For people with epilepsy and their loved ones, staying on schedule with medication is key for preventing seizures. But sometimes an epilepsy treatment schedule may need to be adjusted due to a time change or travel.

One MyEpilepsyTeam member reached out to others to ask about adjusting their medication time. “I’ve heard different opinions, and I’m about to email my neurologist. But I’m curious what you all do! Start taking it an hour before so it’s accurate with what the normal time would be, or keep it where it’s at?”

Your neurologist can advise you on how best to stay on schedule with your or your child’s particular treatment plan during a time change. Here are some rules of thumb you can discuss further with your doctor about adjusting medication for a different time zone. These are also worth considering if the time change is due to daylight saving time.

Why It’s Essential To Stay on Schedule With Epilepsy Treatment

Epilepsy medication needs to be taken on a regular schedule to be as effective as possible in preventing breakthrough seizures — seizures that occur even when the condition has been controlled with medication over a period of time. Epilepsy drugs must be taken every day and are prescribed by your doctor to be taken at specific times. A study in the Journal of Epilepsy Research indicated that approximately 34 percent of breakthrough seizures in children occurred when medications weren’t taken as directed.

Missing Even One Dose Matters

If medication isn’t taken exactly as prescribed, there is a higher risk of seizures and side effects. Even skipping or changing the schedule of a single dose of epilepsy medication raises the risk of a seizure, a cluster of seizures, or longer seizures, depending on how often medication is taken.

If you or your child takes medication just once a day rather than multiple times a day, skipping a single dose or changing the medication time has higher risks. In severe cases, missing a dose may result in status epilepticus — a prolonged seizure — which is a medical emergency.

Medication and Daylight Saving Time

Daylight saving time starts when clocks are set to “spring forward” an hour later on the second Sunday in March. They’re set to “fall back” an hour behind on the first Sunday in November to standard time. If someone were to stick to their usual time for taking medication after the clocks change, the overall change would be a one-hour difference.

Research is limited on the effects of daylight saving time changes on epileptic seizures. However, one large study published in the journal Epilepsia did not show an association between daylight saving time transitions and an increased rate of seizures in people with epilepsy.

For most people, a one-hour change in an epilepsy medication schedule is safe. Depending on what your doctor recommends, you can probably stick to the same time schedule for medication when the clocks change. But to be sure, it’s a good idea to discuss clock changes with your doctor and follow any recommendations they give you.

Different members of MyEpilepsyTeam handle the change in different ways. “When we change to daylight saving time this weekend, I’m resetting my alarms, not the pill time,” shared one member. “Technically, pill time never changes, the ‘hour’ does.”

Managing Sleep Disturbance With Daylight Saving Time

If you or your child are particularly sensitive to sleep disturbance, the time change in March when clocks are set an hour later may affect your or your child’s sleep schedule. When clocks move an hour ahead, you lose an hour and may have trouble getting enough sleep due to a change in the circadian rhythm — the brain’s internal clock that helps regulate sleep.

To be sure you get the extra hour of sleep you need, some experts advise waking up 15 or 20 minutes earlier than usual in the week before the time change. Spending time outside can also help the body adjust to changing light and time. Your doctor can also help you or your child prepare for a time change, if sleep sensitivity is a seizure trigger.

Changing Time Zones and Medication Schedules

Travel across time zones may impact your medication schedule, especially if the time difference is three hours or more. A trip that changes one or two time zones (hours) may not be a problem, and you may be able to safely take your medication at the same time you would at home. If you ordinarily take your medication at 8 a.m., you could continue to take it at 8 a.m., even though you’re in a different time zone.

If you’re more sensitive to time changes, your doctor may advise you to stick to your home time for your medication. For instance, if you normally take medication at 8 a.m. at home and you travel to a time zone that’s two hours ahead, you would take your medication at 10 a.m. — which would be 8 a.m. at home — to maintain your home time schedule. However, it’s important to get medical advice for your or your child’s particular needs.

Traveling Through Multiple Time Zones

Longer trips can cause time zone changes of three or more hours, especially if you or your child are traveling internationally. Your doctor may advise a gradual change to your medication schedule before your trip or in the first few days at your destination. Otherwise, the usual time for your medication may be in the middle of the night in the new time zone, which would not be practical. Your neurologist can advise you on the best way to adjust medication for trips across multiple time zones.

A MyEpilepsyTeam member shared how they adjust their medication when traveling across several time zones: “When I fly home to the East Coast, I generally know well in advance — three-hour time difference, and my destination is three hours ahead. Prior to flying, I gradually get my meds on the destination time zone. That way, it’s only when I fly home that causes disruptions. I gradually get myself back on Mountain time.”

Plan Ahead and Take Precautions With Time Changes

If you or your child will be traveling to another time zone, or if you are concerned about a time change, talk to your health care team as early as possible. Determining medication needs well in advance can help ensure a safe and smooth transition during a time change.

If possible, reach out to your neurologist as early as two months before traveling. If you or your child are on any new medications, be aware that you may need time to adjust to those as well. Make sure you have enough rescue medication on hand.

Here are some travel tips that can help you prepare, particularly if you’re crossing multiple time zones:

• Talk to your doctor about your destination and time zone changes.
• Get travel insurance so you have health coverage when you’re away from home.
• For international trips, find out if there are any restrictions on taking your medication with you, particularly if any drugs are considered controlled substances.
• Try to find out if your medication is available at your destination.
• Determine if you need any vaccinations for travel to another country.

During travel, you can take these important precautions:

• Always carry medication in carry-on bags, and set alarms for taking medication.
• Plan ahead to keep medication cool, if necessary.
• If you’re concerned about seizures while flying, talk to airline staff ahead of time.
• Let airport security staff know if you or your child have a vagus nerve stimulation device.
• Consider wearing medical alert jewelry.

Traveling can be stressful, so it’s essential to be extra careful about staying on the medication you and your doctor have determined is appropriate. It can be helpful to write down any instructions your doctor has given you. Checking off medications you have taken on a chart or seizure calendar can help you be sure you’re staying on schedule. A pillbox can also help you keep track of daily medication needs while traveling.

Jet Lag and Sleep Deprivation May Trigger Seizures

Long flights across multiple time zones can cause jet lag — which can cause extreme tiredness and a lack of sleep. This may trigger seizures for some people with epilepsy.

“​​Thinking of traveling overseas soon, and my kids have epilepsy. Since they’re triggered by sleep deprivation, I’m worried that the travel will exhaust them. The travel time is like 20 hours,” a MyEpilepsyTeam member wrote.

Adjusting your sleep cycle a few days before travel may help you adapt more quickly to your destination. Some experts recommend going to bed one or two hours earlier than your usual bedtime if traveling west, and going to bed an hour or two later if you’re traveling east.

Once you’re in a new time zone, eat small meals, avoid alcohol, drink plenty of water, and take short naps. Longer naps may make it hard to adjust to the local time. Your neurologist can provide additional information on how best to manage jet lag and sleep problems that may trigger seizures.

Find Your Team

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. More than 120,000 members come together to ask questions, give advice, and share their experiences with others who understand life with epilepsy.

How have you adjusted your medication with time changes or travel? Do you have any travel tips for others? Share what’s worked for you or your child in the comments below or by posting on your Activities page.