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.
Could learning to apply healthy sleep hygiene habits help improve sleep and overall health for individuals with sleeping difficulties?
Primary Insomnia
Insomnia affects most adults at some point in their lives. Primary insomnia is a fairly common condition characterized by difficulty sleeping, and sometimes, it can resolve without treatment. A diagnosis of primary insomnia means that there is no need to worry that a medical or psychological issue is causing sleep problems. Secondary insomnia is the result of medication side effects or medical or psychological issues. However, individuals may need a diagnostic evaluation, including blood tests or an overnight sleep study, to determine an underlying cause for persistent insomnia. Managing lifestyle habits is usually effective for the relief of primary insomnia. If that doesn’t work, medical treatment may be recommended.
Symptoms
Primary insomnia means not getting enough sleep. Individuals with primary insomnia average six hours of sleep per night (Flynn-Evans E. E. et al., 2017). They often toss and turn or get out of bed frequently. Typically, primary insomnia makes it hard to fall asleep and/or stay asleep. Individuals can wake up easily by triggers like noises or even without triggers. Sleep deprivation can lead to several health problems when awake. Symptoms of insomnia fatigue include: (Salisbury-Afshar E. 2018)
Trouble waking up in the morning
Constant yawning
Feeling tired and sleepy throughout the day
Lack of energy for physical activity
Lack of motivation
Hunger
Difficulty concentrating
Irritability
Headaches
Hypersomnia or falling asleep during the day
Sensitivity to noise or lights when awake
Bouts of hyperactivity
Jumpiness
Being easily alarmed or frightened
Individuals can experience these symptoms for a few days in a row and resolve the day after a restful night of sleep or after a nap. There are times when fatigue can help with falling asleep, which helps to resolve insomnia.
Complications
Individuals can develop severe anxiety and distress about the fact that they are not getting enough sleep. This anxiety is usually more severe before going to bed or in the middle of the night, but the worry can continue during the day as well. Persistent insomnia and chronic lack of sleep can lead to depression and predispose the mind and body to health complications. (Sun, Q., & Tan, L. 2019) Insufficient sleep is associated with lowered immune system function, obesity, and heart disease. (Hung C. M. et al., 2018)
Causes
The conundrum of primary insomnia is that it does not have an identifiable cause, but certain risk factors predispose individuals to have primary insomnia. The condition persists throughout a person’s life, often worsening or improving for months or years. Primary insomnia can be more common among those who have family members with insomnia. Research has found that, while primary insomnia isn’t caused by psychiatric issues, tending to stress or a worry-prone personality might be predisposing factors. (Hung C. M. et al., 2018)
Circadian Rhythm
Research has found that primary insomnia is associated with circadian rhythm irregularities. It can result from individuals falling into deeper sleep phases earlier than those who don’t have the condition (Flynn-Evans E. E. et al., 2017). However, it can be challenging to know whether early deep sleep is a cause or an effect of primary insomnia. This is because sleep deprivation can also lead to abrupt or rapid onset of deep sleep.
Diagnosis
Getting enough sleep is a common concern throughout life. Diagnosing primary insomnia involves various steps. One of the main components of identifying insomnia is determining whether the individual needs more sleep than they are getting. For individuals who are unable to get the proper amount of sleep, the second aspect of primary insomnia diagnosis is focused on finding the reason for their lack of sleep. Diagnostic tests measure insomnia and its effects and include:
Sleep Study
A polysomnogram is an overnight sleep study measuring brain activity, muscle activity, and breathing.
The polysomnogram is expected to show decreased sleep and normal breathing patterns if it is primary insomnia. (Sun, Q., & Tan, L. 2019)
Pittsburgh Sleep Quality Index
The PSQI is a questionnaire that includes a self-assessment of sleep.
It helps identify sleep patterns and issues like using the bathroom frequently at night.
Multiple Sleep Latency Test
An MSLT is a daytime nap study in which participants are monitored to determine how fast they fall asleep.
The test results are a reflection of your sleep deprivation.
These studies help assess whether an individual is not getting enough sleep and what type of sleep interruption is experienced. Other tests might include screening questionnaires or other assessments of emotional issues like depression and anxiety. Sometimes, individuals are aware of these problems but may dismiss symptoms of depression and anxiety, and they instead manifest as insomnia.
Individuals might need to have tests to determine whether any of these underlying issues are contributing to their insomnia. Individual medical symptoms and physical examination would guide the diagnostic testing.
Sleep Hygiene Habits
Individuals can start making small lifestyle adjustments to help regulate their sleep. The key is to avoid things that prevent falling asleep when you want to. Healthy habits include:
Avoid caffeine in the afternoon or evening.
Avoid alcohol.
Avoid napping during the day.
Don’t turn on a phone, computer, or television screen in the bedroom before bed.
Staying away from bright lights for several hours before sleep.
Scheduling tasks so you feel caught up before going to sleep.
Getting enough to eat so you aren’t hungry before going to bed.
Not eating so much that you feel bloated before going to bed.
Doing some light exercise several hours before going to bed.
Medical Treatment
If lifestyle habits don’t help alleviate insomnia, talk to a healthcare provider about medical therapy. Some notice a benefit from treatment with non-prescription-based strategies like counseling, cognitive behavioral therapy for insomnia (CBT-I), or acupuncture. These approaches can have a longer-lasting effect without the risk of side effects. (Salisbury-Afshar E. 2018) A healthcare provider might recommend melatonin or may prescribe medication such as antidepressants, antihistamines, or benzodiazepines.
Injury Medical Chiropractic and Functional Medicine Clinic
Navigating insomnia can be challenging, but understanding the treatment process can significantly help the individual. A healthcare provider can determine the most effective treatment strategies. This can include physical therapy, rest, health coaching, and medication. Overcoming these limitations is possible. 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, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Building a Stronger Body
References
Flynn-Evans, E. E., Shekleton, J. A., Miller, B., Epstein, L. J., Kirsch, D., Brogna, L. A., Burke, L. M., Bremer, E., Murray, J. M., Gehrman, P., Rajaratnam, S. M. W., & Lockley, S. W. (2017). Circadian Phase and Phase Angle Disorders in Primary Insomnia. Sleep, 40(12), 10.1093/sleep/zsx163. doi.org/10.1093/sleep/zsx163
Salisbury-Afshar E. (2018). Management of Insomnia Disorder in Adults. American Family Physician, 98(5), 319–322.
Sun, Q., & Tan, L. (2019). Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder. Psychiatry Research, 282, 112514. doi.org/10.1016/j.psychres.2019.112514
Hung, C. M., Li, Y. C., Chen, H. J., Lu, K., Liang, C. L., Liliang, P. C., Tsai, Y. D., & Wang, K. W. (2018). Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study. BMC psychiatry, 18(1), 38. doi.org/10.1186/s12888-018-1623-0
Guo, H. M., Liu, M., Xiang, Y. T., Zhao, J., Ungvari, G. S., Correll, C. U., Ng, C. H., Chiu, H. F., & Duan, Z. P. (2017). Insomnia in Adults With Chronic Hepatitis B, Liver Failure, and Cirrhosis: A Case-Control Study. Perspectives in psychiatric care, 53(1), 67–72. doi.org/10.1111/ppc.12138
Can individuals have a full night of sleep by making small changes to their sleep posture to reduce general aches and pains?
Introduction
Many individuals know that after a long, hard day of working or running errands, getting much rest is necessary to reduce tension in the body and put it in a relaxed state. Getting a quick nap to a full night of sleep is important not only for the body but also for the posture. However, many people get a bad night’s rest from various environmental factors that can keep them from getting the full benefits of eight hours of sleep. It can range from stressful events impacting a person’s life to overlapping risk profiles correlated with chronic conditions. Today’s article focuses on how poor posture can affect sleep and how there are different ways for a person to get a good night’s rest, improve sleep posture, and find the right mattress and pillows to allow the individual to stay asleep. We discuss with certified medical providers who inform our patients how various environmental factors can cause overlapping risk profiles and not getting a full night of rest. While asking informed questions to our associated medical providers, we advise patients to incorporate various techniques to improve sleep posture when getting a full night of quality sleep. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
Poor Posture Affecting Sleep
Do you feel extremely tired throughout the day, even after a full night? Do you experience stiffness in the morning that gets better throughout the day? Or how often do you wake up constantly at night and have trouble staying asleep? Many individuals who have experienced these scenarios are frequently correlated with bad sleeping habits. Many individuals have dealt with poor sleeping habits throughout the day due to environmental factors that can impact their sleep. Some environmental factors, like poor posture, can affect how people sleep at night. Poor posture has always been associated with musculoskeletal disorders. When musculoskeletal disorders have overlapping risk profiles from physical workload and psychological stress, it can become a predictor or even correlate with sleep disorders. (Hammig, 2020) This is because having habitual in-bed behaviors like movement and posture could cause health complications and prevent people from getting a good night’s rest. (Elnaggar et al., 2023)
This is due to how individuals’ posture can affect their sleep quality and overall health. For instance, individuals dealing with chronic spinal pain will begin to develop poor posture over time. When this happens, it can coexist with other comorbidities like insomnia, which can lead to a larger negative effect on a person’s physical and mental functioning while preventing them from being less productive and having poor quality of sleep. (Bilterys et al., 2021) When people experience spinal pain, causing them to develop poor posture, it can lead to sleep disturbances. The correlation between sleep disturbances and poor posture can cause impairment of the physiological process that can contribute to maintaining chronic pain. (Skillgate et al., 2021) However, there are numerous ways for people to get a good night’s rest while improving their posture.
The Benefits Of Stretching-Video
Ways To Get a Good Night Rest
When it comes to finding ways to get a good night’s rest, many people will try to devise solutions to establish a routine for their bedtime. Some of the ways people can utilize for a good night’s rest include:
Lowering room temperature
Keeping a sleep diary
Limit caffeinated drinks in the evening
Limit electronics before bed
Stick and create a sleep schedule
By creating some of these habits and sticking with them, many people can get much-needed rest and more energy when they wake up. At the same time, proper sleeping habits can help improve sleeping posture.
Improving Sleep Posture
There is no right way to do it regarding proper sleeping habits and improving sleep posture. Everyone has a position they favor more to be comfortable. For instance, a person who sleeps on the back is more relaxed than sleeping on their sides. Since sleep posture is associated with sleep quality, poor posture may provoke increased wake time and affect a person’s ability to maintain an asleep state. (Cary et al., 2021) So, by listening to the body and following its natural sleep flow, a person can stay asleep longer and be comfortable.
Finding The Right Mattress & Pillow
At the same time, improving one’s sleeping posture is not the only way to get a good night’s rest. Finding the right mattress and pillows is important, too. When people seek mattresses and pillows to improve their sleep quality, many often seek out tempur-pedic mattresses to support their body and have the best sleep. Many tempur-pedic mattresses can help reduce pressure from the body, making a person comfortable and minimizing movement. Additionally, new pillows supporting the neck and lower back can reduce somatic symptoms and provide neutral spinal alignment for the body. (Yamada et al., 2023) When it comes to having the best quality of sleep, it can be achievable with proper sleep habits, a new set of pillows and mattresses, and a comfortable position that will allow people to feel refreshed and re-energized.
References
Bilterys, T., Siffain, C., De Maeyer, I., Van Looveren, E., Mairesse, O., Nijs, J., Meeus, M., Ickmans, K., Cagnie, B., Goubert, D., Danneels, L., Moens, M., & Malfliet, A. (2021). Associates of Insomnia in People with Chronic Spinal Pain: A Systematic Review and Meta-Analysis. J Clin Med, 10(14). doi.org/10.3390/jcm10143175
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PLOS ONE, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Elnaggar, O., Arelhi, R., Coenen, F., Hopkinson, A., Mason, L., & Paoletti, P. (2023). An interpretable framework for sleep posture change detection and postural inactivity segmentation using wrist kinematics. Sci Rep, 13(1), 18027. doi.org/10.1038/s41598-023-44567-9
Hammig, O. (2020). Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland. BMC Musculoskelet Disord, 21(1), 319. doi.org/10.1186/s12891-020-03327-w
Skillgate, E., Isacson Hjortzberg, M., Stromwall, P., Hallqvist, J., Onell, C., Holm, L. W., & Bohman, T. (2021). Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress-A Prospective Cohort Study. Int J Environ Res Public Health, 18(19). doi.org/10.3390/ijerph181910051
Yamada, S., Hoshi, T., Toda, M., Tsuge, T., Matsudaira, K., & Oka, H. (2023). Changes in neck pain and somatic symptoms before and after the adjustment of the pillow height. Journal of Physical Therapy Science, 35(2), 106-113. doi.org/10.1589/jpts.35.106
Sleep is vital at all ages, but what is the amount of sleep for older individuals?
Amount of Sleep For Older Individuals
Individuals 65 and older are still recommended to get the same amount of sleep as younger adults. (National Council on Aging, 2023) As the body ages, it still needs around 7–9 hours of sleep, but how an individual sleeps is what changes. Older individuals begin to sleep lighter, and their sleep is broken up, causing them to wake up more at night. This can be due to natural changes in the internal body clock, medications, health conditions like arthritis or sleep apnea, or a combination. Older adults often face sleep barriers that are less common in younger individuals, like disabilities and chronic illnesses, and nearly half of adults aged 75 and above have a disability. Aging also shifts the circadian rhythm, causing older individuals to fall asleep and wake up earlier. Melatonin begins to decline with age, starting in the 30s, which can affect body temperature regulation and disrupt the sleep-wake cycle. (Hood S. & Amir S. 2017)
Healthy Sleep and Healthy Aging
Research found that older individuals who sleep poorly have an increased risk of:
As the body ages, a consistent, healthy amount of sleep prepares you for all the ups and downs. Healthy sleep maintains:
Overall health
Mental health
Mood
Memory
Improves cognitive function
Enhances emotional resilience
Supports heart health
Increases immune system function
Keeps energy levels steady.
Well-rested individuals are less likely to have falls or accidents because their focus and coordination are optimal.
Sleeping Healthier as You Age
Maintaining healthy sleep hygiene and being more mindful of routines will improve sleep patterns. This includes:
Going to bed and waking up at the same time every day.
Avoiding long naps during the day.
Monitoring nutrition and physical activity levels.
Creating a calming bedtime routine like meditation and reading.
Keeping the bedroom dark, cool, and quiet.
Reducing caffeine or alcohol, especially in the evening, can affect sleep patterns.
Sleep aids can help for short periods and should be combined with cognitive behavioral therapy and used with caution in the long term to prevent possible dependency. Medications can help by addressing health issues that impact sleep, like pain, depression, or anxiety. However, some medicines can have side effects that alter or worsen sleep patterns.
Injury Medical Chiropractic and Functional Medicine Clinic
Therefore, older individuals still need 7–9 hours of sleep every night to maintain and enhance mental, physical, and emotional well-being, reducing risks associated with aging. 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.
Hood, S., & Amir, S. (2017). The aging clock: circadian rhythms and later life. The Journal of clinical investigation, 127(2), 437–446. doi.org/10.1172/JCI90328
Stone, K. L., & Xiao, Q. (2018). Impact of Poor Sleep on Physical and Mental Health in Older Women. Sleep medicine clinics, 13(3), 457–465. doi.org/10.1016/j.jsmc.2018.04.012
High temperatures can disrupt the body’s sleep cycles, leading to health problems. Can knowing strategies and remedies help manage sleep quality?
Hot Weather Sleep
Sleep is important for refreshing the mind and body and being productive in school, work, relationships, and overall health. With record-breaking temperatures becoming the norm, consistently sleeping healthy is becoming difficult as forecasters predict another scorching summer with above-average temperatures. 2023 was the hottest year ever recorded. (National Oceanic and Atmospheric Administration. 2024) Studies show that high temperatures make it hard to fall asleep and stay asleep, which can negatively affect the immune system, cardiovascular system, cognitive performance, and mood. (Zheng, G., Li, K., and Wang, Y. 2019) (Obradovich, N. et al., 2017) Throughout the night, the body cycles through different sleep stages. (National Heart, Lung, and Blood Institute, 2022)
Because the body’s temperature regulation is less effective during certain stages, a hot environment can cause waking so the body can thermoregulate. The right temperature is imperative for a healthy night’s sleep. For optimal sleep, it is recommended that the bedroom temperature be between 65 and 69 degrees Fahrenheit. However, this isn’t always possible without air conditioning, which increases electricity bills. Here are other strategies to help keep the body cool for better sleep in hot weather.
Cooler Sleeping Environment
Thinking creatively about sleeping arrangements can help. Try to find the place that is the coolest and has the most airflow. Shutters or curtains during the day can help keep the room dark and cooler, and opening the windows can increase airflow. (Fergus Nicol, 2019) Using a fan can help improve air circulation, and putting ice behind the fan can blow cooler air for improved sleep.
Cooling Pillows and Breathable Pajamas
Pajamas and bedding made from breathable fabrics can help keep the body cool, and cooling mattress toppers or pillows can also help. Cooling pillows have gel overlays that absorb body heat and cool the head and neck. Keep an ice pack on the bedside table and a towel and ice to keep the body cool.
Take a Slightly Warm Shower
Taking a cold shower can cool the body down quickly, but studies have shown that showering in warm water before bed can make it easier to fall asleep. (Tai, Y. et al., 2021) The warm shower signals the body into cooling mode, which can help promote sleep as the body temperature falls at night. However, the water shouldn’t be too warm, which could exacerbate sweating.
Sleep Hygiene
It can be difficult to create the perfect sleep environment in hot weather. A healthy going-to-bed routine is essential in the summer, as stress and anxiety can significantly affect sleep quality. Avoid eating close to bedtime, avoid alcohol, and add some time to relax and unwind before going to bed. Sleep experts suggest general sleep hygiene habits like keeping a consistent bedtime and turning off screens an hour before bed can help improve sleep, even in hot weather. (Baranwal, N., Yu, P. K., and Siegel, N. S. 2023)
Chiropractic Treatment
Chiropractic care, massage, and decompression therapy can help improve sleep. Treatment retrains the body to relax; stretching and pulling the muscles increases blood circulation and advanced and improved brain signals telling the body to relax. A chiropractor will evaluate the individual’s sleeping patterns and recommend various strategies. Benefits include:
Muscle tension relief.
Stimulates nerve and blood circulation.
Relaxes the whole body.
Enhances central nervous system function.
Relieves pain and discomfort.
A chiropractor will also provide:
Sleeping position recommendations.
Postural stretches and exercises.
Recommendations on supportive mattresses.
Ergonomics for work, home, and bed.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Beyond Adjustments: Chiropractic and Integrative Healthcare
Zheng, G., Li, K., & Wang, Y. (2019). The Effects of High-Temperature Weather on Human Sleep Quality and Appetite. International journal of environmental research and public health, 16(2), 270. doi.org/10.3390/ijerph16020270
Obradovich, N., Migliorini, R., Mednick, S. C., & Fowler, J. H. (2017). Nighttime temperature and human sleep loss in a changing climate. Science advances, 3(5), e1601555. doi.org/10.1126/sciadv.1601555
Tai, Y., Obayashi, K., Yamagami, Y., Yoshimoto, K., Kurumatani, N., Nishio, K., & Saeki, K. (2021). Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(6), 1257–1266. doi.org/10.5664/jcsm.9180
Baranwal, N., Yu, P. K., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in cardiovascular diseases, 77, 59–69. doi.org/10.1016/j.pcad.2023.02.005
Can understanding night cravings help individuals who constantly eat at night plan meals that satisfy and choose nutritious snacks?
Eating At Night
Snacking after dinner and eating at night is common and not bad; however, snacking mindfully can help one truly enjoy and savor snacks. Consider some of the reasons why you might be hungry or not completely satisfied after dinner. Improving the nutritional value of nighttime snacks can make late-night hunger work toward meeting nutritional needs. Common reasons include:
Not meeting the right macronutrient balance during dinner.
Not being completely satisfied with dinner.
Dehydration.
Macronutrient Profile
Getting the right amount of carbohydrates, fat, and protein during dinner is integral to feeling satisfied. Adults need 130g of carbohydrates, 56g of protein, and 3.7L of water daily. The amount of fat required varies, but monounsaturated and polyunsaturated fats are the most healthy fats to consume, helping the body feel satisfied. Several studies show that eating protein during a meal reduces hunger and decreases cravings. (Kohanmoo, A. et al., 2020)
Unsatisfying Dinner
Another reason individuals eat at night is that they are unsatisfied with dinner. Eating satiating foods can help the mind and body feel full throughout the evening.
Satiety is the sense of satisfaction from food.
Foods high in fiber and healthy fats are known to help produce satisfaction.
When the body is full and satisfied, it produces hormones that signal to the brain there is no need to continue eating.
Try to plan healthy meals that are genuinely exciting to eat.
Create time to cook and make and eat meals you can genuinely enjoy.
Dehydration
Sometimes, when the body is dehydrated, it can have difficulty distinguishing thirst from hunger. As a result, some may eat in reaction to dehydration. This isn’t always bad, as some foods, specifically water-rich foods like melon and other fruits, can provide hydration. But sometimes, individuals don’t realize they are misreading their body’s thirst for hunger, and they reach for any food. They are still dehydrated, so they keep eating. If hunger persists after dinner, drink a glass of water and wait 20 minutes to see if that impacts hunger.
Maximize Nutrition
Snacking at night is not bad, but it is wise to plan to ensure the body gets the right balance of nutrients.
Satisfy Cravings
Many crave something sweet after dinner or later on. Eating healthy foods that satisfy cravings will help trigger hormones that tell the body it is done eating. Keep your favorite fruits and vegetables for a quick bite to get some sweetness and fiber. Vegetables like red bell peppers and carrots provide sweetness and crunchiness and can be satisfying. One small red pepper provides 100% of the daily recommended Vitamin C in 20 calories. (U.S. Department of Agriculture. Agricultural Research Service. 2018)
Foods that Promote Sleep
The foods chosen can affect sleep. Whole grains, walnuts, cherries, and kiwi increase serotonin and decrease the stress hormone cortisol. Complex carbohydrates contain melatonin, a hormone responsible for feeling sleepy. A whole-grain snack is a healthy choice before going to bed. (Nisar, M. et al., 2019) Some research shows that dark chocolate is rich in magnesium and can help promote deep sleep. However, it also contains caffeine, which can inhibit sleep. If dark chocolate is a favorite, make sure to eat it early enough in the evening.
Alternative Nighttime Routine
Some people eat out of boredom at night. To curb this, individuals in this category should change their routines. Here are a few tips to help adjust nighttime habits.
Healthy After-Dinner Activities
Go for a quick walk after dinner. 10 to 20 minutes can help, as physical activity signals the shift from dinner to other evening activities.
It also gives the body a chance to feel the fullness sensation.
Hobbies and other light meditative activities can help take the mind off eating.
Watch TV Mindfully
Many individuals eat more at night because snacking can go on and on in front of the television.
Use smart and healthy snacking strategies like portion control.
Remember to take a drink of water in between snacking.
Stay active – simple chores or activities while watching TV can help avoid overeating.
Rest and Sleep
Not getting enough sleep has been linked with increased appetite. (Hibi, M. et al., 2017)
Engage in activities to encourage rest.
Meditation can help calm down the mind and body.
Consider going to bed earlier.
Using an integrated approach, Dr. Jimenez’s Functional Medicine Team aims to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. We focus on what works for the individual through researched methods and total wellness programs.
Eating Right to Feel Better
References
Kohanmoo, A., Faghih, S., & Akhlaghi, M. (2020). Effect of short- and long-term protein consumption on appetite and appetite-regulating gastrointestinal hormones, a systematic review and meta-analysis of randomized controlled trials. Physiology & behavior, 226, 113123. doi.org/10.1016/j.physbeh.2020.113123
Nisar, M., Mohammad, R. M., Arshad, A., Hashmi, I., Yousuf, S. M., & Baig, S. (2019). Influence of Dietary Intake on Sleeping Patterns of Medical Students. Cureus, 11(2), e4106. doi.org/10.7759/cureus.4106
Hibi, M., Kubota, C., Mizuno, T., Aritake, S., Mitsui, Y., Katashima, M., & Uchida, S. (2017). Effect of shortened sleep on energy expenditure, core body temperature, and appetite: a human randomised crossover trial. Scientific reports, 7, 39640. doi.org/10.1038/srep39640
For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?
Sleep With A Pillow Between The Legs
Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.
The Benefits
Some potential benefits of sleeping with a pillow between the knees.
Reduce Back and Hip Pain
When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.
Reduce Sciatica Symptoms
Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.
Reduce Herniated Disc Symptoms
A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)
Improve Posture
Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)
Increased weight leads to increased pressure on joints.
Significant change in the center of gravity.
Hormonal changes make connective tissues more lax.
Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.
Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.
What Causes Disc Herniation?
References
Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777
Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248
O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4
Can acupuncture treatment help individuals dealing with or experiencing insomnia and sleep issues and/or disorders?
Acupuncture For Insomnia
Acupuncture is a type of holistic medicine that involves inserting sterile, disposable, thin needles at specific points known as acupoints on the body. Each needle is inserted into a different area to stimulate symptom relief of various conditions, like chronic pain and nausea. (Johns Hopkins Medicine. 2024) Recent research has looked into acupuncture for insomnia and found that it may be an effective alternative. (Mingming Zhang et al., 2019)
Insomnia
Insomnia causes individuals to have trouble falling or staying asleep. Individuals who have insomnia tend to wake up earlier than they intend to and find it difficult to impossible to get back to sleep once they are awake. The sleep disorder is quite common, with around 10% of individuals experiencing it at some point. (Andrew D. Krystal et al., 2019)
There are three categories, all characterized by the duration of the disorder. They include: (Andrew D. Krystal et al., 2019)
Acute/Short-Term
Lasting less than three months.
Episodic
Happens once in a while for less than three months.
Chronic
Lasting more than three months.
Health Issues
Insomnia can cause various health issues, and individuals can develop mood changes, irritability, fatigue, and problems with memory, impulse control, and concentration. (Andrew D. Krystal et al., 2019)
Insomnia has also been shown to increase the risk of heart failure, heart attack, and other chronic health conditions. (Mingming Zhang et al., 2019)
Benefits
Studies on the use of acupuncture for insomnia have found that it may improve sleep because of its influence on certain neurotransmitters. One review noted that specific neurotransmitters involved in the sleep-wake cycle are positively affected by acupuncture. (Kaicun Zhao 2013) The neurotransmitters include:
Norepinephrine
Helps with waking up and staying alert.
Melatonin
A hormone that helps the body calm down and prepare for sleep.
Gamma-aminobutyric acid – GABA
Helps the body fall asleep and stay asleep.
However, more research is needed to confirm the benefits of acupuncture for insomnia further.
Conditions
Certain conditions can contribute to insomnia, including:
Mood disorders
Chronic pain
Other sleep disorders
Acupuncture can help lower the effects of these disorders.
Pain
Because of the way acupuncture affects certain chemicals, it is a proven complementary treatment for pain.
The needles enhance chemicals like endorphins, dynorphins, and encephalins.
Acupuncture also releases corticosteroids, which are stress hormones.
Each of these chemicals has a role in pain symptoms.
Studies have found that individuals with anxiety can also benefit from acupuncture to help reduce symptoms. (Meixuan Li et al., 2019)
Sleep Apnea
Sleep apnea is a sleep-breathing disorder that causes an individual to stop breathing during the night temporarily.
The muscles in the nasal cavity, nose, mouth, or throat become overly relaxed.
Acupuncture can help stimulate the muscles and prevent over-relaxation, preventing apneas.
Data suggests that acupuncture may affect the apnea-hypopnea index, the number of times an individual stops and starts breathing during sleep. (Liaoyao Wang et al., 2020)
Session
Individuals should not feel pain and just a small amount of pressure in the needles’ insertion area.
If pain is present, it could be because the needles are not inserted in the right spot.
Bleeding or bruising where the needle was inserted.
Nausea
Fainting
Pins and needles sensation
Feeling more pain treatment
Prior to getting acupuncture, individuals are recommended to speak to their healthcare provider. They can advise on how it can help and any side effects that may occur due to the individual’s health, underlying conditions, and medical history. Once cleared, they can recommend a licensed acupuncturist.
Zhang, M., Zhao, J., Li, X., Chen, X., Xie, J., Meng, L., & Gao, X. (2019). Effectiveness and safety of acupuncture for insomnia: Protocol for a systematic review. Medicine, 98(45), e17842. doi.org/10.1097/MD.0000000000017842
Krystal, A. D., Prather, A. A., & Ashbrook, L. H. (2019). The assessment and management of insomnia: an update. World psychiatry: official journal of the World Psychiatric Association (WPA), 18(3), 337–352. doi.org/10.1002/wps.20674
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1
Li, M., Xing, X., Yao, L., Li, X., He, W., Wang, M., Li, H., Wang, X., Xun, Y., Yan, P., Lu, Z., Zhou, B., Yang, X., & Yang, K. (2019). Acupuncture for treatment of anxiety, an overview of systematic reviews. Complementary therapies in medicine, 43, 247–252. doi.org/10.1016/j.ctim.2019.02.013
Wang, L., Xu, J., Zhan, Y., & Pei, J. (2020). Acupuncture for Obstructive Sleep Apnea (OSA) in Adults: A Systematic Review and Meta-Analysis. BioMed research international, 2020, 6972327. doi.org/10.1155/2020/6972327
Chan, M. W. C., Wu, X. Y., Wu, J. C. Y., Wong, S. Y. S., & Chung, V. C. H. (2017). Safety of Acupuncture: Overview of Systematic Reviews. Scientific reports, 7(1), 3369. doi.org/10.1038/s41598-017-03272-0
Ernst, G., Strzyz, H., & Hagmeister, H. (2003). Incidence of adverse effects during acupuncture therapy-a multicentre survey. Complementary therapies in medicine, 11(2), 93–97. doi.org/10.1016/s0965-2299(03)00004-9
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