Epilepsy and shift work: recording seizures and sleep beside your shifts, UK occupational health and US reasonable accommodation
Epilepsy and shift work: how to record seizures and sleep beside your shifts, UK occupational health and US reasonable accommodation for your rota. General info.
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If you work shifts or nights with epilepsy, the question everyone wants answered is whether your seizures connect to your shifts and your sleep. That link is hard to see from memory and easy to see from a record kept beside your rota. You can keep it on paper or in the epilepsy program in Sam, a diary with its own doctor report, where an entry made today brings in sleep, resting heart rate and heart rate variability from Apple Health when a value exists. Whether night shifts suit you is decided by professionals, not by an app.
This is general information, not legal advice for your situation. In the UK, get advice from Acas, Citizens Advice or your union, and talk to occupational health and your neurologist. In the US, the Equal Employment Opportunity Commission (EEOC) and the Job Accommodation Network (JAN) explain accommodation rights, and your neurologist advises on your case.
Why shift and night work matter in epilepsy
Epilepsy Action lists tiredness and poor sleep as common seizure triggers for many people, and shift work can make regular sleep harder. It must be judged in your individual case, not assumed from a general rule. A 2024 study using UK Biobank data, published in BMC Public Health, found that usual or permanent night shift work and poor sleep quality were associated with a higher risk of newly developing epilepsy. The night-shift trend was borderline and the study is observational, so it describes large groups and says nothing about you as one person. It only explains why sleep is taken seriously here.
What makes the difference for you is a record that shows what actually happened beside your rota.
How to record seizures beside your shifts
For a link to appear, your record must hold at least three things for each seizure:
- The date and time.
- The shift around it, whether night, day or rotating.
- How long you slept before it, and when that sleep was.
Only when those facts lie side by side can a pattern show. A seizure after a long night shift with little sleep only becomes visible if the shift and the sleep sit in the same entry or on the same date. You do not need to interpret the link. Just place the facts unlabelled.
Symptom entries that belong to no specific diagnosis go in the symptom diary as dated entries, even without a program.
Who decides whether night shifts fit you
It is a professional judgement. In the UK, occupational health assesses how your work affects your health, and how your health affects your work. It suggests reasonable adjustments and input to your risk assessment. Your neurologist adds the epilepsy side.
In the US, your doctor and your employer work through an accommodation process. In either country, your job is the material: a complete, long record of seizures, time, shift and sleep. Weeks and months of data support a firmer assessment than an acute episode alone. For the wider record, see how to track seizures and tracking with your doctor and living with epilepsy: sleep, triggers and daily routines.
Reasonable adjustments in the UK
In England, Scotland and Wales, the Equality Act 2010 requires employers to make reasonable adjustments to remove or reduce a disadvantage linked to your disability, where it is reasonable to do so. In Northern Ireland the Disability Discrimination Act applies instead. Acas lists changing working patterns, distributing breaks more evenly, flexible working, phased returns and paid time off for appointments as examples.
Occupational health assessments are a common part of this process and can feed the risk assessment. An employer does not have to do what is unreasonable, but it must still support you in other reasonable ways. Epilepsy Action notes that flexible working, such as staggered hours, is one kind of adjustment.
Reasonable accommodation in the US
Under the Americans with Disabilities Act, an employer with 15 or more employees must provide a reasonable accommodation for a known disability unless it would cause undue hardship. The Job Accommodation Network says an employer must provide a modified or part-time schedule when it is required as a reasonable accommodation, and the EEOC says an employer must consider each request. Some state disability laws also cover employers with fewer than 15 employees, so ask about your state's rules too.
You do not need special words to ask. Explain plainly that a change would help because of your medical condition, such as avoiding or reducing shifts that disrupt your sleep. A letter from your neurologist helps document the need. Related leave and documentation sit in our guide to intermittent leave for migraine and epilepsy.
Night work protections in the UK
If you are a night worker in the UK, the law caps your hours. Northern Ireland's nidirect page gives the same limits. GOV.UK says a night worker must not work more than an average of 8 hours in a 24-hour period, usually averaged over 17 weeks, and you cannot opt out of that limit. Where night work involves special hazards or heavy physical or mental strain, the limit is 8 hours in any 24-hour period, with no averaging.
Employers must offer a free health assessment before you become a night worker and regularly afterwards. If a health professional confirms that night working has affected your health, the employer must look for other suitable work where possible. How often you are assessed depends on the results for you.
When to get help or call the emergency number
A seizure can become an emergency. The NHS says to call 999 if it is a first seizure, if it lasts longer than is usual for you (or longer than five minutes if you do not know how long your seizures usually last), if you do not regain full consciousness or have several seizures without recovering, or if you are seriously injured or have difficulty breathing afterwards. Use your local emergency number, 999 in the UK, 911 in the US, 112 in the EU.
The daytime sleep after a night shift is often short and broken. Record it anyway, because it is part of the picture your team can see. Sam does not detect seizures and does not judge whether you can work shifts. For the first weeks after a diagnosis, see epilepsy newly diagnosed: what now.
Log seizures, sleep and shifts in Sam and take them with you
You arrive with a record in which seizures stand next to your shifts and your sleep, not a story rebuilt from memory.
- Instead of paper: each seizure is an entry with date and time, and for today's entries sleep, resting heart rate and heart rate variability come from Apple Health when a value exists.
- Instead of memory: the doctor report as a PDF covers the period you choose and shows how many seizures were at night.
- Instead of a separate sleep list: the epilepsy program keeps the context in one place, so your team and occupational health have your seizures, shifts and sleep in one place to look through.
Sam makes no judgement about whether you can work nights. Your occupational health and neurology team, with your employer, decide that; your record is the material they use.
Try Sam for freeSam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.
General information, not legal advice. Laws, deadlines and agency practice change, and your case may differ. Before applications, deadlines and conversations with employers, insurers or agencies, get advice from an adviser or lawyer. Legal state: October 2026.
Related reading
- Epilepsy newly diagnosed: your first weeks
- Living with epilepsy: triggers, sleep and daily routines
- Sleep and epilepsy triggers
Sources
Updated: October 2026
- nidirect: Working at night
- GOV.UK: Night working hours: hours and limits and Night working hours: health assessments
- Acas: Reasonable adjustments at work (last updated 30 January 2025)
- Epilepsy Action: Work and epilepsy (last modified July 2026) and Seizure triggers
- NHS: What to do if someone has a seizure (fit)
- Job Accommodation Network: Modified schedule
- U.S. Equal Employment Opportunity Commission: Epilepsy in the workplace and the ADA
- Dong X. et al.: Night shift work, poor sleep quality and unhealthy sleep behaviors are positively associated with the risk of epilepsy disease. BMC Public Health 2024;24:3166 (UK Biobank)
More on Epilepsy
Frequently Asked Questions
Can I work night shifts with epilepsy?+
No one decides that for you here. Epilepsy Action lists tiredness and poor sleep as common seizure triggers, and shift work can make regular sleep harder, so the question must be judged in your individual case. Your neurologist, occupational health in the UK or your doctor and employer in the US, with a good record, are the ones to assess it. Sam makes no judgement.
What do I record if I have a seizure while working shifts?+
For each seizure record the date and time, the shift around it (night, day or rotating), and how long you slept before it and when that sleep was. Only when those facts sit side by side can a link appear. You do not need to interpret the pattern; just place the facts unlabelled.
Can my employer change my shift pattern because of epilepsy in the UK?+
In England, Scotland and Wales, the Equality Act 2010 requires an employer to make reasonable adjustments to reduce a disadvantage linked to your disability; in Northern Ireland the Disability Discrimination Act applies instead. Acas lists changing working patterns, spreading breaks, flexible working and paid time off for appointments as examples. Whether a change to your rota is reasonable depends on your situation and your employer.
Does the US have an equivalent for a shift change?+
Yes. Under the Americans with Disabilities Act, an employer with 15 or more employees must provide a reasonable accommodation for a known disability unless it would cause undue hardship. The Job Accommodation Network says an employer must provide a modified or part-time schedule when it is required as a reasonable accommodation, and the EEOC says an employer must consider each request. Some state disability laws also cover employers with fewer than 15 employees, so ask about your state's rules too. Ask in plain terms what change would help.
Are there protections for night workers in the UK?+
Yes. GOV.UK says a night worker must not work more than an average of 8 hours in a 24-hour period, usually averaged over 17 weeks, and cannot opt out of that limit. Where the work involves special hazards or heavy physical or mental strain, the limit is 8 hours in any 24-hour period, with no averaging. Employers must offer a free health assessment before you start night work and regularly afterwards. If night work has affected your health, the employer must look for other suitable work where possible.
Is there research linking night shift work and epilepsy?+
A 2024 study using UK Biobank data, published in BMC Public Health, found that usual or permanent night shift work and poor sleep quality were associated with a higher risk of newly developing epilepsy. The night-shift trend was borderline and the study is observational, so it shows an association in large groups, not a prediction about you. It only explains why sleep is taken seriously here.