Has Science Finally Found an Ideal Sleep Position?

 Sleep Position and The Brain

Optimal sleeping position has been a topic that is riddled with a lot of conjecture, but with very little evidence to support anyone’s expert opinion. What we do have are a plethora of infographics like the one you see below created by the likes of Cleveland Clinic, The Huffington Post, and this particular one from the Wall Street Journal:

Sleep Infographic Credit WSJ vis The Best Infographics

Sleep Infographic Credit WSJ vis The Best Infographics

I’ll be honest. I make the same recommendations in my practice because this is what I’ve been taught for a long time, and they do make sense from a biomchanical and physiologic basis. However, if you take a quick search through Pubmed, you won’t see much. A few articles about how back sleeping causes snoring and worsens sleep apnea, but that’s about it.

Building Theories with Sleeping Rats

A recent study in the prestigious Journal of Neuroscience provided some clues that may lead to some insight. The authors studied rats and mice using contrast MRI and studied their brains after death.

They were looking at a system called the Glymphatic System. For comparison’s sake, the glymphatic system is like a plumbing system for your brain. It helps get rid of waste products from your brain.

If you want a more in depth explanation on this interesting system, you can read about it in some of my other articles here:

Research: Dementia from Head Injury May Be a Plumbing Problem 

I’ll be honest, I don’t quite understand many of the methods used in the paper. The science is a little bit beyond my pay grade. But here’s what I have gathered from the summary and discussion section:

  1. Side sleeping increases the effectiveness of the brain’s glymphatic (plumbing) system.
  2. Sleeping on the stomach made this system less effective.
  3. When the plumbing system doesn’t work as well, metabolic waste tends to remain in the brain.
  4. The inability to remove metabolic waste (amyloid proteins, etc) is linked to dementia and Alzheimer’s Disease.

What Is Special About Side Sleeping?

Side sleeping is the most commonly observed, and commonly reported sleeping position in human beings. It is also the default sleeping position of most mammals including dogs, rats, and even elephants.

Scientists don’t really know why side sleeping is preferred, but they suspect that it has a lot to do with head positioning.  The authors also suggest that positioning may have a stretching or compressing effect on the nerves and blood vessels of the neck and trunk. When these vessels and nerves are compressed it can impact the autonomic aka automatic part of the nervous system. It’s the system that is responsible for controlling your heart, lungs, stomach, hormones, etc. All the stuff that you don’t think about (hence “automatic” nervous system because it’s on autopilot).

When you combine the altered nerve activity, with sluggish blood flow, then you have an effect on how the brain drains during sleep.

What Does this Mean for People?

This study can’t be generalized to people…..yet.

Rodent spinal anatomy and human spinal anatomy are pretty different, so we’ll see how this plays out.

Here’s what I do know from clinical experience:

  1. People generally sleep better when I suggest a side lying sleep position. That includes musculoskeletal problems like back/neck pain and breathing problems like snoring.
  2. In terms of Structural Chiropractic and NUCCA, head positioning makes a HUGE difference in someone’s overall sense of well-being.
  3. When people have their head and neck corrected, one of the most common benefits is that they tend to sleep deeper and easier then they had in the past. Better sleep = healthier brain = more robust healing response.

In the end, sleeping position may not matter that much for most people. The most important thing to remember above all else, is that you get high quality, high quanitity, consistent, deep, restful sleep on a regular basis. If you have a choice of losing sleep with an “ideal” sleep position, you are better off choosing comfort over theory.


One Stunning Image That Redefines What We Know About Aging

One Stunning Image That Redefines What We Know About Aging

One of the coolest things about social media is the way that it allows you to learn and interact with people that you may never have interacted with in the past. Using sites like Twitter and Facebook have given us unprecedented access to follow our favorite athletes and celebrities, and actually give them an opportunity to interact with you.

I’m not really a celebrity type guy, and I don’t really get too star struck, but I do geek out over the chance to follow and interact with people that are smarter and more innovative than I am. It allows me to see what other practitioners are doing, and gives me the chance to give my patients better care.

One of these guys is Dr. Brian Tiu. Brian is a Structural Chiropractor in Seattle that has a strong background in sports. If you’re not following him on Twitter, make sure you do today. Lots of good free stuff from him on a daily basis. You can find him here.

Anyway, here’s one of his posts that came across my newsfeed that really blew my mind about exercise and lean muscle mass:

If you missed the arrows, the white part of the image is fat tissue, and the dark gray parts are muscle. That’s amazing! The fact that men in their 70’s could maintain their muscle mass, prevent fat from invading muscle tissue, and maintain a level of fitness to run in triathalons is simply phenomenal.
The image is taken from a study that compared the muscle composition of chronic exercisers (they couldn’t find a better term for this? Really?) versus healthy controls. They performed MRI studies on the thighs of both groups and evaluated fat to muscle ratios and how much fat had infiltrated muscle tissue.
Before I talk about the results of the study, let’s make sure to mention this.

Conventional Theory

Current theories on aging  simply state that muscle mass will fade once you hit the age of 30.  Once you hit the age of 40 you start losing about 1% of muscle mass per year. Once you hit 70, you may lose an average of 15% in 10 years.

Here’s what happens to people as they lose muscle mass:

  • Increase in overall mortality
  • Osteoporosis
  • Increased risk of fractures
  • Increased risk of disability
  • Use assistive devices (canes,wheelchairs)
  • Poor balance and prone to falls

Essentially, a bulk of the problems associated with aging.

Now it’s a bit silly to say that you can stop the clock, and stop the body from getting older. That’s why I’ve always found the term anti-aging to be rather silly. However, with that being said, aging is so profoundly affects quality of life, that we should be encouraged to use tools to mitigate their effects.

When you’ve finally reached retirement, you have the freedom to see the world, time take on hobbies, and ability do things that you didn’t have time or money for in your earlier ages. Why would you want to spend those years with immobility, wheel chairs, and fearing the next fall?

The problem is that these studies were focused on people that were reported as “healthy” because they didn’t show any symptoms….(because symptoms are the only thing that matter in health….a topic I’ll tackle on another day).

The Study

The study was published in  The Physician and Sports Medicine in 2011. The image that they use in the journal article is actually even more striking than the one in Dr. Tiu’s post above. Let’s take a look.

Image Credit: Wrobleski et al. The Physician and Sport Medicine. Volume 39 Issue 3. 2011

Image Credit: Wrobleski et al. The Physician and Sport Medicine. Volume 39 Issue 3. 2011

The bottom two images are the leg muscles of 2 men in their 70’s. You can see that the sedentary man muscles are atrophied, and there’s actually bits of fat in the middle of gray muscle tissue which indicates that the man’s muscles are becoming less functional. The top image is a thigh of a man in his 40’s.

Now if you compare the image of the 40-year-old thigh versus the 70-year-old thigh you can see that the muscle density is pretty similar. So in a span of 30 years, where muscle mass should have dropped about 25%, the 70-year-old athlete was able to maintain just about all of his muscle.

What Does This Mean For You?

This study looked at people who are sedentary and compared them to people who do some pretty intense training for triathalons. You’re basically looking at polar opposites in terms of what someone’s day to day life looks like. One is doing almost no exercise at all outside of what it takes to live, the other is probably running, swimming, biking, or weight lifting multiple times a day, a few days a week.

What does this mean for the casual exerciser? Can you achieve similar results if you start exercising later in life?

It’s hard to say just from this study, but my guess is that you can still achieve great muscle mass without triathalon levels of training. The key is finding the right exercise for you, and using that as a way to be consistent. Here are some tips:

  1. Learn to love squats – most of us are probably worried about how squats can affect your back or your knees. I’ll address some of those concerns in another post, but just know that squats can be done safely to take advantage of some amazing benefits.Squatting stimulates the release of growth hormone and induces muscle hypertrophy better than almost any other exercise around. Finding a good trainer and getting on a regiment of squatting 2 times a week can make some dramatic changes in your body composition.
  2. Find Movement You Love – Not everyone enjoys working out and running. The truth is if you dread your exercise routine, you will give up on it before long, no matter how dedicated you are. Movement is more important than the concept of exercising. Moving our bodies is like food for our brain and our muscles. Some people love dancing. Some love rock climbing. Others enjoy going on a bike ride in the city. Lots of my patients just like working in a garden. All of these activities can help you maintain some level of muscle mass and reduce fat infiltration. It may take a LOT more dancing, biking, and gardening to achieve the same outcome as a good gym regiment, but at least you know that you’ll keep going.
  3. Give Yourself Something to Work For Multiple Times per Year – Human beings are driven by excitement and enthusiasm towards a goal. Here’s a short list of ways to use a goal to drive an exercise program you love to do:

    Runners/Bikers/Swimmers – compete in a 5k/half-marathon/triathalon 2-3 times per year so that you are always working towards a race.

    Gardeners – choose a project you want to accomplish for your home once per year. You’ll be kept busy by regular up-keep as well

    Dancers – look into local competitions so you can focus on improving your skills and find a platform to show off once in a while

    Outdoor enthusiasts – don’t like exercising, but you enjoy being outdoors. Check out sites like meetup.com to find groups that have your same interests. There are almost always groups that have get togethers for hiking, beach yoga, and a variety of other activities

Your ability to move is tied directly to your health as you age. The big key is turning our activity into things that we enjoy so that we can turn that into a sustainable habit that will be with us through our lives.

There are even new thoughts in the scientific community that believe muscle can serve as protein storage houses for building antibodies, a key tool in immune function. When we lose muscle mass, we lose one of the building blocks of our cells and immune function.

Don’t fall into the trap of people selling you anti-aging creams, juices, and miracle supplements. The most valuable nutrient you can have in your life, is free, and you can take it everyday. All you have to do is get up and move.

Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health.

Dr. Chung is a practicing Structural Chiropractor in the West Palm Beach area. He has been published in peer reviewed scientific journals and is a sought after speaker in health and wellness. Follow his blog at http://keystonechiropractic.smbusinesswebsite.com/category/keystone-chiropractic-blog/ or find him on twitter at @drjonathanchung

Is Your Blood Pressure a Brain Stem Problem?

Is Your Blood Pressure a Brain Stem Problem?

blood pressure cuff

A recent study has brought hypertension  back into the spotlight as a leading cause of death worldwide, and the leading cause of cardiovascular disease.  Because hypertension has no symptoms, almost 50% of the participants in the study had no idea that they even had high blood pressure. It’s easy to see why this is such a serious problem. Hypertension is a large risk factor for things like heart attack, stroke, and Alzheimers Disease.

Fortunately, doctors and scientists have found easy and reliable ways to control blood pressure for most people. Simple changes to dietary salt, reducing sugar intake, a yoga, meditation exercise, and a multitude of medications have all shown the ability to help reduce blood pressure levels.

But what if this artery problem were really a problem at the level of the nervous system? What do the people do who eat well, exercise, and seemingly have no answer for their blood pressure problem? Is the best answer to really take anti-hypertensive medications for the rest of their lives?

Enter a study by Bakris and Dickholtz in 2007. It showed that people who received an real Atlas Correction using the NUCCA protocol had the same anti-hypertensive effects as 2 blood pressure medications! The average blood pressure reduction was 17 points, while just 1 correction was given during the 8 week period.

Now this is not to say that Atlas Corrections are used to reduce blood pressure. It’s not. It may even raise blood pressure in certain folks with hypotension, or low blood pressure. The only goal for an Atlas Correction is to restore the normal structural alignment of the upper cervical spine to regain normal function of the brain stem.
nuccaWhat does that mean for people suffering with high or low blood pressure? It means that someone’s blood pressure problem may have nothing to do with diet or medication, but it may be a problem with the functioning of the brain stem and central nervous system.

The control centers for blood pressure regulation actually lie within the brain stem. A stuctural shift in the top bone of the neck may compromise the blood flow into the brainstem and trick the body into thinking it needs to pump blood harder. In this way, hypertension may merely be a Secondary Condition to the Atlas Displacement Complex.

Structural Based Chiropractic isn’t for everyone. But if you’re continuing to struggle with something that many other doctors can’t solve, then it may just require looking for something outside the box for a new solution.