Back Clinic Sleep Hygiene Chiropractic Team. The ideal sleep environment is cool, quiet, and dark. However, research has shown that continuous sleep can be interrupted by uncomfortable room temperature, light, and noises. Proper sleep hygiene specialists may also recommend selecting a comfortable mattress, pillows, and bedding and moving or hiding a visible clock. This prevents the sleeper from focusing on time passing while trying to fall asleep. Dr. Alex Jimenez describes sleep hygiene as a variety of habits that are often necessary to achieve a proper quality of sleep to rise with full daytime alertness.
Sleep is essential for an individual’s mental and physical health and well-being because it is important in the body’s natural healing and repairing functions. Therefore, the most important sleeping measure is to maintain regular sleeping patterns. According to Dr. Jimenez, heavy meals before bed, caffeine or alcohol before bed, and even improper sleeping postures accompanied by pain and discomfort can be frequent poor sleep hygiene practices that can interfere with the sleep quality of many individuals. Sleep and hygiene articles can help provide useful insight towards improving sleep and overall health.
Discover tips and techniques for improving TBI recovery through sleep to support brain health and overall well-being.
The Critical Role of Sleep in Traumatic Brain Injury Recovery: A Comprehensive Guide to Natural Healing
When the brain is injured—by a car crash, a sports accident, or a hard fall—the road to recovery can feel long and uncertain. Sleep, often overlooked, is actually one of the most essential tools for healing the brain and restoring overall health after a traumatic brain injury (TBI). Yet, TBI often disrupts sleep in frustrating ways, making recovery even harder. People recovering from TBI may find themselves struggling with restless nights, constant fatigue, headaches, memory lapses, and physical pain. It’s not just the injury—environmental factors like noise, temperature, and light can make sleep even more difficult. These challenges don’t affect just one part of the body; they ripple through the brain, nerves, muscles, and even how we feel emotionally.
Fortunately, science shows that improving sleep can help the brain and body heal more effectively. There are also many natural, non-surgical treatments—including chiropractic care, acupuncture, physical therapy, massage, and integrative wellness approaches—that can help restore healthy sleep patterns and support recovery. By understanding the vital connection between sleep and brain health, and learning how both our environment and different therapies influence recovery, people with TBI can find hope and real strategies for reclaiming restful nights and stronger days. This article will guide you through the science behind sleep and TBI, explain why sleep is so important for brain and body healing, explore common symptoms and risk profiles after brain injury, and share safe, evidence-based ways to improve sleep and support recovery—so you can move forward on your journey to better health.
Understanding Traumatic Brain Injury and Sleep Disruption
Traumatic brain injury affects millions of people each year, creating a cascade of physical, cognitive, and emotional challenges. The relationship between TBI and sleep is particularly profound, as sleep-wake disturbances are among the most common and debilitating consequences of injury (Sandsmark et al., 2017). Research indicates that approximately 30-85% of individuals who experience a TBI report sleep disturbances, with these problems often persisting for years after the initial injury (Aoun et al., 2019). The brain injury itself triggers multiple mechanisms that disrupt normal sleep architecture. When trauma occurs, the brain undergoes diffuse axonal injury, in which nerve fibers throughout the brain are damaged or torn. This damage particularly affects the arousal and sleep-regulation systems, creating fundamental problems in how the brain controls sleep and wakefulness (Sandsmark et al., 2017). The injury disrupts key brain structures, including the hypothalamus, brainstem, and reticular activating system—all essential components of maintaining healthy sleep-wake cycles.
Beyond the direct structural damage, TBI causes profound hormonal disruptions that further compromise sleep quality. Studies have shown that 95% of patients with acute TBI have low cerebrospinal fluid hypocretin levels, a wake-promoting neurotransmitter (Aoun et al., 2019). When hypocretin levels drop, excessive daytime sleepiness often results. Additionally, traumatic brain injury reduces levels of histamine, another wake-promoting substance, and melatonin, the hormone that regulates sleep-wake cycles. These hormonal imbalances create a perfect storm for sleep dysfunction that can manifest as insomnia, hypersomnia, or disrupted circadian rhythms.
The Glymphatic System: Sleep’s Critical Waste Removal Function
One of the most important discoveries in recent years has been understanding the glymphatic system and its relationship to sleep and brain health. The glymphatic system serves as the brain’s waste-clearance pathway, removing toxic metabolites and proteins that accumulate during waking hours. This system operates primarily during sleep, when it becomes 80-90% more active compared to the waking state (Aoun et al., 2019). During deep sleep, particularly slow-wave sleep, the brain undergoes critical housekeeping functions. Cerebrospinal fluid flows through the brain tissue, washing away cellular debris, proteins such as beta-amyloid and tau, and other potentially harmful substances that accumulate during daily activities (Piantino et al., 2022). When sleep is disrupted after TBI, this waste-clearance process is impaired. The accumulation of these neurotoxic substances can then potentiate cognitive dysfunction, slow recovery, and potentially increase the risk of long-term neurodegenerative conditions.
The bidirectional relationship between sleep disturbances and TBI symptoms creates a vicious cycle. The brain injury disrupts sleep, impairing glymphatic clearance. This impairment leads to increased accumulation of waste products, worsening cognitive symptoms and brain inflammation, and further disrupting sleep (Piantino et al., 2022). Breaking this cycle through targeted sleep interventions becomes essential for optimal recovery.
Common Sleep Disorders Following Traumatic Brain Injury
Understanding the specific types of sleep disorders that develop after TBI helps guide appropriate treatment strategies. The most common sleep disturbances include insomnia, post-traumatic hypersomnia, sleep-disordered breathing, circadian rhythm disorders, and parasomnias (Viola-Saltzman & Watson, 2012).
Insomnia represents the most frequently reported sleep complaint after TBI, affecting 25-29% of patients compared to only 6-10% of the general population (Aoun et al., 2019). People with insomnia following brain injury typically experience difficulty falling asleep, staying asleep throughout the night, or waking too early in the morning. The insomnia often stems from multiple factors, including heightened anxiety about sleep, pain, increased sensitivity to noise and light, and dysfunction in the brain regions that control sleep initiation and maintenance.
Post-traumatic hypersomnia affects approximately 20-25% of individuals after brain injury, manifesting as excessive daytime sleepiness, longer sleep durations, or an increased need for daytime naps (Aoun et al., 2019). This condition can significantly impair daily functioning, making it difficult to maintain work responsibilities, social activities, or rehabilitation programs. The excessive sleepiness often relates to reduced hypocretin levels and disruption of wake-promoting neurochemical systems.
Sleep-disordered breathing, including obstructive sleep apnea, occurs in approximately 23% of TBI patients (Aoun et al., 2019). Brain injury can affect the upper airway muscles, contribute to weight gain due to reduced activity, or damage brainstem regions that control breathing during sleep. When breathing becomes repeatedly interrupted throughout the night, oxygen levels drop, sleep quality plummets, and the brain’s recovery process becomes compromised.
Circadian rhythm disorders develop when the brain’s internal clock becomes disrupted. The suprachiasmatic nucleus in the hypothalamus serves as the master circadian pacemaker, but brain injury can damage this region or the pathways connecting it to other brain areas (Aoun et al., 2019). When circadian rhythms shift, people may find themselves unable to fall asleep until very late at night, waking up at inappropriate times, or experiencing irregular sleep-wake patterns that make maintaining a consistent schedule nearly impossible.
How Environmental Factors Affect Brain Activity and Sleep
The environment plays a powerful role in either supporting or sabotaging sleep quality, particularly for individuals recovering from traumatic brain injury. People with TBI often develop heightened sensitivities to environmental stimuli, making the sleep environment especially critical for recovery.
Light exposure represents one of the most potent environmental influences on sleep and circadian rhythms. Light suppresses melatonin production, the hormone that signals the brain that it’s time to sleep. Artificial light from streetlights, electronic devices, and indoor lighting can delay sleep onset and disrupt circadian phase (Environmental Determinants, 2018). For TBI patients who may already have reduced melatonin production, exposure to light at night can compound sleep difficulties. Even small amounts of light pollution have been shown to significantly affect sleep architecture, reducing sleep efficiency and increasing wakefulness after sleep onset.
Environmental noise creates another major barrier to quality sleep. Traffic sounds, aircraft noise, and urban noise pollution fragment sleep by causing brief arousals throughout the night. Studies have shown that exposure to airplane noise increases the risk of sleeping fewer than 7 hours per night (The Influence of Environmental Factors, 2025). For individuals with TBI, who often experience increased sensitivity to sensory stimuli, noise pollution can be particularly disruptive. The brain’s heightened arousal state makes it more difficult to filter out environmental sounds, leading to more frequent awakenings and lighter, less restorative sleep.
Temperature regulation affects sleep quality by influencing the body’s thermoregulatory system. The ideal sleep environment typically ranges from 60 to 67 degrees Fahrenheit. People living in warmer climates often experience more difficulty sleeping, especially during summer months when higher temperatures can interfere with the natural drop in core body temperature that facilitates sleep onset (Where You Live, 2023). Following TBI, some individuals develop problems with temperature regulation, making environmental temperature control even more important.
Indoor air quality influences sleep by affecting breathing and overall comfort. Poor ventilation, allergens, dust, and chemical pollutants can trigger respiratory issues, allergic reactions, or general discomfort that disrupts sleep. Maintaining clean air through proper ventilation, air filtration, and reducing indoor pollution sources supports better breathing and more restful sleep.
Neurological Disorders and Overlapping Risk Profiles
Traumatic brain injury rarely exists in isolation. The complex neurological changes that follow brain injury often create overlapping symptom profiles that affect multiple body systems simultaneously. Understanding these interconnected symptoms helps explain why TBI recovery requires a comprehensive, whole-person approach.
Headaches represent one of the most common and persistent symptoms following TBI, affecting the majority of individuals during recovery. These headaches can range from tension-type headaches caused by muscle tension and stress to migraine-like headaches with throbbing pain, light sensitivity, and nausea. The relationship between headaches and sleep is bidirectional—poor sleep can trigger or worsen headaches, while severe headaches make falling asleep or staying asleep extremely difficult. Chronic headaches activate pain pathways that increase brain arousal, directly interfering with the relaxation necessary for sleep onset.
Cognitive issues, including problems with memory, attention, concentration, and executive function, create significant challenges after TBI. Sleep plays an essential role in cognitive functioning, as memory consolidation, learning, and cognitive processing all depend on adequate sleep (Sanchez et al., 2022). When sleep becomes disrupted, cognitive symptoms worsen, creating frustration and anxiety that further impair sleep. Research has shown that better sleep during the hospitalization phase after TBI predicts more favorable long-term cognitive outcomes years later (Sanchez et al., 2022).
Fatigue affects 43-73% of people following TBI and differs from normal tiredness (Aoun et al., 2019). This pathological fatigue persists despite rest, creating overwhelming exhaustion that makes even simple daily tasks feel impossible. The fatigue relates to the brain’s increased energy demands during healing, disrupted sleep architecture, and neuroinflammation. When fatigue and sleep disturbances coexist, they create a reinforcing cycle where fatigue makes it harder to maintain normal activity levels, disrupting circadian rhythms and further impairing sleep quality.
Sleep disturbances themselves become both a symptom and a perpetuating factor in TBI recovery. The various forms of sleep disruption—from insomnia to hypersomnia to circadian rhythm shifts—all impair the brain’s ability to heal and regenerate. Poor sleep increases inflammation, impairs immune function, worsens mood and anxiety, and slows cognitive recovery (Zielinski & Gibbons, 2022).
Muscle instability and musculoskeletal pain frequently develop after TBI due to the accident mechanism, reduced activity during recovery, or changes in muscle tone and coordination. The relationship between musculoskeletal pain and sleep is well-established—pain makes finding comfortable sleep positions difficult and triggers frequent awakenings throughout the night. Simultaneously, poor sleep increases pain sensitivity by impairing the body’s natural pain modulation systems (Sleep Disturbance in Musculoskeletal Conditions, 2023).
These overlapping symptoms create what researchers call a “symptom cluster”—a group of interconnected problems that influence and worsen each other. Addressing only one symptom in isolation rarely produces lasting improvement. Instead, comprehensive treatment approaches that target multiple symptoms simultaneously tend to yield better outcomes.
Sleep Disturbances and the Musculoskeletal System
The connection between sleep quality and musculoskeletal health extends beyond simple pain, keeping someone awake. Poor sleep fundamentally changes how the body processes and responds to pain signals, creating physiological changes that perpetuate both sleep problems and musculoskeletal dysfunction. When sleep becomes disrupted, several neurochemical changes occur that affect pain processing. Sleep deprivation increases inflammatory cytokines—proteins that promote inflammation throughout the body. This heightened inflammatory state sensitizes pain receptors, making normally non-painful stimuli feel painful and amplifying existing pain (Sleep Disorders in Chronic Pain, 2023). Additionally, poor sleep impairs the descending pain-inhibitory pathways—the brain’s natural pain-suppression system—making it more difficult for the body to modulate pain signals.
The coexistence of insomnia and chronic musculoskeletal pain results in greater pain intensity and alterations in sleep homeostasis. Among patients with neuropathic pain, those with poor sleep quality experience more severe pain, more severe depressive states, and worse quality of life than patients with good sleep quality (Sleep Disorders in Chronic Pain, 2023). This creates a vicious cycle where pain disrupts sleep, poor sleep increases pain sensitivity, heightened pain further disrupts sleep, and the cycle continues. Sleep disturbances also affect muscle recovery and tissue repair. During deep sleep, the body releases growth hormone, which promotes tissue healing and muscle regeneration. When sleep quality suffers, this repair process becomes impaired, potentially slowing recovery from injuries and contributing to ongoing musculoskeletal dysfunction. The reduced physical activity that often accompanies both TBI and sleep problems can lead to muscle deconditioning, decreased flexibility, and altered movement patterns that increase injury risk and perpetuate pain.
The Autonomic Nervous System: Understanding the Body’s Control Center
To understand how various treatments improve sleep after TBI, it’s essential to grasp the role of the autonomic nervous system (ANS) in sleep regulation. The ANS controls involuntary body functions, including heart rate, breathing, digestion, and the sleep-wake cycle. It consists of two main branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The sympathetic nervous system governs the “fight, flight, or freeze” response. When activated, it increases heart rate, raises blood pressure, heightens alertness, and prepares the body for action. While this system serves important protective functions, chronic activation—common after TBI due to anxiety, pain, and stress—makes falling asleep and staying asleep extremely difficult.
The parasympathetic nervous system promotes “rest and digest” functions. When activated, it slows heart rate, promotes relaxation, aids digestion, and facilitates sleep. The vagus nerve serves as the primary pathway for parasympathetic signals, connecting the brain to organs throughout the body. Strong vagal tone—the measure of vagus nerve activity—indicates good parasympathetic function and associates with better stress resilience, improved sleep quality, and enhanced overall health (The Vagus Nerve, 2024). After traumatic brain injury, the balance between these two systems often becomes disrupted, with excessive sympathetic activation and reduced parasympathetic activity. This imbalance manifests as difficulty relaxing, heightened anxiety, rapid heart rate, and sleep disturbances. Restoring autonomic balance becomes a key goal of many non-surgical treatment approaches.
Neuroinflammation and Sleep Regulation
Neuroinflammation—inflammation within the brain and central nervous system—plays a central role in both TBI pathophysiology and sleep regulation. When a brain injury occurs, the immune system responds by activating inflammatory processes intended to clear damaged tissue and promote healing. However, when this inflammation becomes excessive or prolonged, it can impair recovery and disrupt normal brain function. Inflammatory cytokines, particularly interleukin-1β and tumor necrosis factor-α, directly influence sleep regulation. These molecules can promote sleepiness during acute phases of inflammation, which may explain the excessive sleepiness some people experience immediately after brain injury. However, chronic elevation of these inflammatory markers can disrupt sleep architecture, reduce sleep efficiency, and fragment sleep (Zielinski & Gibbons, 2022).
The relationship between inflammation and sleep is bidirectional. Poor sleep increases inflammatory markers, while elevated inflammation disrupts sleep. This creates another reinforcing cycle that can impede TBI recovery. Inflammation also impairs the glymphatic system’s ability to clear waste products from the brain. The combination of impaired glymphatic function and elevated neuroinflammation creates conditions that slow healing and perpetuate cognitive dysfunction. The vagus nerve plays a crucial role in regulating inflammation through what scientists call the “inflammatory reflex.” When the vagus nerve detects inflammatory signals, it can activate anti-inflammatory pathways that help modulate the immune response (Zielinski & Gibbons, 2022). This connection between the vagus nerve, inflammation, and sleep helps explain why treatments that stimulate vagal activity can improve both inflammation and sleep quality.
Non-Surgical Treatments for Improving Sleep After TBI
While medications can provide short-term relief for sleep problems, they rarely address the underlying causes of sleep dysfunction and can carry risks of dependency and side effects. Non-surgical treatments offer effective alternatives that target the root causes of sleep disturbances while promoting overall healing and recovery.
Chiropractic Care: Restoring Nervous System Function
Chiropractic care focuses on the relationship between the spine and nervous system, recognizing that spinal misalignments can interfere with nervous system function and overall health. For individuals recovering from TBI, chiropractic care offers multiple benefits, including improvements in sleep quality and neurological recovery. Research has demonstrated that chiropractic adjustments can improve brain function, with studies showing up to a 20% boost following a single adjustment (How Chiropractic Neurology Supports, 2025). These improvements include enhanced cerebrospinal fluid flow, reduced pressure on the nervous system, and improved blood circulation to the brain—all factors critical for TBI recovery. Chiropractic care affects sleep through several mechanisms. By addressing misalignments in the spine, particularly in the upper cervical region, chiropractors help improve nervous system function and reduce interference with sleep-regulating pathways (The Relationship Between Chiropractic Care and Sleep, 2023). Spinal adjustments activate the parasympathetic nervous system, promoting the relaxation response necessary for falling asleep. Studies have shown significant improvements in light sleep stages and overall quality of life following chiropractic treatment, along with reductions in anxiety, depression, fatigue, and pain—all factors that commonly disrupt sleep after TBI (Neuroplastic Responses to Chiropractic Care, 2024).
Dr. Alexander Jimenez, DC, FNP-BC, has observed in his clinical practice that chiropractic care combined with functional medicine approaches can significantly improve outcomes for patients with TBI and sleep disturbances. His integrated approach addresses not only structural alignment but also nutritional factors, lifestyle modifications, and the underlying causes of nervous system dysfunction. By restoring proper spinal alignment and nervous system function, chiropractic care helps patients achieve better sleep patterns, reduced pain, and improved overall recovery.
Acupuncture: Modulating Neurotransmitters and Autonomic Function
Acupuncture, a key component of traditional Chinese medicine, involves inserting thin needles at specific points on the body to influence energy flow and promote healing. Modern research has revealed that acupuncture exerts powerful effects on neurotransmitter systems, autonomic nervous system function, and neuroplasticity—all of which are relevant to improving sleep after TBI. Studies have demonstrated that acupuncture therapy can effectively treat sleep disorders by modulating several key neurotransmitter systems. Acupuncture increases gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that promotes calmness and sleep, while decreasing glutamate, an excitatory neurotransmitter that promotes wakefulness (The Effects of Acupuncture on Sleep Disorders, 2023). This shift in the excitatory-inhibitory balance creates conditions more conducive to falling asleep and maintaining sleep throughout the night.
Acupuncture also affects the autonomic nervous system by modulating vagus nerve activity. Research shows that acupuncture can directly influence peripheral nerves and muscles, which in turn modulate autonomic tone and central nervous system activation (Autonomic Activation in Insomnia, 2011). By activating parasympathetic pathways, acupuncture promotes the relaxation response, reduces stress hormone levels, and improves sleep quality. For stroke patients with sleep disorders—conditions that share similarities with TBI—acupuncture combined with conventional treatments produced significant improvements in sleep quality and neurological function (Effect of Acupuncture on Sleep Quality, 2021). The treatment reduced the time needed to fall asleep, increased total sleep duration, improved sleep efficiency, and decreased the frequency and duration of breathing interruptions during sleep. In Dr. Jimenez’s integrative practice, acupuncture serves as a valuable tool for addressing sleep disturbances in TBI patients. The treatment’s ability to reduce pain, decrease anxiety, improve autonomic balance, and directly influence sleep-regulating neurotransmitters makes it particularly effective when combined with other therapeutic modalities.
Physical Therapy: Exercise and Movement for Better Sleep
Physical therapy uses targeted exercises, manual techniques, and movement strategies to restore function, reduce pain, and improve overall physical health. For individuals recovering from TBI, physical therapy offers benefits that extend well beyond musculoskeletal improvements, enhancing sleep quality and neurological recovery. Exercise represents one of the most effective non-pharmacological interventions for improving sleep. A meta-analysis demonstrated that exercise interventions resulted in significant improvements in overall sleep quality, subjective sleep perception, and sleep latency—the time needed to fall asleep (Sleep Disturbance in Musculoskeletal Conditions, 2023). Exercise promotes better sleep through multiple mechanisms, including reducing anxiety and depression, regulating circadian rhythms, increasing sleep drive, and promoting deeper, more restorative sleep stages.
Physical therapy also addresses the musculoskeletal pain that commonly disrupts sleep after TBI. Through manual therapy techniques, therapeutic exercises, and posture education, physical therapists help reduce pain, improve mobility, and restore normal movement patterns. When pain decreases, sleep quality typically improves as individuals can find comfortable positions and experience fewer pain-related awakenings (How Physical Therapy Supports Better Sleep, 2025). The timing and type of exercise matter for sleep quality. Regular aerobic exercise improves sleep, but exercising too close to bedtime can be stimulating and delay sleep onset. Physical therapists help patients develop appropriate exercise programs that promote sleep without interfering with the ability to fall asleep. Moderate-intensity exercise training has been shown to have significant beneficial effects on both sleep quality and cardio-autonomic function (Sleep Disturbance in Musculoskeletal Conditions, 2023). For TBI patients specifically, research has shown that physical therapy exercises represent a safe and useful strategy for managing sleep disorders in neurorehabilitation (Physical Therapy Exercises for Sleep Disorders, 2021). The combination of improved physical function, reduced pain, better mood, and normalized circadian rhythms creates optimal conditions for restorative sleep.
Massage Therapy: Activating the Parasympathetic Response
Massage therapy involves manipulating soft tissues to promote relaxation, reduce muscle tension, and improve circulation. This hands-on approach offers powerful benefits for sleep quality by directly influencing the nervous system and supporting the body’s natural healing processes. The scientific foundation for massage therapy’s sleep benefits lies in its effects on the autonomic nervous system. Massage activates the parasympathetic nervous system, signaling the body to shift from the stress response to the relaxation response (How Massage Therapy Improves Sleep Quality, 2024). This activation reduces heart rate, lowers blood pressure, decreases cortisol (the primary stress hormone), and increases production of serotonin and dopamine—neurotransmitters associated with mood regulation and relaxation.
Massage therapy supports better sleep by increasing serotonin levels, which serve as a precursor to melatonin. By promoting the production of these sleep-regulating hormones, massage helps the body naturally fall into a healthy sleep cycle (How Massage Therapy Can Improve Sleep Quality, 2024). This natural approach to improving melatonin production can be particularly valuable for TBI patients who may have reduced melatonin levels due to brain injury. Research has demonstrated that massage therapy reduces muscle pain and tension, improves circulation and oxygen flow, and creates overall physical relaxation that facilitates sleep (Massage Positively Influences Daytime Brain Activity, 2025). For individuals with musculoskeletal pain following TBI, massage addresses both the pain itself and the muscle guarding and tension that develop in response to pain.
Studies examining massage therapy in postmenopausal women with insomnia found significant improvements in sleep architecture, including decreased REM latency, reduced time in stage 1 sleep, and increased time in the deeper stages 3 and 4 sleep (The Beneficial Effects of Massage Therapy, 2014). These changes represent meaningful improvements in sleep quality, as deeper sleep stages provide more restorative benefits. In clinical practice, massage therapy is often integrated with other treatment modalities to provide comprehensive care for TBI patients. The combination of massage with chiropractic care, physical therapy, and other approaches creates synergistic effects that enhance overall outcomes.
Restoring Communication Between Brain and Body
All of these non-surgical treatments share a common goal: restoring proper communication between the brain and body. Traumatic brain injury disrupts this communication on multiple levels—from direct damage to neural pathways to hormonal imbalances to autonomic dysfunction. By addressing these disruptions through various therapeutic approaches, practitioners help reestablish the connections necessary for healing. The central nervous system coordinates all body functions through intricate networks of neurons that transmit signals between the brain, spinal cord, and peripheral nerves. When TBI occurs, this communication system becomes compromised. Chiropractic care addresses structural barriers to nerve transmission; acupuncture modulates neurotransmitter activity; physical therapy restores movement patterns that influence neural feedback; and massage therapy activates sensory pathways that signal safety and relaxation to the brain.
Vagal tone—the activity level of the vagus nerve—serves as a key indicator of how well the brain and body communicate. Higher vagal tone associates with better stress resilience, improved mood, better cognitive function, and enhanced sleep quality (The Vagus Nerve, 2024). Many of the non-surgical treatments discussed here work, in part, by improving vagal tone. Chiropractic adjustments, acupuncture, massage, and certain breathing exercises can all activate the vagus nerve, strengthening the parasympathetic response and improving autonomic balance. The somatic nervous system, which controls voluntary movements and processes sensory information, also plays a role in sleep quality. When musculoskeletal pain or movement dysfunction affects the somatic system, it can create ongoing sensory signals that keep the nervous system in a heightened state of alertness. Treatments that address these somatic issues—through physical therapy, massage, and manual techniques—help quiet these alerting signals and allow the nervous system to transition into sleep states more easily.
The Science of Motion- Video
Developing an Effective Sleep Routine After TBI
Creating and maintaining a consistent sleep routine represents one of the most important steps for improving sleep quality after traumatic brain injury. A well-designed sleep routine helps regulate circadian rhythms, signals the brain that it’s time for sleep, and creates optimal conditions for restorative rest.
Establish Consistent Sleep and Wake Times
The foundation of good sleep hygiene involves going to bed and waking up at approximately the same time every day, including weekends. This consistency helps program the brain’s internal clock, making it easier to fall asleep at bedtime and wake up feeling more refreshed (Enhancing Sleep Quality After TBI, 2024). After TBI, when circadian rhythms may be disrupted, this consistency becomes even more critical for reestablishing normal sleep-wake patterns.
Choose a bedtime that allows for 7-9 hours of sleep before your desired wake time. While individual sleep needs vary, most adults require at least seven hours of sleep per night for optimal health and recovery. Avoid the temptation to “sleep in” to make up for poor sleep, as this can further disrupt circadian rhythms and make it more difficult to fall asleep the following night.
Create a Relaxing Pre-Sleep Routine
Dedicate the 60-90 minutes before bedtime to calming activities that help transition from wakefulness to sleep. This wind-down period signals to the brain and body that sleep is approaching, allowing physiological systems to prepare for rest (Sleep After Traumatic Brain Injury, 2025).
Consider incorporating the following elements into your pre-sleep routine:
Dim the lights throughout your living space in the evening. Bright light suppresses melatonin production, making it harder to feel sleepy. Use soft, warm-toned lighting and avoid bright overhead lights as bedtime approaches.
Avoid screens from phones, tablets, computers, and televisions for at least 30-60 minutes before bed. The blue light emitted by electronic devices particularly suppresses melatonin and can delay sleep onset by up to two hours (Assessment and Management of Sleep Disturbances, 2024). If you must use devices, enable night mode or a blue light filter, and keep the screen brightness low.
Practice relaxation techniques such as deep breathing exercises, progressive muscle relaxation, gentle stretching, or meditation. These activities activate the parasympathetic nervous system, reduce stress hormone levels, and prepare the body for sleep. Even 10-15 minutes of focused relaxation can significantly improve your ability to fall asleep.
Take a warm bath or shower 60-90 minutes before bed. The subsequent cooling of body temperature after getting out of the bath mimics the natural temperature drop that occurs at sleep onset, helping to trigger sleepiness.
Engage in quiet, non-stimulating activities like reading a book (preferably a physical book rather than an e-reader), listening to calming music, or journaling. Avoid activities that are mentally or emotionally stimulating, such as work-related tasks, intense discussions, or watching exciting or disturbing content.
Optimize Your Sleep Environment
The bedroom environment significantly influences sleep quality, particularly for individuals with TBI who may have heightened sensory sensitivities.
Keep the bedroom cool, ideally between 60 and 67 degrees Fahrenheit. A cooler room temperature supports the natural drop in core body temperature that facilitates sleep onset and helps maintain sleep throughout the night (Where You Live, 2023).
Make the room as dark as possible. Use blackout curtains or shades to block outside light, cover or remove electronic devices with glowing lights, and consider using a sleep mask if complete darkness isn’t achievable. Even small amounts of light can disrupt sleep architecture and reduce sleep quality.
Minimize noise by using earplugs, white noise machines, or fans to create a consistent background sound that masks disruptive environmental noises. For some individuals, complete silence works best, while others find gentle, consistent sounds more soothing.
Ensure your bed is comfortable with a supportive mattress and pillows appropriate for your preferred sleep position. If musculoskeletal pain disrupts your sleep, consider using additional pillows for support or trying different sleep positions to reduce pressure on painful areas.
Use the bedroom only for sleep and intimacy. Avoid working, watching television, or engaging in other wakeful activities in bed. This helps strengthen the mental association between the bedroom and sleep, making it easier to fall asleep when you get into bed.
Manage Daytime Behaviors That Affect Nighttime Sleep
Actions taken during the day significantly impact nighttime sleep quality.
Get exposure to natural light early in the morning and throughout the day. Sunlight exposure helps regulate circadian rhythms, suppresses daytime melatonin production, and strengthens the contrast between day and night signals to the brain (Assessment and Management of Sleep Disturbances, 2024). Aim for at least 30 minutes of natural light exposure in the morning.
Exercise regularly, but not within 2-3 hours of bedtime. Regular physical activity improves sleep quality, but exercising too close to bedtime can be stimulating and delay sleep onset (Warding Off Sleep Issues, 2024). Morning or early afternoon exercise provides the best sleep benefits.
Limit naps to 20-30 minutes and avoid napping after 3:00 PM. While short naps can be refreshing, long or late-day naps can interfere with nighttime sleep. If you’re experiencing excessive daytime sleepiness after TBI, discuss appropriate napping strategies with your healthcare provider, as this may indicate an underlying sleep disorder requiring specific treatment.
Avoid caffeine for at least 5-6 hours before bedtime. Caffeine has a half-life of 5-6 hours, meaning half of the caffeine consumed remains in your system that long after consumption. For sensitive individuals or those with sleep difficulties, avoiding caffeine after noon may be necessary (Warding Off Sleep Issues, 2024).
Limit alcohol consumption and avoid alcohol close to bedtime. While alcohol may initially make you feel sleepy, it disrupts sleep architecture, reduces REM sleep, and causes more frequent awakenings during the night. Alcohol also affects breathing during sleep and can worsen sleep-disordered breathing.
Avoid large meals within 2-3 hours of bedtime. Eating too close to bedtime can cause digestive discomfort that interferes with sleep. If you’re hungry before bed, choose a light snack that combines complex carbohydrates with a small amount of protein.
Address Specific Sleep Problems
Different sleep problems require targeted strategies.
For difficulty falling asleep, try the “cognitive shuffle” technique or counting backwards by threes from a random number. These activities occupy the mind with neutral content, preventing anxious or racing thoughts that can delay sleep onset. If you don’t fall asleep within 20-30 minutes, get out of bed and engage in a quiet, non-stimulating activity until you feel sleepy.
For frequent nighttime awakenings, practice staying calm and avoiding clock-watching, which can increase anxiety about sleep. Use the same relaxation techniques you employ before bed to help return to sleep. If awakening relates to pain, work with your healthcare providers to address pain management strategies.
For early morning awakening, ensure you’re getting adequate light exposure during the day and avoiding light exposure in the evening. This helps shift your circadian rhythm to a more appropriate schedule.
When to Seek Professional Help
While good sleep hygiene provides the foundation for better sleep, it’s not sufficient as a standalone treatment for specific sleep disorders. If you’re implementing these strategies consistently for 2-3 weeks without significant improvement, consult with healthcare providers who specialize in sleep medicine or TBI rehabilitation (Assessment and Management of Sleep Disturbances, 2024).
A professional evaluation can identify specific sleep disorders like sleep apnea, narcolepsy, or circadian rhythm disorders that require targeted treatments. Sleep studies, including polysomnography and multiple sleep latency testing, provide objective measurements of sleep architecture and can reveal problems not apparent from self-report alone.
A Questionnaire Example of TBI Symptoms
The Role of Functional Medicine in TBI and Sleep Recovery
Functional medicine takes a comprehensive, patient-centered approach to health, seeking to identify and address the root causes of illness rather than simply managing symptoms. For individuals recovering from TBI with sleep disturbances, functional medicine offers valuable insights and treatment strategies that complement other therapeutic interventions. Dr. Alexander Jimenez’s clinical approach exemplifies the principles of functional medicine applied to TBI and sleep disorders. As both a chiropractor and board-certified Family Practice Nurse Practitioner with training in functional and integrative medicine, Dr. Jimenez conducts detailed assessments that evaluate personal history, current nutrition, activity behaviors, environmental exposures, genetic factors, and psychological and emotional elements that may contribute to sleep problems.
This comprehensive evaluation often reveals multiple contributing factors that conventional approaches might miss. For example, nutrient deficiencies in magnesium, vitamin D, or B vitamins can significantly impact sleep quality and neurological recovery. Chronic inflammation driven by dietary factors, environmental toxins, or gut health problems can impair both sleep and healing. Hormonal imbalances, blood sugar dysregulation, and mitochondrial dysfunction can all contribute to the fatigue, cognitive problems, and sleep disturbances that follow TBI. By identifying these underlying issues, functional medicine practitioners can create personalized treatment plans that address multiple factors simultaneously. This might include nutritional interventions to correct deficiencies and reduce inflammation, dietary modifications to support stable blood sugar and gut health, targeted supplementation to support mitochondrial function and neurological healing, stress management strategies to balance the autonomic nervous system, and environmental modifications to reduce toxic exposures and optimize the sleep environment. The integration of functional medicine with chiropractic care, physical therapy, acupuncture, and other modalities creates a truly comprehensive approach to TBI recovery. Rather than viewing sleep problems as an isolated issue, this integrated perspective recognizes sleep as one component of overall health that both affects and is affected by multiple body systems.
The Science of Recovery: Why Comprehensive Care Matters
The evidence supporting non-surgical, integrative approaches to TBI and sleep disorders continues to grow. Research consistently demonstrates that addressing sleep problems after TBI can improve multiple outcomes, including cognitive function, pain levels, mood and anxiety, quality of life, and overall recovery trajectories (Wickwire, 2020). Studies examining sleep quality during the acute hospitalization phase after TBI have found that better sleep during this critical period predicts more favorable long-term cognitive outcomes years later (Sanchez et al., 2022). Specifically, less fragmented sleep, more slow-wave sleep, and higher spindle density during hospitalization are associated with better memory and executive function at long-term follow-up. Importantly, these sleep measures were better predictors of cognitive outcomes than traditional injury severity markers, highlighting sleep’s critical role in recovery.
Cognitive behavioral therapy for insomnia (CBT-I) has emerged as a highly effective treatment for TBI-related sleep problems, with 70-80% of patients experiencing lasting benefit and approximately 50% achieving complete resolution of insomnia (Perspective: Cognitive Behavioral Therapy, 2023). CBT-I teaches skills and strategies that address the perpetuating factors maintaining insomnia, including dysfunctional beliefs about sleep, behaviors that interfere with sleep, and cognitive processes that increase arousal at bedtime. The combination of non-surgical treatments—chiropractic care, acupuncture, physical therapy, and massage therapy—with behavioral interventions like CBT-I and functional medicine approaches creates optimal conditions for recovery. Each modality addresses different aspects of the complex pathophysiology underlying TBI and sleep disturbances. Together, they work synergistically to restore nervous system function, reduce inflammation, improve autonomic balance, address pain and musculoskeletal dysfunction, optimize nutritional status, and reestablish healthy sleep-wake cycles.
Conclusion: Hope for Recovery Through Holistic Healing
Traumatic brain injury and the sleep disturbances that follow can feel overwhelming, but effective treatments exist that can significantly improve quality of life and support the brain’s remarkable capacity for healing. By understanding the complex relationships among brain injury, sleep, inflammation, autonomic function, and overall health, individuals can make informed decisions about their care and take an active role in their recovery. The non-surgical approaches discussed in this article—chiropractic care, acupuncture, physical therapy, and massage therapy—offer safe, effective options for improving sleep quality while supporting overall neurological recovery. These treatments work by restoring proper nervous system function, reducing inflammation, improving autonomic balance, addressing pain and musculoskeletal dysfunction, and reestablishing healthy communication between the brain and body.
Implementing consistent sleep hygiene practices and developing personalized sleep routines provides the foundation for better rest. When combined with professional guidance from healthcare providers trained in functional and integrative medicine, such as Dr. Alexander Jimenez, individuals can address the root causes of their sleep problems rather than simply managing symptoms. Recovery from TBI is rarely linear, and sleep problems may persist for months or years. However, with patience, persistence, and comprehensive care that addresses the whole person rather than isolated symptoms, meaningful improvement is possible. The brain possesses remarkable neuroplasticity—the ability to form new neural connections and pathways—that continues throughout life. By creating optimal conditions for healing through quality sleep, proper nutrition, appropriate therapies, and supportive environments, individuals can harness this neuroplasticity to support recovery and reclaim their lives after traumatic brain injury.
References
Aoun, R., Rawal, H., Attarian, H., & Sahni, A. (2019). Impact of traumatic brain injury on sleep: An overview. Nature and Science of Sleep, 11, 131-140. https://doi.org/10.2147/NSS.S182158
Landvater, J., Kim, S., Caswell, K., Kwon, C., Odafe, E., Roe, G., Tripathi, A., Vukovics, C., Wang, J., Ryan, K., Cocozza, V., Brock, M., Tchopev, Z., Tonkin, B., Capaldi, V., Collen, J., Creamer, J., Irfan, M., Wickwire, E. M., Williams, S., & Werner, J. K. (2024). Traumatic brain injury and sleep in military and veteran populations: A literature review. NeuroRehabilitation, 55(3), 245-270. https://doi.org/10.3233/NRE-230380
Physical therapy exercises for sleep disorders in a rehabilitation setting: A systematic review and meta-analysis. (2021, September 4). PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC8416054/
Piantino, J. A., Iliff, J. J., & Lim, M. M. (2022). The bidirectional link between sleep disturbances and traumatic brain injury symptoms: A role for glymphatic dysfunction? Biological Psychiatry, 91(5), 478-487. https://doi.org/10.1016/j.biopsych.2021.06.025
Poulsen, I., Langhorn, L., Egerod, I., & Aadal, L. (2021). Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review. Australian Critical Care, 34(1), 76-82. https://doi.org/10.1016/j.aucc.2020.05.006
Sanchez, E., Blais, H., Duclos, C., Arbour, C., Van Der Maren, S., El-Khatib, H., Baril, A. A., Bernard, F., Carrier, J., & Gosselin, N. (2022). Sleep from acute to chronic traumatic brain injury and cognitive outcomes. Sleep, 45(8), zsac123. https://doi.org/10.1093/sleep/zsac123
Sandsmark, D. K., Elliott, J. E., & Lim, M. M. (2017). Sleep-wake disturbances after traumatic brain injury: Synthesis of human and animal studies. Sleep, 40(5), zsx044. https://doi.org/10.1093/sleep/zsx044
The beneficial effects of massage therapy for insomnia in postmenopausal women. (2014, September 15). Sleep Medicine Research, 5(2), 51-54. https://doi.org/10.17241/smr.2014.5.2.51
The effects of acupuncture on sleep disorders and its underlying mechanism: A literature review of rodent studies. (2023, August 7). Frontiers in Neuroscience, 17. https://doi.org/10.3389/fnins.2023.1243029
Viola-Saltzman, M., & Watson, N. F. (2012). Traumatic brain injury and sleep disorders. Neurologic Clinics, 30(4), 1299-1312. https://doi.org/10.1016/j.ncl.2012.08.008
Wickwire, E. M. (2020). Why sleep matters after traumatic brain injury. Journal of Clinical Sleep Medicine, 16(Suppl 1), 5S-6S. https://doi.org/10.5664/jcsm.8872
Zielinski, M. R., & Gibbons, A. J. (2022). Neuroinflammation, sleep, and circadian rhythms. Frontiers in Cellular and Infection Microbiology, 12, 853096. https://doi.org/10.3389/fcimb.2022.853096
Gut Health for Faster Recovery—El Paso Back Clinic
Why your gut matters when you’re healing
After a back or neck injury—from daily strain, sports, work, or a car crash—pain and limited mobility can dominate your life. But there’s a powerful helper inside you: the gut microbiome. These trillions of microbes influence digestion, inflammation, immunity, energy, and even sleep. When they fall out of balance (called dysbiosis), bloating, irregular stools, fatigue, and higher inflammation can slow your rehab progress. The positive news is that simple daily steps can reset the balance and support your recovery. (Cleveland Clinic, 2023/2022). (Cleveland Clinic)
At El Paso Back Clinic, we often combine spine-focused care—such as chiropractic adjustments when appropriate, therapeutic exercise, soft-tissue work, and, if indicated, imaging—with practical gut-support strategies, helping patients recover more comfortably and steadily. (Dr. Alex Jimenez, El Paso clinic pages). (El Paso, TX Doctor Of Chiropractic)
Dysbiosis in plain language
Dysbiosis means your gut community is out of balance—too many “unhelpful” species, not enough beneficial ones, or less diversity overall. Diets high in refined sugars and ultra-processed foods, repeated courses of antibiotics, stress, poor sleep, and alcohol/environmental toxins are common triggers. (Cleveland Clinic, 2024; Better Health Channel, 2023; USDA ARS, 2025). (Cleveland Clinic)
Ultra-processed foods tend to be low in fiber and high in additives; over time, they’re linked with inflammation and a less favorable gut environment—exactly what you don’t want while healing. (Cleveland Clinic Newsroom, 2023). (Cleveland Clinic)
How “unhealthy” bacteria gain ground
Unwanted bacteria flourish when conditions favor them. Three everyday drivers:
Low fiber, high ultra-processed intake. Beneficial microbes feed on plant fibers and resistant starches from beans, whole grains, vegetables, and fruit. Starve them, and opportunistic species take over. (Wilson et al., 2020; Singh et al., 2017). (PMC)
Antibiotics and antimicrobials. Essential when needed, but they can also reduce helpful species; rebuilding with fiber-rich foods (and sometimes probiotics) helps restore balance. (Cleveland Clinic, 2024). (Cleveland Clinic)
Stress and poor sleep. Both alter motility and immune signaling via the brain–gut axis, nudging the microbiome toward dysbiosis. (Better Health Channel, 2023). (Better Health Channel)
SIBO: a special case to know about
Small Intestinal Bacterial Overgrowth (SIBO) happens when excess bacteria build up in the small intestine, which normally has low counts. Symptoms can include bloating, abdominal discomfort, diarrhea, early fullness, weight loss, or malnutrition. (Mayo Clinic, 2024). (Mayo Clinic)
Treatment often pairs targeted antibiotics with nutrition and root-cause fixes (e.g., motility support or addressing structural issues). Without tackling the cause, SIBO can recur. (Mayo Clinic, 2024). (Mayo Clinic)
If you notice persistent bloating, pain, or weight loss, ask your clinician about evaluation and a phased plan that treats the cause, then carefully re-expands fibers and fermented foods.
How better gut habits speed musculoskeletal recovery
Lower, steadier inflammation: A fiber-rich, plant-forward pattern boosts short-chain fatty acids (SCFAs) like butyrate that help protect the gut lining and may dampen systemic inflammation tied to pain. (Singh et al., 2017). (PMC)
Energy and participation: Balanced digestion supports energy, sleep, and mood—key drivers of successful physical therapy and home exercise. (Cleveland Clinic, 2022). (Cleveland Clinic)
Medication tolerance: If you need antibiotics or other meds, a microbiome-friendly plan can reduce GI side effects. (Cleveland Clinic, 2024). (Cleveland Clinic)
The El Paso Back Clinic approach (dual-scope care)
Our team—led by Alexander Jimenez, DC, APRN, FNP-BC—blends chiropractic care with nurse-practitioner medical evaluation. When appropriate, we use X-ray/MRI to clarify the diagnosis, and we coordinate conservative therapies with nutrition and lifestyle coaching. For injury cases, we also provide the documentation insurers and attorneys require. (El Paso, TX Doctor Of Chiropractic)
Common elements of a plan:
Dual-scope assessment: History, neuro/orthopedic testing, and imaging when indicated to pinpoint pain drivers (joint, nerve, soft tissue). (El Paso, TX Doctor Of Chiropractic)
Conservative therapies: Chiropractic adjustments (as indicated), therapeutic exercise, massage/soft-tissue work; acupuncture may be added to modulate pain and stress. (El Paso, TX Doctor Of Chiropractic)
Gut-support basics: Plant variety, fiber targets, and live-culture foods; stress and sleep tools that calm the gut–brain axis. (Cleveland Clinic Magazine; Penn State Health). (Cleveland Clinic)
Medical-legal readiness: Structured notes, imaging reports, and measurable outcomes for personal-injury and MVA cases. (El Paso, TX Doctor Of Chiropractic)
Clinical observation: Patients with back/neck pain who improve sleep and add one fermented food daily—while increasing beans/whole grains and veggies—often report less bloating and steadier energy within weeks, which helps them stay consistent with rehab.
A 4–6 week “gut-reset” that fits rehab
1) Make plants the base (daily)
Aim for colorful vegetables and fruits, beans/lentils 4–5 days/week, and whole grains (oats, barley, brown rice, quinoa). These choices feed beneficial microbes and boost SCFAs. (Wilson et al., 2020). (PMC)
2) Add one fermented food most days
Yogurt or kefir with live active cultures, kimchi, sauerkraut, or kombucha. Not all fermented foods have live microbes after processing—check the label. (Healthline; Cleveland Clinic Magazine). (Healthline)
3) Tame ultra-processed foods
Swap sugary drinks for water/unsweetened tea; favor whole-grain staples; keep packaged snacks as occasional treats. (Cleveland Clinic, 2023). (Cleveland Clinic)
4) Support sleep and stress
Target 7–9 hours with a consistent wind-down; try 5 minutes of slow breathing before bed; walk 20–30 minutes most days, and add two short strength sessions weekly. (Better Health Channel, 2023). (Better Health Channel)
5) Medications—coordinate with your clinician
Don’t stop prescribed meds on your own. If antibiotics are necessary, ask whether a food-first strategy and a short-term probiotic make sense for you. (Cleveland Clinic, 2024). (Cleveland Clinic)
6) Hygiene matters
Wash hands, rinse produce, and avoid kitchen cross-contamination to reduce exposure to harmful bacteria. (Better Health Channel, 2023). (Better Health Channel)
Two-week starter plan (easy, budget-minded)
Breakfast: Oats + kefir or yogurt + berries + nuts.
Dinner: Slow-cooker chili or lentil curry; salad with olive oil; baked potato (cool leftovers for resistant starch).
Snacks: Fruit + nut butter; carrots + hummus; plain popcorn; small kefir smoothie.
Small, steady changes add up; focus on what you can repeat during busy treatment weeks. (Penn State Health, 2018). (Penn State)
When to seek medical care now
Unintended weight loss, blood in stool, fever, severe or night-time symptoms, or a history of GI surgery.
Talk with your clinician about evaluation, including possible SIBO testing when appropriate. (Mayo Clinic, 2024). (Mayo Clinic)
Local help in El Paso
If you’re recovering from a back or neck injury and want a plan that connects spine care, gut health, and documentation for injury cases, our team can help you build a sustainable routine while we treat the root musculoskeletal drivers. (El Paso Back Clinic/Dr. Jimenez). (El Paso, TX Doctor Of Chiropractic)
The Importance of Sleep in Back Injury Recovery After Car Accidents
Recovering from back injuries caused by car accidents can be demanding, with pain and limited movement affecting daily life. A key element in healing that is often underappreciated is quality sleep. It supports the body’s repair mechanisms, reduces inflammation in the spine and muscles, and helps control discomfort and tension. During rest, tissues mend, the immune response strengthens, and hormones that aid recovery are balanced. Lack of sleep can delay this, leading to extended pain and potential ongoing issues. Recognizing sleep’s role can improve outcomes for those dealing with accident-related back problems.
Sleep’s Contribution to Tissue Repair
Car accidents frequently result in back strains, disc issues, or whiplash that impacts the spine. Sleep allows the body to focus on fixing these areas. Tissues in the back and surrounding muscles regenerate, while growth factors promote cell renewal (OrthoCarolina, 2023). This process is crucial for reducing swelling and restoring strength in the lower back, neck, and joints that are commonly affected in collisions.
Additionally, sleep plays a role in pain relief for back injuries. It decreases inflammation signals and increases natural pain-suppressing compounds, making it easier to participate in rehabilitation activities (Daniel Stark, 2023). Hormonal balance during sleep also supports the uptake of energy and nutrients, preventing further strain on injured areas (Tyson Mutrux, 2023). For accident victims, this means faster progress toward mobility and comfort.
Consequences of Insufficient Sleep
Post-accident, sleep disturbances arise from back pain, anxiety, or disrupted routines. This shortfall impairs repair, weakening immunity and prolonging inflammation in spinal regions (Complete Care, 2023). A temporary back issue could become chronic, with stiffness or radiating pain persisting.
Mental effects compound the problem, including reduced concentration or heightened irritability, which can interfere with following recovery plans (Tennessee Injury Attorney, 2023). In the long term, poor sleep increases the risk of conditions such as persistent back weakness or related health concerns (JSW Law Offices, 2023). Addressing sleep issues early is essential for comprehensive back healing after an accident.
Insights from Back Injury Specialists
Professionals at a dedicated back care facility in El Paso offer valuable perspectives on integrating sleep into recovery. With extensive experience in managing accident-induced spinal and musculoskeletal problems, these experts link rest to effective outcomes. Shared through various channels, including social platforms and professional updates, their observations emphasize the connection between back injuries and broader health factors (Jimenez, 2023, LinkedIn; Jimenez, 2023, Instagram).
They correlate injuries with co-existing conditions using diagnostics, such as imaging, to pinpoint spinal misalignments or soft tissue damage (Jimenez, 2023, Facebook). This dual-focus approach ensures treatments target underlying issues. Their proficiency in both medical and administrative aspects supports both patient care and claim handling, streamlining the process for patients.
Chiropractic and Holistic Methods for Back Recovery
Chiropractic techniques realign the spine, alleviating pressure from accident impacts and promoting natural back restoration (Jimenez, 2023, WhatsApp). Holistic practices incorporate nutrition and lifestyle adjustments to combat root inflammation, enhancing overall spinal health.
Advanced assessments, such as functional evaluations, identify imbalances that affect back recovery, leading to personalized strategies that include dietary support or exercises (Jimenez, 2023, Pinterest). This integrated care, often involving teamwork with other healthcare providers, fosters resilience and prevents reinjury, making it suitable for various age groups.
Conclusion
Adequate sleep is essential, not optional, for recovering from back injuries after car accidents. It bolsters natural repair, manages pain and stress, and lowers long-term risks. Combined with specialized chiropractic and holistic care that addresses core issues, it leads to improved spinal function and well-being. Prioritizing rest alongside expert guidance ensures a more complete return to health.
Healthy Eating to Prevent Drowsy Driving and Support Recovery from Motor Vehicle Accidents
Drowsy driving is a serious issue that contributes to thousands of motor vehicle accidents (MVAs) each year, leading to injuries, fatalities, and significant economic costs. According to the National Highway Traffic Safety Administration, drowsy driving was responsible for an estimated 91,000 crashes in 2017 alone, resulting in 50,000 injuries and nearly 800 deaths (NHTSA, 2019). These accidents often cause musculoskeletal injuries, such as back and neck pain, which can significantly impact a person’s quality of life. Fortunately, adopting healthy eating habits can help drivers stay alert and energized, reducing the risk of drowsy driving. Additionally, chiropractic care and integrative medicine, practiced by experts such as Dr. Alexander Jimenez in El Paso, Texas, provide effective solutions for recovery and long-term wellness for individuals who have experienced motor vehicle accidents (MVAs).
This blog post examines the relationship between nutrition, drowsy driving prevention, and recovery from motor vehicle accident (MVA)- related injuries. We’ll discuss the best foods and snacks to keep drivers awake, the role of chiropractic and integrative medicine in treating musculoskeletal injuries, and how Dr. Jimenez’s unique approach combines advanced diagnostics, nutrition, and health coaching to promote healing and overall well-being. This guide offers practical tips and evidence-based insights to help you stay safe on the road and recover effectively in the event of an accident.
The Dangers of Drowsy Driving
Drowsy driving occurs when a driver operates a vehicle while fatigued, impairing their reaction time, decision-making, and overall alertness. Fatigue can stem from a lack of sleep, long driving hours, or poor dietary choices that lead to energy crashes. The consequences are severe: drowsy driving increases the likelihood of MVAs, which can cause injuries ranging from whiplash to complex spinal issues.
Why Drowsiness Matters
Fatigue affects the brain’s ability to process information, similar to the effects of alcohol impairment. A study by the AAA Foundation for Traffic Safety found that drivers who slept only 4–5 hours in the past 24 hours had a crash risk comparable to those with a blood alcohol concentration above the legal limit (AAA Foundation, 2016). For adult drivers, especially those with demanding schedules, maintaining alertness is critical to preventing accidents.
The Role of Nutrition
Diet plays a significant role in combating fatigue. Foods that cause rapid spikes and drops in blood sugar, such as sugary snacks or refined carbohydrates, can lead to energy crashes that exacerbate drowsiness. Conversely, nutrient-dense foods provide sustained energy, keeping drivers alert for longer periods. By selecting appropriate snacks, drivers can minimize the likelihood of falling asleep while driving, thereby safeguarding both themselves and other road users.
To avoid drowsiness, drivers should prioritize foods that provide steady energy without causing blood sugar spikes. Below, we outline the best snacks for sustained alertness, based on scientific research and expert recommendations.
Fruits for Steady Energy
Fruits like apples and bananas are excellent choices for drivers. Apples contain natural sugars, fiber, and antioxidants, which provide a gradual release of energy. A study published in Nutrients found that apples improve cognitive performance due to their high flavonoid content (Bondonno et al., 2018). Bananas, rich in potassium, vitamin B6, and complex carbohydrates, offer long-lasting energy and help regulate blood sugar levels (Medical News Today, 2018).
How to Pack: Slice apples and pair with a small amount of peanut butter for added protein. Store bananas in a cool, dry place in your vehicle for a convenient on-the-go snack.
Nuts for Sustained Fuel
Nuts, such as almonds and walnuts, are rich in healthy fats, protein, and fiber, making them an ideal choice for maintaining energy levels. Almonds contain magnesium, which supports muscle function and reduces fatigue, while walnuts provide omega-3 fatty acids that enhance brain function (Healthline, 2020). These nutrients help drivers stay focused during long trips.
How to Pack: Portion out 1-ounce servings of mixed nuts in resealable bags to avoid overeating. Combine with dried fruit for a balanced snack.
Protein-Rich Snacks
Protein helps stabilize blood sugar and promotes satiety, preventing energy dips. Yogurt with nuts and berries is a great option, as it combines protein, probiotics, and antioxidants. Greek yogurt, in particular, has been shown to improve mental alertness due to its high protein content (Cleveland Clinic, 2021). Peanut butter on whole wheat crackers provides a mix of protein, healthy fats, and complex carbohydrates, offering sustained energy without the crash (Yuma Truck Driving School, 2023).
How to Pack: Use a small cooler to keep yogurt fresh. Pre-spread peanut butter on whole-wheat crackers and store them in an airtight container for convenience.
Hydration: The Unsung Hero
Staying hydrated is equally important for preventing fatigue. Dehydration can cause drowsiness, reduced concentration, and slower reaction times. Drinking water or unsweetened herbal teas keeps the body and brain functioning optimally (Doug Andrus, 2022).
How to Pack: Carry a reusable water bottle and refill it at rest stops. Avoid sugary drinks or excessive caffeine, as they can lead to energy crashes (Sleep Foundation, 2023).
Foods to Avoid
Avoid high-sugar snacks, such as candy bars, sodas, or pastries, as they can cause rapid blood sugar spikes followed by crashes, which can increase drowsiness. Heavy, greasy meals can also divert blood flow to the digestive system, making you feel sluggish (Logmate, 2022).
The Consequences of MVAs: Musculoskeletal Injuries
When drowsy driving leads to a motor vehicle accident (MVA), the physical toll can be significant. Common injuries include whiplash, back pain, neck pain, and complex spinal issues, which can cause chronic discomfort and limit mobility. These injuries often require specialized care to restore function and prevent long-term complications.
Common MVA Injuries
Whiplash: A sudden jolt in a collision can strain or tear neck muscles and ligaments, leading to pain, stiffness, and headaches. Whiplash is one of the most common MVA injuries, affecting millions annually (Jimenez, 2018).
Back Pain: An accident can compress spinal discs or misalign vertebrae, causing lower back pain or sciatica. These conditions may persist without proper treatment (El Paso Back Clinic, 2023).
Neck Pain: Beyond whiplash, neck pain can result from muscle strains or nerve irritation, impacting daily activities and sleep quality (Jimenez, 2025).
The Long-Term Impact
Untreated musculoskeletal injuries can lead to chronic pain, reduced mobility, and secondary issues like depression or poor posture. For example, a study in Pain Research and Management found that 20–50% of whiplash patients develop chronic symptoms if not treated early (Sterling et al., 2019). Early intervention is crucial in preventing these outcomes.
Chiropractic care is a cornerstone of recovery for MVA-related injuries, offering non-invasive, evidence-based treatments to restore mobility and alleviate pain. Dr. Alexander Jimenez, a chiropractor and board-certified nurse practitioner in El Paso, Texas, is renowned for his expertise in treating MVA victims, combining chiropractic techniques with integrative medicine for optimal outcomes.
How Chiropractic Helps
Chiropractic care focuses on restoring spinal alignment, reducing nerve interference, and promoting natural healing. Common techniques include:
Spinal Adjustments: Realign vertebrae to relieve pressure on nerves and discs, reducing pain and improving function.
Manual Therapies: Target soft tissue injuries to reduce inflammation and enhance mobility.
Spinal Decompression: Relieves pressure on compressed discs, alleviating sciatica and back pain (Jimenez, 2023).
A 2020 study in the Journal of Manipulative and Physiological Therapeutics found that chiropractic adjustments significantly reduced pain and improved range of motion in patients with whiplash-associated disorders (DeVocht et al., 2020).
Dr. Jimenez’s Approach
Dr. Jimenez’s dual licensure as a chiropractor and nurse practitioner allows him to provide comprehensive care that bridges biomechanical and medical perspectives. His practice at Injury Medical & Chiropractic Clinic emphasizes:
Dual-Scope Procedures: Combining chiropractic adjustments with medical assessments to address both musculoskeletal and systemic issues.
Diagnostic assessments, including blood panels and functional medicine tools like the Living Matrix, help identify underlying causes of pain, such as inflammation or hormonal imbalances (El Paso Back Clinic, 2023).
This integrated approach not only treats injuries but also supports legal documentation for personal injury cases, ensuring patients receive appropriate compensation for their medical needs (Jimenez, 2025).
Integrative medicine, as practiced by Dr. Jimenez, goes beyond symptom relief to address the root causes of health issues. Nutrition and health coaching are integral components of this approach, supporting recovery from motor vehicle accident (MVA) injuries and promoting overall well-being.
The Role of Nutrition
Nutrition plays a crucial role in the healing of musculoskeletal injuries. Anti-inflammatory diets, rich in omega-3 fatty acids, antioxidants, and lean proteins, reduce pain and swelling, accelerating recovery. For example:
Omega-3s, found in walnuts and fatty fish, decrease inflammation, supporting joint and tissue repair (Kaushik et al., 2020).
Lean Proteins: Eggs and Greek yogurt provide amino acids for muscle repair and immune function (Cleveland Clinic, 2021).
Dr. Jimenez creates personalized nutrition plans tailored to each patient’s needs, ensuring optimal nutrient intake for recovery (El Paso Back Clinic, 2023).
Health Coaching
Health coaching empowers patients to adopt sustainable lifestyle changes, such as stress management, sleep optimization, and ergonomic adjustments. These practices prevent injury recurrence and enhance long-term health. A 2019 study in the Journal of Clinical Endocrinology & Metabolism linked stress management to reduced cortisol levels, which can exacerbate chronic pain (Hannibal et al., 2019).
Dr. Jimenez’s virtual and in-person coaching sessions guide patients in implementing these changes, ensuring they remain on track with their recovery goals (Jimenez, 2025).
Functional Medicine Assessments
Using tools like the Neural Zoomer Plus, Dr. Jimenez identifies neurological and systemic contributors to pain, including inflammation and nutrient deficiencies. These assessments enable precise interventions, addressing the whole person rather than just symptoms (El Paso Back Clinic, 2019).
Dr. Jimenez’s Expertise in El Paso Personal Injury Cases
Dr. Alexander Jimenez is a leading figure in El Paso’s chiropractic and integrative medicine community, with over 25 years of experience treating MVA victims. His practice, Injury Medical & Chiropractic Clinic, is recognized for its patient-centered approach, which combines advanced diagnostics, chiropractic care, and functional medicine to achieve measurable health outcomes.
Clinical Rationale
Dr. Jimenez’s clinical rationale emphasizes the correlation between patient injuries and advanced diagnostics. For example:
Advanced Imaging: MRI and CT scans reveal hidden injuries, such as herniated discs or soft tissue damage, that may not be evident in initial exams (Jimenez, 2023).
Dual-Scope Procedures: By integrating chiropractic and medical assessments, Dr. Jimenez addresses both biomechanical dysfunctions and systemic issues, ensuring comprehensive care.
Diagnostic Assessments: Tools like blood panels and functional medicine evaluations uncover underlying factors, such as inflammation or hormonal imbalances, that prolong recovery (El Paso Back Clinic, 2023).
This approach not only facilitates physical recovery but also provides detailed documentation for personal injury cases, supporting patients’ legal claims (Jimenez, 2025).
Success Stories
Patient testimonials highlight Dr. Jimenez’s transformative impact. For example, a 2023 case study on elpasobackclinic.com described a patient who recovered from severe whiplash and sciatica through a combination of chiropractic adjustments, nutritional therapy, and health coaching. Such outcomes demonstrate the efficacy of Dr. Jimenez’s holistic approach.
To incorporate these insights into your daily routine, follow these practical tips:
Plan Your Snacks: Pack a cooler with apples, bananas, nuts, yogurt, and whole-wheat crackers with peanut butter for long drives.
Stay Hydrated: Keep a water bottle handy and sip regularly to avoid dehydration-related fatigue.
Take Breaks: Stop every 2 hours to stretch, eat a healthy snack, and refresh your mind (New Cars Online, 2023).
Seek Care After an MVA: If you’re in an accident, consult a specialist like Dr. Jimenez for a comprehensive evaluation and personalized treatment plan.
Adopt a Healthy Lifestyle: Follow an anti-inflammatory diet and engage in regular exercise to support overall health and resilience.
Drowsy driving is a preventable risk that can lead to devastating MVAs and musculoskeletal injuries. By choosing nutrient-dense snacks like apples, bananas, nuts, and protein-rich foods, drivers can maintain alertness and reduce the likelihood of accidents. For those who experience MVAs, chiropractic care and integrative medicine, as exemplified by Dr. Alexander Jimenez in El Paso, offer a path to recovery. Through advanced imaging, dual-scope procedures, and personalized nutrition plans, Dr. Jimenez addresses the root causes of injuries, enabling patients to regain mobility and improve their quality of life. By combining healthy eating habits with proactive medical care, drivers can stay safe on the road and thrive after an accident.
For more information or to schedule a consultation with Dr. Jimenez, visit dralexjimenez.com or call 915-850-0900.
Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?
Sleep Cervical Neck Roll
Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.
For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.
Neck Support During Sleep
The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)
Individuals can purchase a cervical roll online or at a store or pharmacy.
Individuals can also contact a physical therapist to help them obtain a cervical roll.
Making Your Own
Making a cervical roll is simple to do. Here’s how:
Using a hand towel.
Fold it in half.
Slide the towel into the pillowcase along the lower edge.
Be sure the towel is tucked in so it doesn’t slip out.
Individuals can place tape around it so it stays in the rolled shape.
The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)
If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.
Injury Medical Chiropractic & Functional Medicine Clinic
A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Road To Recovery: Chiropractic Care
References
Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6
Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2
Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530
Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain
What type of exercise is recommended for individuals who want to exercise before bed?
Exercising Before Bed
Exercising sounds like a good way to tire the mind and body before bed. However, research shows that moderate to vigorous exercise later in the day can negatively impact sleep quality. (Alkhaldi E. H. et al., 2023)
To improve sleep, it is recommended that you exercise in the morning or earlier in the day, at least four hours before bed.
Individuals who exercise later should aim for lighter activities, such as non-strenuous walking or gentle, restorative yoga.
Light physical activity, like a slow walk after dinner, is OK.
Advantages
Daily exercise improves sleep quality. (Johns Hopkins Medicine, 2025) Mild exercise before bed and engaging in light activities like walking or stretching can positively affect health (Hijikata Y, Yamada S. 2011). These include:
Decrease muscle tension
Improve digestion
Improve blood sugar regulation
Relax the mind and body
Disadvantages
The nervous system naturally switches between active and calm. It is ready to work and engage in physical activities when it is active. When it is resting, sleep occurs. Activating the nervous system before bed can affect sleep, and exercising can affect body temperature, producing sleep challenges. Typically, body temperature decreases as the body prepares for sleep. Exercising before bed can increase core temperature and disrupt the process. (Szymusiak R. 2018) Moderate or vigorous physical activity close to going to sleep can: (Alkhaldi E. H. et al., 2023)
Make it more difficult to fall asleep
This leads to more waking up during the night.
Decrease sleep quality
Recommended Types of Exercise
Pre-bedtime activities should not be vigorous or engaging enough to make the body and mind more alert. Some exercises to calm the body and mind before bed include: (Sleep Foundation, 2023)
Restorative Yoga
Yoga Nidra and other low-intensity yoga can help promote sleep.
More intense forms of yoga, such as vinyasa/flow, should be done earlier.
Tai Chi
A Chinese practice that incorporates slow, gentle movements and focuses on breathing to promote peace and relaxation.
Slow Walking
Walking at a leisurely pace can help the body unwind and relax.
A slow heart rate and breathing indicate that the activity is calming and not stimulating.
Exercises to Avoid
Moderate to high-intensity workouts before bed that increase breathing and heart rate can disrupt sleep. Individuals who struggle to fall asleep or get restful sleep should try reducing the intensity of certain exercises or avoiding them one to two hours before bed. Examples of moderate to vigorous exercises include: (American Heart Association, 2024)
Gardening or heavy yard work
Running
Brisk walking
Cycling
Dancing
Sports activities
Working Out In The Evening
Sometimes, exercising later in the day or close to bedtime is the only time to get physical activity. If this is the case, late exercise is better than no exercise at all, but there are ways to lessen its impact on sleep, including:
Light physical activity, like walking, can be done up to an hour before bed.
Do more intense exercises at the beginning of the workout.
End the workout with a cooldown, like walking or stretching, to relax the mind and body.
Know how your workout schedule impacts your sleep, and adjust as necessary.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Optimizing Your Wellness
References
Alkhaldi, E. H., Battar, S., Alsuwailem, S. I., Almutairi, K. S., Alshamari, W. K., & Alkhaldi, A. H. (2023). Effect of Nighttime Exercise on Sleep Quality Among the General Population in Riyadh, Saudi Arabia: A Cross-Sectional Study. Cureus, 15(7), e41638. https://doi.org/10.7759/cureus.41638
Johns Hopkins Medicine. (2025). Exercising for better sleep. https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep
Hijikata, Y., & Yamada, S. (2011). Walking just after a meal seems to be more effective for weight loss than waiting for one hour to walk after a meal. International journal of general medicine, 4, 447–450. https://doi.org/10.2147/IJGM.S18837
Szymusiak R. (2018). Body temperature and sleep. Handbook of clinical neurology, 156, 341–351. https://doi.org/10.1016/B978-0-444-63912-7.00020-5
Sleep Foundation. (2023). Bedtime routines for adults. https://www.sleepfoundation.org/sleep-hygiene/bedtime-routine-for-adults
American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
Harvard Health Publishing. (2024). Does exercising at night affect sleep? https://www.health.harvard.edu/staying-healthy/does-exercising-at-night-affect-sleep
For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?
Weight Resistance Training
Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.
Resistance Training and Improved Sleep
Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:
Your body weight
Resistance bands
Free weights
Weight-lifting machines
The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.
Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)
How Much Resistance Training Is Needed?
Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.
The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
They added that higher intensity and frequency of training could have a greater effect on sleep.
In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)
Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.
Strength Workouts
Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including:
Leg presses
Chest presses
Lat pulldowns
Bicep curls
Abdominal crunches
Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)
However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.
Other Ways to Improve Sleep Without Meds
Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Weight Loss Techniques
References
Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. https://doi.org/10.1371/journal.pone.0301616
Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. https://doi.org/10.1016/j.jpsychores.2017.12.012
Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. https://doi.org/10.3390/ijerph20054431
Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. https://doi.org/10.1519/JSC.0000000000000750
Iowa State University. (2022). Pumping iron may improve sleep more than cardio workouts. https://www.news.iastate.edu/news/2022/03/03/resistance-exercise-sleep
Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. https://doi.org/10.1249/JES.0000000000000273
American Heart Association. (2022). Resistance exercise may improve sleep more than aerobic exercise. https://www.heart.org/en/news/2022/03/03/resistance-exercise-may-improve-sleep-more-than-aerobic-exercise#:~:text=The%20results%20are%20considered%20preliminary,at%20night%2C%22%20Brellenthin%20said.
Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. https://doi.org/10.1016/j.smrv.2017.07.002
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
