Can You Stop Breathing During A Seizure?

Breathing can stop during some types of seizures. This is a medical emergency called ictal apnea. It happens when the part of the brain that controls breathing is disrupted by the seizure activity.

The term sounds frightening, and it is serious. But not all seizures cause breathing to stop. And when it does happen, it is usually brief. The body often resumes breathing on its own. The key is knowing what to watch for and what to do.

What Does It Mean to Stop Breathing During a Seizure?

Stopping breathing during a seizure is not the same as choking. The airway is not blocked. The brain simply stops sending the signal to breathe. This is known as central apnea.

It occurs most often during generalized tonic-clonic seizures. These are the seizures where a person loses consciousness and has stiffening and jerking movements. During the tonic phase, the chest muscles contract. Air cannot move in or out. The person may turn blue or gray, especially around the lips. This is called cyanosis.

Research published in the journal Neurology found that about one-third of people with epilepsy show some breathing impairment during seizures recorded in monitoring units. In most cases, oxygen levels dropped but returned to normal without help. The body has built-in protective reflexes that usually kick in after 30 to 60 seconds.

Can You Stop Breathing During a Seizure and Not Wake Up?

This is the question that worries people most. The answer is yes, it is possible. It is called sudden unexpected death in epilepsy, or SUDEP. It is rare but real.

The CDC estimates that about 1 in 1,000 adults with epilepsy dies from SUDEP each year. Among people with poorly controlled tonic-clonic seizures, the risk is higher. Breathing that does not restart after a seizure is believed to be the main cause.

But here is what the evidence actually says. Most people who stop breathing during a seizure do wake up. The brain does not simply forget to breathe forever. In SUDEP cases, researchers believe multiple things go wrong at once. Breathing stops, the heart rhythm becomes abnormal, and the person cannot be aroused from the post-seizure state.

This is not something that happens with every seizure. It is more likely in people who have frequent nighttime seizures, who sleep on their stomach, or who miss their seizure medications. The Epilepsy Foundation reports that taking medication as prescribed reduces SUDEP risk by more than 60 percent.

What Types of Seizures Cause Breathing to Stop?

Generalized tonic-clonic seizures carry the highest risk. The stiffening phase locks the chest wall. The jerking phase does not allow normal breathing patterns. After the seizure ends, there is a period called the postictal phase. During this time, breathing can be shallow or irregular. Some people stop breathing again during this phase.

Focal seizures that start in the temporal lobe can also affect breathing centers. But the effect is usually less dramatic. The person may appear to hold their breath briefly or have shallow breathing. It rarely causes cyanosis.

How Can You Tell If Someone Has Stopped Breathing During a Seizure?

You do not need a medical device to know. Look for these signs:

• No chest movement for more than 10 seconds
• Lips or face turning blue, gray, or pale
• No sound of breathing when you put your ear near their mouth
• No air felt on your cheek when held near their nose
• After the jerking stops, they remain limp and do not start breathing

Time it. Most seizures last less than two minutes. If the active seizure continues past five minutes, it is status epilepticus. This is a medical emergency. Call 911 immediately.

If the seizure ends but the person does not start breathing within 30 seconds, call 911. Begin CPR if you are trained. The American Heart Association recommends hands-only CPR for adults who are unresponsive and not breathing normally. Push hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute.

A common mistake is putting something in the person’s mouth. Do not do this. People do not swallow their tongue. Objects in the mouth can break teeth or block the airway. Roll the person onto their side after the jerking stops. This helps keep the airway clear and allows fluid to drain.

What Can You Do to Reduce the Risk of Breathing Problems During Seizures?

Medication adherence is the single most effective step. The Epilepsy Foundation states that consistent use of anti-seizure medications prevents seizures in about 70 percent of people. Fewer seizures means fewer chances for breathing to stop.

Sleep position matters. People who have nighttime seizures should avoid sleeping on their stomach. The American Academy of Neurology advises that people with epilepsy sleep on their back or side. There are devices like seizure detection pillows and wearable monitors that alert caregivers if a seizure occurs during sleep.

Seizure first aid training is worth taking. Many local epilepsy organizations offer free classes. Knowing what to do in the moment reduces panic and improves outcomes. If you live with someone who has epilepsy, learn CPR. It is a skill that takes a few hours to learn and could save a life.

Some studies suggest that oxygen levels drop more in people who have seizures while lying face down. If you care for someone with epilepsy, check on them during the night. A simple baby monitor with video can alert you to unusual movements or sounds.

Common Misconceptions About Breathing and Seizures

The most persistent myth is that you can stop a seizure by holding the person down or putting something in their mouth. Neither works. Seizures are electrical storms in the brain. Physical restraint does not stop them. It can cause injury to both the person having the seizure and the person trying to help.

Another myth is that if someone stops breathing during a seizure, they are dead. This is not true. The body has survival reflexes. Most people resume breathing within seconds to a minute. The color returns. They wake up confused and tired but alive.

There is also a widespread belief that all seizures cause breathing problems. This is false. Absence seizures, which look like staring spells, do not affect breathing at all. Focal aware seizures, where the person remains conscious, rarely cause any breathing changes. Only certain types of seizures carry the risk of respiratory arrest.

Some people believe that giving rescue breaths during a seizure helps. It does not. The problem is not that the lungs cannot take in air. The problem is that the brain is not telling the body to breathe. Rescue breaths may push air into the lungs, but they do not restart the brain’s breathing signal. Once the seizure ends and the brain recovers, breathing starts on its own. Rescue breaths are only needed if breathing does not restart after the seizure ends.