When the major risk factors for cardiovascular disease are listed, sleep deprivation is not usually among them. However, a growing body of research suggests a link between sleep duration and cardiovascular disease. While this pairing seems unlikely, it adds urgency to having timely and restful sleep to minimize the risk of danger to the heart.

The Dangers of Cardiovascular Disease

Cardiovascular disease, disease of the heart, causes over 787,000 deaths in the United States each year. There are many different kinds of heart disease, each with varying levels of mortality and treatability: 

• Coronary heart disease
• Heart failure
• Atherosclerosis
• Arrhythmia
• Heart attack
• Stroke

The Importance of a Good Night’s Sleep

The CDC recommends that people 18 years or older should get 7 or more hours of sleep per night. The quality of sleep is also critical. Restless sleep or sleep that does not leave a person feeling rested does not have the health benefits that a night of restful sleep does, and the quality of sleep a person gets appears to contribute to cardiovascular disease risk.

There are many remedies for sleep that is not restful. These are dependent on the underlying cause of restless sleep, i.e. insomnia, sleep apnea, etc. Speak with your primary physician about how you can have more restful sleep and minimize your risk of cardiovascular disease.

Sleep Duration and Cardiovascular Disease—An Unlikely Pairing

In this article, we will focus on a meta-analysis published in the Journal of the American Heart Association in 2018. The analysis pooled the research of 74 studies representing over 3 million participants. The conclusion was a definite relationship between sleep duration and cardiovascular disease.

Is Less More?

Despite the well-known adverse effects of getting insufficient sleep, no significant difference in cardiovascular risk levels were observed for sleep duration less than 7 hours. This was true for markers of both stroke and cardiovascular disease mortality. 

That being said, short sleep duration has a known relationship with increased levels of ghrelin and leptin, and these lead to increased appetite and caloric intake in addition to reduced energy expenditure, facilitating the development of obesity and impaired glycemic control. Reduced sleep is also associated with low-grade inflammation, which may be associated with cancer and cardiovascular disease.

Don’t Overdo It

If the relationship between sleep duration and cardiovascular disease was tenuous at fewer than 8 hours of sleep, it is definitive for more than 8 hours. Despite the easy assumption that more sleep equates to better health, duration of sleep greater than 8 hours was associated with higher risk of cardiovascular event. Risk of mortality from stroke and other cardiovascular disease increased to moderate past the 8-hour mark, and the risk only rose with each hour:

• 9 hours of sleep – 14% increased risk  
• 10 hours of sleep – 30% increased risk  
• 11 hours of sleep – 47% increased risk 

From the data, we can see that “the greater the divergence from the recommended durations of sleep, the greater the association for cardiovascular harm and mortality.” Though the bell-curve remains, this is more true of longer sleep duration than of shorter duration. 

While higher risk of mortality due to cardiovascular event should be impetus enough for getting 40 winks, it should also be noted that researchers found that non-cardiovascular factors such as low physical activity, unemployment, low socioeconomic status, and depression were also associated with long sleep duration.

Quality Matters

The research shows a clear correlation between sleep duration and cardiovascular disease. It also indicates that the quality of sleep is fundamental to low risk levels. While “poor sleep quality” is a subjective metric, factors such as waking up unrefreshed were measured and discovered to be markers of elevated cardiovascular risk.

Specifically, a significant increase in coronary heart disease was observed. Abnormal sleep increased the risk of coronary heart disease by 47%. Incidence and mortality markers of other cardiovascular diseases were not observed.

Conclusions

The meta‐analysis, systematic review, and spline analysis of the cohort studies in question revealed a bell curve relationship between sleep duration and cardiovascular disease, both of incidence and mortality. Poor sleep quality was also discovered to increase risk of coronary heart disease. 

The CDC’s recommendation of 7 or more hours of sleep per night is too broad a stroke to limit the risk of cardiovascular disease. A recommendation which better incorporates the relationship between sleep duration and cardiovascular disease is between 7 and 8 hours of restful sleep each night.

COPD causes respiratory problems in millions of people across the world. While traditional medicine cannot do much for its correction, a growing body of research indicates that treating COPD with spinal manipulation can help minimize symptoms and pain.

What Is COPD?

Chronic obstructive pulmonary disease (COPD) is a term for a group of conditions that causes respiratory problems due to airflow blockage. Emphysema and chronic bronchitis are examples. In these and other COPD conditions, airflow is limited, making simple tasks like walking upstairs difficult.

COPD is diagnosed using a simple breathing test called spirometry, in which a small machine connected to a mouthpiece is used to monitor the volume and rate of airflow breathed in and out over a period of time. The test is brief and safe and allows medical professionals to detect COPD to begin treating it.

Inhalation of tobacco smoke is the most common cause of the disease, though air pollution, respiratory infection, and a family history of COPD also put people at risk. Across the world, COPD ranks as the sixth highest cause of death for both men and women. 16 million Americans have been diagnosed, and many more may go undiagnosed. COPD does not have a cure, but it can be treated.

Reviewing the Role of Spinal Manipulation in Treating COPD

The effectiveness of treating COPD with spinal manipulation has long been a subject of study, and in 2016, Wearing, et al. published their compiled findings from past research in The Journal of Alternative and Complementary Medicine, published under the title “Use of Spinal Manipulation Therapy for Management of COPD.” 

These authors reviewed studies that documented treating COPD with spinal manipulation (defined by low-amplitude, high-velocity manipulation common in chiropractic). This included research of COPD treatment utilizing spinal manipulation with and without the employment of other therapies, such as exercise, making it the first systematic review of its kind.

Wearing, et al. limited their review to studies with participants above the age of 18 years with a pre-existing diagnosis of COPD. Six articles met the inclusion criteria and were included in the review. These include three randomized controlled trials in which exercise from a pulmonary rehabilitation program was combined with spinal manipulation therapy, one case series, one pre-post observational study, and one single case study. 

The manual therapies employed in the review incorporated a range of spinal manipulation techniques. The review also examined variations in results when physical exercises and/or pharmacological interventions were employed in addition to spinal manipulation. Measures of the success of treating COPD with spinal manipulation included a six-minute walking test, various lung-capacity tests, and a number of respiratory questionnaires.

Though sample sizes were small, ranging from 1 to 33 participants, the results compiled by Wearing, et al. hint at the effectiveness of spinal manipulation as a treatment method for the management of COPD. They also highlight the need for further research about the value of combining exercise with such treatment.

The Efficacy of Treating COPD with Spinal Manipulation 

Taking all findings into account, treating COPD with spinal manipulation was found to have great potential to alter respiratory mechanics in COPD and other chronic respiratory diseases such as asthma. Patients with COPD and other respiratory conditions may take heart that methodologies as natural as spinal manipulation can help improve breathing ability and minimize fear.

The review indicated that manual therapy—which includes joint mobilization, spinal manipulation, and soft tissue therapy in addition to other techniques—offered redress for changes in respiratory mechanics associated with declining lung function caused by COPD. These improvements included increased flexibility of both chest wall and thoracic excursion which helped to reduce the work of breathing in patients for which breathing is naturally more difficult.

Though the ill side effect of muscle soreness up to 24 hours after treatment was present in the data, such soreness resolved itself without additional treatment and did not outweigh the improvements to exercise capacity and lung function. Exercise capacity has been shown to be a predictor of mortality in COPD cases, so even small improvements should not be underestimated. Following the administration of spinal manipulation therapy, five of the six studies reported improvements in both exercise performance and lung function.

All three of the randomized trials reviewed resulted in improved exercise capacity and lung function following a combination of spinal manipulation therapy in conjunction with exercise. These findings point to the efficacy of non-pharmacological interventions in treating COPD and improved benefits when spinal manipulation and exercise as treatment methods are combined as compared to when either modality is used alone.

Muscle reactivation, or simply muscle activation, is a clinical procedure specifically designed to correct a muscle that cannot engage. Sometimes muscles will shut down, refusing to respond to the brain’s commands to contract, almost like a home’s circuit breaker, which if a fuse is blown cannot provide power to the house.

As we discuss muscle reactivation, we do not mean engaging a muscle or set of muscles to perform a certain activity. This is not the same terminology a personal trainer uses when she says “activate your core.” We are referring to a process that identifies neuromuscular disconnects that prohibit muscle activation on the most basic level and mends those disconnects for renewed muscle performance.

Why is Muscle Reactivation Necessary?

If the brain cannot communicate with a muscle and make it contract, that muscle is considered inactivated. Muscles take a lot of stress, sometimes more than we ever know, and when it becomes too much for them, they can revert to a protective splinting or spasms state instead of performing normally in order to protect the muscles from damage. This is more common in conditions of prolonged stress.

When a muscle is deactivated, no amount of exercise will strengthen it because the muscle has closed itself off in order to protect itself. The problem is that muscles, if not exercised, atrophy, and the other muscles around them must pick up the slack, causing misalignment. 

What Causes Muscles to Deactivate?

Muscles can “switch off” if the demand placed on them is too intense. This can occur through overtraining or under use, such as extended periods of sitting. Stress is another contributing factor to muscle inhibition, as is physical trauma. It is commonly associated with recovery periods after surgery or injury or during the rapid changes of puberty.

The Dangers of Muscle Deactivation

Other weaknesses and misalignments can follow muscle shutdown as other muscles and joints try to compensate for the loss. These symptoms can present themselves immediately or manifest over an extended period of time. The most insidious examples don’t produce noticeable pain for years, so the body has plenty of time to grow acclimated to incorrect posturing. Such prolonged compensation has a domino effect and can lead to even more muscle shutdown. 

How Does Muscle Reactivation Work?

Muscle reactivation works under the principles of pinpointing and reactivating muscles that have shut down so they perform normally again. The process necessitates an examination to discover which muscles have been inhibited. During this test, each of the body’s 600 muscle divisions are examined to assess their communication with the brain. Despite the years’-worth of damages that can lead to treating muscle shutdown, the process of muscle reactivation can take only 10-15 minutes per muscle. This is a conservative estimate if the body’s compensatory mechanisms have inhibited a significant number of muscles.

At Utah Sports and Wellness, we utilize the AMIT method to facilitate muscle reactivation. Treatment results in lessening of tension and pain and a restoration of muscle mobility. The key to recovery is to focus on positive goals rather than negative ones (i.e. returning to optimized performance levels and the ability to do what you love rather than just getting rid of pain). Our goal is to correct the issue permanently, not just minimize pain. 

Full Recovery with AMIT

The Advanced Muscle Integration Technique was developed by Dr. Alan G. Beardall as he gathered understanding of the human muscular system through an impressive career and his extensive work with the Utah Jazz.  His research into chronic injury led to the development of a process that restores neuromuscular communication rapidly, allowing patients to get back to doing what they love.

AMIT is an extremely effective measure to use to determine if your body is working the way it is meant to. Not only does the test take only about 15 minutes; once we find an inactive muscle, it generally only takes 5-10 minutes to reactivate it, making it one of the most immediate healing mechanisms. Patients feel their muscle inflammation reduced, tension decreased, and healing commence.

Muscle reactivation should be addressed as soon as a problem is identified in order to begin the healing process as soon as possible. If you experience limited range of motion or muscle tension and pain that might be caused by muscle inhibition, consider scheduling a 15-minute AMIT-focused visit in which a member of our team can assess the integrity of pained areas. Reactivating inhibited muscles will significantly contribute to you living pain-free and improving your performance when doing the activities you love.