Sleep Disorder Improvements Have Been Linked to Chiropractic Care
FEATURE
Mark Studin
DC, FASBE(C), DAAPM, DAAMLP
According to Wikipedia (2015):
Asleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental, social, and emotional functioning.
Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night tenors. When a person suffers fr om difficulty falling asleep and/or staying asleep with no obvious cause, it is refened to as insomnia.
Sleep disorders aie broadly classified into dyssomnias, parasomnias, circadian rhythm sleep disorders involving the timing of sleep, and other disorders including ones caused by medical or psychological conditions and sleeping sickness. Some common sleep disorders include sleep apnea (stops in breathing during sleep), narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), cataplexy (sudden and transient loss of muscle tone while awake), and sleeping sickness (disruption of sleep cycle due to infection). Other disorders include sleepwalking, night ten ors, and bed wetting. Management of sleep disturbances that aie secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions, (https:// en.wikipedia.org/wiki/Sleep_disorder)
According to the Centers for Disease Control and Prevention (2015):
Sleep is increasingly recognized as important to public health, with sleep insufficiency linked to motor vehicle crashes, industrial disasters, and medical and other occupational errors. Unintentionally falling asleep, nodding off while driving, and having difficulty performing daily tasks because of sleepiness all may contribute to these hazardous outcomes. Persons experiencing sleep insufficiency aie also more likely to suffer from chronic diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity. Sleep insufficiency may be caused by broad scale societal factors such as round-the-clock access to technology and work schedules, but sleep disorders such as insomnia or obstructive sleep apnea also play an important role. An estimated 50 - 70 million US adults have sleep or wakefulness disorder. Notably, snoring is a major indicator of obstructive sleep apnea, (http : //www. ede. gov/features/dssleep/).
According to SLEEPMED of Santa Barbara (2016):
Insomnia Statistics
• 2 0 to 40% of all adults have insomnia in the course of any year
• 1 out of 3 people have insomnia at some point in their lives
• Over 70 million Americans suffer from disorders of sleep and wakefulness
• Of those, 60% have a chronic disorder
Narcolepsy Statistic
• Affects as many as 200,000 Americans
• Fewer than 50,000 are diagnosed
• 8 to 12% have a close relative with the disease
• Affects men slightly more than women
• 20 to 2 5 % of people with narcolepsy have all four symptoms (excessive daytime sleepiness, sudden loss of muscle function, sleep paralysis, hallucinations)
Children and Sleep Statistics
• Over 2 million children suffer from sleep disorders
• Estimated that 30 to 40% of children do not sleep enough
• Children require an average of 9 to 10 hours of sleep each night
Women and Sleep Statistics
• Women aie twice as likely as men to have difficulty falling and staying asleep
• Pregnancy can worsen sleep patterns
• Menopause and hormone changes cause changes in sleep
Older Adult Statistics
• Over half of those over the age of65 experience disturbed sleep
• Those over 65 make up about 13% of the US population, but consume over 30% of prescription drugs and 40% of sleeping pills
General Statistics
• Adults require an average of 8 to 8.5 of sleep each night
• Sleep problems add an estimated $15.9 billion to national health care costs
• 84 classifications of sleep disorders exist (http://www.sleepmedsite.com/page/sb/sleep_disorders/ sleepstatistics)
During research conducted at the University of Madrid Medical School in Madrid, Spain, and the Department of Health Sciences at the University of Jaén in Andalucía, Spain, Plaza-Manzano et al. (2014) found a link between sleep disorders and chiropractic care. They were studying manipulation, or what chiropractors do when we adjust our patients, and the cause for eradication of pain. They concluded that certain neuropeptides, or transmitters in the brain, increase when chiropractic patients are adjusted. The specific neurotransmitter is called orexin A and is commonly known, in medical terms, as a hypocretin.
According to Ebrahim, Howard, Kopelman, Sharief, and Williams (2002), “The hypocretins (orexins)... have an important role in the regulation of sleep and [mental] arousal states” (p. 227). They also state, “The hypocretins aie thought to act primarily as excitatory neurotransmitters...suggesting a role for the hypocretins in various central nervous functions related to noradrenergic innervation, including vigilance, attention, learning, and memory. Their actions on serotonin, histamine, acetylcholine and dopamine neurotransmission is also thought to be excitatory and a facilitatory role on gamma-aminobutyric acid (GABA) and glutamate-mediated neurotransmission is suggested” (Ebrahim et al., 2002, p. 227). If we focus simply on serotonin, which is responsible for mood, appetite, and sleep, then we could explain many of the effects on sleep patterns if imbalanced or depleted.
A chiropractic adjustment has proven to increase the orexin or hypocretins in the human body, which has a direct effect on the production of serotonin in the human body. Serotonin has been known for many years and recognized in scientific literature for playing a role in the modulation of sleep. Although more research is still needed to quantify the results, this now gives a verified scientific explanation of the results chiropractic patients have experienced over the past century.
As with all of my articles from here forward, I would like to leave you with a last and seemingly unrelated statement. We, myself and coauthors of other articles, feel it is important to add this at the end since many of our critics negatively portray the safety of chiropractic care. This statement should put that to rest, leaving only personal biases. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects, and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et ak, 2015, p. 5). This study supersedes all of the rhetoric about chiropractic and stroke, and it renders an outcome assessment to help guide the triage pattem of mechanical spine patients.
References:
1. Sleep Disorder. (2015). Wikipedia. Retrieved from https:// en. w ikipedia. org/w iki/ Sleep disorder
2. Centers for Disease Control and Prevention. (2015). Insufficient sleep is a public health problem. Retrieved from http://www.cdc. gov/features/dssleep
3. SLEEPMED of Santa Barbara. (2016). Sleep statistics. Retrieved from http://www. sleepmedsite. com page/sb/sleep disorders sleep statistics
4. Plaza-Manzano, G.,Molina-Ortega, E, Lomas-Vega, R, MartinezAmat,A.,Achalandabaso,A., & Hita-Coutreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. Journal of Orthopedic and Sports Physical Therapy, 44(4), 231-239.
5. Ebrahim, I. O., Howard, R. S., Kopelman, M. I)., Sharief M. K., & Williams, A. J. (2002). The hypocretin/orexin system. Journal of the Royal Society of Medicine, 95(5), 227-230.
6. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-2
Dr. Mark Studin is an adjunct associate professor of chiropractic at the University of Bridgeport Col— C ;M lege of Chiropractic, an adjunct professor of clinical ■L Æ sciences at Texas Chiropractic College, and a clinical I presenter for the State of New York at Buffalo, School \ IfÆBL of Medicine and Biomedical Sciences for postdoctoral education, teaching MRI spine interpretation, spinal biomechanical engineering, and triaging trauma cases. He is also the president of the Academy of Chiropractic teaching doctors of chiropractic how to interface with the medical and legal communities (www.DoctorsPIProgram.com) ; teaches MRI interpretation and triaging trauma cases to doctors of all disciplines nationally; and studies trends in health care on a national scale (www.TeachDoctors.com). He can be reached by e-mail at DrMarkfifiAcademyofChiropractic.com or by phone at 631-786-4253.
