Chiropractic is well known for the management of pain in the back, neck, arms, and legs, but what about enhancing sleep quality? Chronic, long-term sleep-related disorders affect an estimated 1.5 million Americans each year and account for an estimated $16 billion in medical costs annually, not including indirect costs due to lost productivity and other factors! Sleep deprivation can interfere with work, driving, social activities, overall quality of life, and even cause serious health problems (even a shorter lifespan!). With over 80 defined sleep disorders, insomnia (difficulty falling asleep, staying asleep, and/or poor sleep quality) is one of the most common followed by sleep apnea (interrupted breathing while sleeping), restless-leg syndrome (tingly/prickly leg sensations), and narcolepsy (daytime “sleep attacks”).
According to the National Institutes of Health (NIH), sleep is a “neurobiologic need.” Think of it like recharging a battery, except the battery is your brain! The optimum amount of sleep needed changes with age. Infants need nine to ten hours at night AND three or more hours of naps, while toddlers need the same nine hours at night but two to three hours/less daytime naps. School-age children do best with nine to eleven hours and adults with seven to eight hours. When sleep-deprived (>1-2 hrs of less than normal sleep), daytime napping needs increase as well as the need for longer nighttime sleep. Without establishing a sleep cycle or when interrupting the normal circadian rhythm (cycle of sleep and wakefulness), long-term problems can arise. This can occur as a result of missing as little as one to two hours a night. Though many claim and even brag about only needing a few hours of sleep a night, it is reported that they are less able to perform well on complex mental tasks compared with those who get closer to seven hours of nighttime sleep. It has also been reported that a higher mortality rate is associated with getting less OR much more than seven hours of sleep per night.
As chiropractors, spinal manipulation, exercise training, dietary supplements, relaxation therapy, massage therapy, and acupuncture are all viable options to help in the effort to fall asleep faster, stay asleep longer, and improve the overall quality of sleep. Lifestyle coaching facilitating sleep improvement includes: 1) Establishing a regular sleep schedule; 2) Relaxing (like reading) before bedtime; 3) Regular exercise (≥2 hrs pre-bedtime); and 4) Avoiding alcohol, caffeine, and nicotine! Medication side-effects can be a culprit and sleep aid medications can leave one too sleepy the next day to optimally function. Herbal supplements can include the valerian (when taken for four to six weeks, it can improve sleep quality and reduce falling asleep time—it is often combined with others such as lavender, lemon balm, and skullcap); chamomile tea at bedtime; and kava. The supplement melatonin is another popular approach shown to help with insomnia, particularly falling asleep faster and for those with circadian rhythm interruptions. The amino acid L-Tryptophan converts to 5-HTP followed by serotonin (a brain neurotransmitter) and finally into melatonin. Other forms of therapy include music therapy and the use of sound machines, which can especially help older adults and children. Certain exercise such as yoga, tai-chi, and / or qigong act like a combination of both meditation and exercise. Combining some of these methods with cognitive-behavioral therapy (such as sleep restriction and stimulus control) has been shown to demonstrate some lasting improvements in sleep quality. The use of nasal dialator strips were also reported to be helpful in those with insomnia and sleep disordered breathing.