John-David Kato, DC, MSc, ACSM-RCEP, CSEP-CEP. April 18th 2008.
I attended the Living-With-Living-Well education session "Wake Up: Sleep has an impact on your health!" put on by Toronto Rehab. This session covered a number of topics including obstructive sleep apnea (OSA), narcolepsy, insomnia and how these conditions can affect your health. People with conditions such as these have disturbed sleep and often have excessive daytime sleepiness as well as other health concerns. For example OSA can cause elevated blood pressure. The repetitive periods of waking at night are related to an increase in adrenaline levels in the body, which raises the blood pressure throughout the day. Many people with OSA are often not aware that they wake up at night, and they might not even feel tired during the day. High blood pressure itself usually has no symptoms, but can lead to many health problems over time such as heart disease or stroke.
The physical signs and symptoms associated with obstructive sleep apnea (OSA) include restless sleep, high blood pressure, night time chest pain, large neck (>17” circumference for men, >16” for women), excess weight, morning headaches and having to go to the bathroom several times during the night.
Another interesting aspect of sleep disturbances that was mentioned was the link between sleep and pain. Though the mechanism is still not fully understood, some studies have shown that individuals with disturbed sleep, particularly those with chronic pain (e.g.: fibromyalgia), may experience an enhanced perception of pain. Of course, in some cases it may be the pain that causes the sleep disturbance in the first place, thus potentially leading to increased daytime pain and a vicious cycle. This can make teasing out what is causing what more challenging. In addition to affecting pain sensation, poor sleep can have an impact on a number of other areas of our lives: mood, personality, concentration, memory, thinking, and even libido to name a few.
Identifying the presence of a sleep disorder is the first step in tackling it. If you do have excessive daytime sleepiness, the first thing to ask yourself is whether you are getting enough sleep. Keep in mind that “enough sleep” for one person may not be the same for another. You might also find that your sleep needs change, as you grow older. An easy test to see if you are getting enough sleep is trying to sleep longer and seeing if you feel more rested. If you still feel tired talk to your doctor: he/she will be able to assess whether you might benefit from a thorough sleep assessment to rule out a more serious cause such as OSA. You could see a complementary health care professional, like a naturopath, to see what non-medical strategies there are to help sleep. Seeing a chiropractor is of course another option. Although treatment of a sleep disorder is not in a chiropractor's scope of practice in Ontario, they treat injuries, relieve pain and tension, and give some recommendations (for exercise, sleep hygiene, weight loss, and other lifestyle advice), all of which may help improve the quality of your sleep.
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