, during the early morning of January 3, 2019, she exhibited symptoms similar to seizures (unconsciousness, neck stiffness, eyes open, and salivating or vomiting stomach acid) along with sleepwalking symptoms.
My wife has never had seizures before, nor is there a family history of such conditions.
Is this a normal occurrence during pregnancy that will resolve postpartum, or are there any precautions we should take to reduce the likelihood of these symptoms?
Answer: This is not a normal occurrence during pregnancy; she should visit a medical center for a high-risk pregnancy consultation.

Reply Date: 2019/01/03

More Info

Sleep disorders during pregnancy can be a significant concern for many women, particularly when symptoms such as seizures or sleepwalking arise. In your wife's case, experiencing episodes of sleepwalking and what appears to be seizure-like activity during her second pregnancy is understandably alarming. It is essential to address these symptoms with a comprehensive understanding of their potential implications and management strategies.

Firstly, it is important to differentiate between sleepwalking (somnambulism) and seizures. Sleepwalking typically occurs during the non-REM sleep phase and is characterized by complex behaviors while the individual remains in a state of partial arousal. On the other hand, seizures, particularly generalized tonic-clonic seizures, involve a loss of consciousness, muscle rigidity, and may include involuntary movements, tongue biting, or loss of bladder control. The symptoms you described—neck stiffness, open eyes, and the expulsion of saliva or gastric contents—could suggest a seizure rather than sleepwalking, especially since your wife has no prior history of seizures or family history of epilepsy.

Pregnancy can bring about various physiological changes that may influence sleep patterns and neurological function. Hormonal fluctuations, increased stress, and physical discomfort can all contribute to sleep disturbances. Additionally, conditions such as pregnancy-induced hypertension or preeclampsia can lead to neurological symptoms, including seizures. Therefore, it is crucial for your wife to be evaluated by a healthcare professional, preferably a neurologist or an obstetrician with experience in managing high-risk pregnancies, to rule out any underlying conditions that may require intervention.

In terms of management, if these episodes are confirmed to be seizures, your wife's healthcare provider may consider a range of options. This could include monitoring her condition closely, lifestyle modifications, and potentially medication if the episodes are frequent or severe. It is essential to ensure that any medication prescribed is safe for use during pregnancy, as some antiepileptic drugs can pose risks to fetal development.

Furthermore, maintaining a healthy sleep environment and practicing good sleep hygiene can help improve overall sleep quality. This includes establishing a regular sleep schedule, creating a comfortable sleep environment, and minimizing stress through relaxation techniques such as prenatal yoga or meditation.

In conclusion, while some sleep disturbances can be common during pregnancy, the specific symptoms your wife is experiencing warrant immediate medical attention. It is crucial to obtain a proper diagnosis and treatment plan to ensure both her health and the health of the developing fetus. Open communication with healthcare providers and monitoring her condition closely will be vital in managing these symptoms effectively.

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