The brain plays a vital role in every function within the human body, and sleep is no exception.

“The relationship between sleep and the nervous system is a two-way street,” says Calvin Stafford, M.D., chief of the Section of Neurology at Taylor Hospital and medical director of the Crozer-Keystone Sleep Center at Taylor. “It’s actually the brain that sleeps. Most neurological disorders have an impact on sleep, and disturbed sleep has an impact on neurological function.”

Some well-known and common sleep disorders, such as REM behavior disorder, Restless Leg Syndrome and narcolepsy, are neurological in nature.

REM behavior disorder is characterized by the sufferer “acting out” dreams during sleep. When we sleep, our muscles go into a temporary state of paralysis. A person who suffers from REM behavior disorder can get up, move their arms and legs, and interact with their environment (or bed partner) while asleep. “The person responds physically to their dreams, which can be hazardous to the bed partner,” Stafford says. He adds that research has found that REM behavior disorder is part of a spectrum of neurodegenerative conditions, and that sufferers have a substantially higher risk of having or developing other neurodegenerative conditions (such as Parkinson’s disease).

Restless Leg Syndrome (RLS) is another neurological condition that affects sleep. It is characterized by an “itchy, crawly, tingling or burning” sensation that causes an urge to move the legs. Sensations usually occur at nighttime (but also can happen during the day) and either prevent the sufferer from falling asleep or cause them to wake up many times throughout the night.

“Most patients who have Restless Leg Syndrome also suffer from a condition called Periodic Limb Movement Disorder,” says Khalid Tabbarah, M.D., CKHS neurologist and physician for the Crozer-Keystone Sleep Center at Taylor Hospital. “PLMD occurs when the person is asleep and causes frequent arousals or ‘micro-arousals’ that negatively affect sleep quality.”

The causes of RLS are largely unknown, but sometimes can be traced back to heredity or an underlying secondary condition — such as kidney failure, neuropathy, iron deficiency and pregnancy. Sometimes, just treating the secondary condition is enough to make RLS go away (and pregnant women usually find relief after they have delivered their baby); however, RLS that is primary in nature can only be managed with medication.

Narcolepsy is a sleep disorder with a neurological basis. It is characterized by falling asleep at “inappropriate” times (such as when working, driving, having a conversation, etc.). Events that should occur during sleep occur during wakefulness and vice-versa. It is a disturbance of the sleep-wake cycle and is characterized by excessive daytime drowsiness, sleep paralysis, hallucinations when falling asleep, and cataplexy (a sudden, temporary loss of muscle control).

“Narcolepsy is a common sleep disorder,” says Annmarie Gaskin, M.D., CKHS neurologist and physician for the Crozer-Keystone Sleep Center at Taylor Hospital. “It seems to run in families and is a genetic disorder. Symptoms usually first appear in a person’s early teens and twenties — although it can occur later in life. Currently, there is no cure for narcolepsy. However, medications are available to combat and control episodes of excessive daytime sleepiness and cataplexy.”

Although it is more of a pulmonary rather than neurological disorder, sleep apnea can have a serious if not life-threatening effect on the brain — in the form of a stroke.

“Anyone who snores, experiences pauses in breathing while asleep, and daytime drowsiness during the day, is at high risk for sleep apnea,” says Kelly Brown, M.D., CKHS neurologist and physician for the Crozer-Keystone Sleep Center at Taylor Hospital. “In addition, those who have untreated sleep apnea are at increased risk for stroke.” Brown explains that treating all of the identifiable risk factors for stroke — such as sleep apnea, obesity, hypertension and atrial fibrillation — is important. “Identifying and treating sleep apnea can improve blood pressure and atrial fibrillation, as well as other conditions associated with stroke,” she says.

Brown, along with Bradley Grayum, M.D., chief of the Division of Neurology at Crozer-Chester Medical Center and co-chairman of the Taylor Hospital Stroke Committee, are currently fine-tuning guidelines for the treatment of patients who have had a stroke to determine their risk of having sleep apnea. “We will be implementing screening techniques and a questionnaire about sleep habits and daytime drowsiness to determine who is a candidate for a sleep study,” Brown says. “By treating a patient’s sleep apnea, we may be able to prevent stroke or heart attack.”

Although other neurological conditions — such as epilepsy, multiple sclerosis (MS) and Alzheimer’s disease — are not sleep disorders, they are very closely connected to sleep (and lack thereof).

For example, it has been proven that sleep deprivation can trigger an epileptic seizure. And people with Alzheimer’s usually “do better” during the day only to become agitated and delusional at night. Insomnia is commonly reported among Alzheimer’s patients. Finally, those with MS experience profound fatigue, disturbed sleep and insomnia. They also may sleep for long periods during the day.

How a Sleep Study Can Help

Sometimes, a detailed medical history and clinical examination are all that is needed to diagnose a sleep disorder. However, “if other conditions — such as snoring — are present, or if you suspect you may have narcolepsy or Restless Leg Syndrome, you may need a sleep evaluation,” Stafford says.

Fortunately, Crozer-Keystone Health System has a comprehensive sleep program with three locations throughout Delaware County for those who are experiencing symptoms of a sleep disorder. For more than 30 years, our multidisciplinary approach has helped thousands of people from all over the Greater Delaware Valley and beyond.

Crozer-Keystone’s unique approach to treating sleep disorders cannot be found at every sleep center. With resources and specialists in the areas of ear, nose and throat, neurology, neuropsychology, oral and maxillofacial surgery and pulmonology, the Crozer-Keystone Sleep Centers are the premier leader in the Delaware Valley for the diagnosis and treatment of all types of sleep disorders.

The Crozer-Keystone Sleep Centers are located at Crozer Health Pavilion at Brinton Lake in Glen Mills, Delaware County Memorial Hospital in Drexel Hill, and Taylor Hospital in Ridley Park. For more information or to request an appointment, call 1-888-SLEEP03 (1-888-753-3703) or visit http://sleepcenters.crozer.org.