Sleep Soundly

By Dr. Kevin Wong

Have you ever woken up from a long night of slumber with a sore neck and wondered what happened? Have you ever heard the alarm clock go off in the morning and realized you didn't sleep more than a couple of hours the entire night? Do you wake up every hour and get frustrated at why it is so late (and how tired you are) and yet you can't seem to stay asleep?

It is amazing how many millions of people lie down at night with the hopes of getting some restful sleep, but never seem to be able to. Of course, there are some genuine health reasons why people may have trouble sleeping, such as sleep apnea, side effects of prescription medications, and pain from debilitating medical problems. Those are just a few of the many causes that might prevent someone from sleeping well. For the average person, however, better sleep can be attained simply by taking some steps that are completely under your control.

It's important to understand that sleeping is as individual an event as exercising, eating right or deciding what to wear every day. Our society makes you think that if you have any old mattress and a pillow, and time to sleep, everything will take care of itself. Not true. Here are a few suggestions on how to make your sleep more individualized and restful.

Your Mattress

Sleep Soundly - Copyright – Stock Photo / Register Mark Most people buy a new mattress when their old one "wears out," meaning it's tattered, torn, excessively stained and/or otherwise unappealing to sleep on. Generally, it is not a good idea to keep a mattress longer than 10-15 years due to the wear and tear you put it through. Depending on the quality, it may last longer or shorter. Going to a store and lying on a mattress for a few minutes is not enough time to make a decision on something you will have to lie on for years to come. You need to test it out in a real sleep environment to make sure you can experience deep, rejuvenating sleep for years. After all, why pay good money to end up tossing and turning every night?

Choose a mattress that has a trial period so that if you do not like it, you can return it and get another. Most good mattresses come with trial periods of anywhere from 90 days to up to five years, depending on where you buy them. Do not buy a mattress if you have no ability to return it. They cost far too much money to have buyer's remorse later.

Again, in terms of which specific mattress type/style to choose, it really boils down to how it makes you feel/sleep. Some people prefer a firm mattress, while others like a softer mattress. As long as it adequately supports your head, neck and back during sleep (meaning you don't sink into it excessively or don't hurt the next day from lying on something that feels like your hard floor), it's what makes you sleep well that matters most.

Sleeping Position

OK, so you've picked out your "perfect" mattress; now how do you sleep on it? From a health perspective, the best position for sleep is on your back with a pillow under your knees. The pillow should be comfortable for you and help take pressure off the small of your back. The second-best position is on your side with a pillow between your knees. The pillow between the knees must be thick enough to keep your thighs hip-width apart. On your side also means you need a supportive pillow (I'll explain what kind of pillow in just a minute).

The most undesirable position for sleeping is on your stomach. This is because you need to turn your head to either side in order to breathe and this can cause neck pain. Often I notice that people who sleep on their stomachs also throw one or both arms over their head, which can lead to pain in the shoulders as well. Please try to avoid this position, as it is not healthy for your body.

I know you sometimes think it's the most relaxing position, but it doesn't last and can do more damage than good. Many times your body tells you if it is in an uncomfortable position. It wakes you up and makes you move. I know this is a hard one for many of you because your favorite position to sleep goes all the way back to when you were a baby. Try to make sure you make the appropriate changes because they will help you.

Your Pillow

Think about how you like to sleep before you choose your pillow. People who sleep on their back need a thinner pillow than those who sleep on their side. There are so many pillows to choose from, but my best advice to you is to take your current pillow to your chiropractor and let them analyze it for you.

pillow - Copyright – Stock Photo / Register Mark When my patients bring their pillows to me, I have them lie flat on their back and check the angle of their head. Your head should not be lifted too high so that it cranes your neck. While on your side, your pillow should cradle your neck so that your spine forms a 90 degree angle with a line through the shoulders.

Don't be fooled! Just because you have an orthopedic or fancy memory foam pillow doesn't mean it is right for you. In fact, it could be one of the causes of your sleep problems. Again, let your doctor evaluate your pillow and discuss the best option to maximize your sleep.

A Few Other Ideas to Help Ensure Peaceful Sleep

No distractions in your bedroom. Watching TV, typing on the laptop or listening to your iPod before bed gets your metabolism going and disrupts the body's relaxation mechanisms for getting sleepy. Try to turn off the TV or handheld device at least 30 minutes before bed so you can have quiet time to prepare for sleep.

No drinking alcohol or exercising within a couple of hours of bedtime. These activities affect your metabolism and will delay the onset of sleep.

Keep a consistent bedtime and wake time (even on weekends). This helps to keep your body's clock ("circadian rhythm") regulated. Your body does well on a schedule; if you disrupt that schedule, the body has trouble adjusting. You may get eight hours of sleep if you go to bed at 9:00 a few nights a week and midnight a few others, but the difference in quality of sleep will probably be noticeable. Try to stick to a consistent schedule whenever possible.

Biomechanics of Sleep

You can tell so far that we have been talking about setting up your sleep conditions so that you have the best chances of not only falling asleep, but getting great rest. Now I really want you to stop for a moment and go through your ritual of getting ready for bed, going to bed, sleeping and then waking up the next morning. If you find that you are having trouble getting to sleep, waking up repeatedly in the night or having trouble waking up because you are so groggy or unrested, it's time to sit down and consider how some of the above variables (mattress, pillow, sleep position) may be playing a role.

Another big key to all of this is making sure you are adjusted regularly by your chiropractor. Having your neck, shoulders, back and hips adjusted regularly will not only help to keep them healthy biomechanically, but help keep stress off the joints when you are sleeping. Less stress means less injury and pain.

Talking about sleep and sleep habits with my patients is one of the most important parts of my treatment plan. How you sleep can negatively affect the way your chiropractic adjustments hold and can prolong pain and healing time. Sleep is something we take for granted ... until you don't get enough of it. If you're experiencing sleep problems, talk to your doctor and evaluate whether your mattress, pillow and sleep position are to blame.

Don't Skimp on Sleep

Who's got time to sleep? Among other culprits, we can blame technology. Consider that before the introduction of cell phones, blogging, text messaging, social media sites, video games and even cable television, people generally went to bed earlier, and for several reasons. First, without those technological "distractions" to occupy countless hours of late-night time, there was nothing to keep you from lying down and dozing off. Second, those distractions overstimulate your brain, make it more difficult to sleep once you decide it's time for bed.

sleep and texting - Copyright – Stock Photo / Register Mark No big deal, right? That's the world we live in. Consider the some of the potential short- and long-term health consequences of poor sleep, courtesy of WebMD:

Short-Term Consequences

  • Worse performance: Anyone who's had a late night and then rushed to work the next morning knows that it's a little harder to focus and stay sharp, particularly as the day wears on.
  • Worse memory: Your ability to think and process information declines in the absence of quality sleep.
  • Higher injury risk: Excessive sleepiness contributes to higher risk of occupational injuries, not to mention automobile accidents.

Long-Term Consequences

  • High blood pressure
  • Heart attack
  • Stroke
  • Obesity
  • Attention deficit disorder
  • Depression
  • Poor quality of life

Remember, poor sleep, particularly if it becomes chronic, could be a sign of an underlying medical condition, so talk to your doctor if you're having trouble sleeping so they can help determine what's causing it and then do something about it!

Kevin M. Wong, DC, a 1996 graduate of Palmer College of Chiropractic West in San Jose, Calif., practices full-time in Orinda, Calif. He is also an instructor for Foot Levelers, Inc.

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