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Even with spectacular improvements in healthcare during the past century,
disease continues to persist. In many ways the causes behind this fact are linked to sleep. Sleep is one of the most important factors in good health and longevity. With Americans sleeping about two hours less on average than they did in 1900, one of the reasons for increased disease is apparent.

The study of sleep is a young science. The important modern beginning of the science of sleep began in the 1950s and the basic understanding that there are different stages or types of sleep was learned in the 1960s. During that period there were very few people involved in sleep research. Today there are thousands of sleep scientists and healthcare professionals focused on sleep research. There is much yet to learn about why we sleep, the mechanisms of sleep, our internal biological timekeepers, and the impact sleep has on our lives.

We have been making sleep products for over forty years. We have always been keenly interested in making our products perform the best and provide the best sleep possible. Our products have improved as our knowledge of sleep increases. Working with Nebraska Wesleyan University and pioneers in the field of sleep we founded a sleep research group, American Sleep Research Institute, that in 1988 built the world’s first stand-alone sleep research facility to study what healthy sleep is, good sleep bio-mechanics, and how to achieve it. The research that followed yielded some surprising and important conclusions. We have not only learned that quality sleep is very important to good health, but how long and how well we sleep can predict how long we might live.

The healthiest and longest lived people sleep about eight hours a night on average. A shorter life span is associated with less than seven and more than nine hours per night average sleep. Less than seven hours is apparently not enough to receive the full health benefits of sleep and sleeping more than nine or ten hours can indicate a sleep disorder that robs the benefit of quality sleep.

Among the reasons for shorter than average lifespans is that lack of sleep is linked to heart disease, cancer, diabetes, and many other serious diseases. For example: studies have shown that night shift workers have higher cancer rates. Shift workers struggle with sleeping in synch with their internal bodyclock because the world around them is on a different schedule. Night shift workers also have higher traffic accident rates. So, it is not only disease that works into the statistics of shorter lifespan.

How are disease and sleep linked? One reason is that our immune systems recharge during sleep. Lack of sleep lowers our defenses against disease. The first half of a night’s sleep is the most important in physical healing and prevention of illness. The internal timekeepers that we all have orchestrate repair and rebuilding so that it occurs only during certain phases of sleep. If we do not sleep during those important phases the risk of disease increases.

Another reason for the link between sleep and longevity is the immediate effect lack of sleep has on human performance. Missing sleep leads to poor decision making and can affect everything we do: rushing when we should be methodical, forgetting important procedures, loss of attention (such as when driving), not having the energy to exercise, poorer reaction time, higher stress levels, elevated blood pressure, and inability to adapt to change. These things lead to accidents in the short term, and poor health in the long term. It is only necessary to look at our own or other people’s behavior after a single night of poor sleep. Irritable - Fatigued – Scattered - Sound familiar?

Poor sleep can also contribute to obesity. Even a few nights of short sleep reduces our ability to utilize insulin by forty percent. This creates increased stress on our hormone system. There is good news though, quality sleep is an easy and important part of a weight loss program. When sleep is missed, we become hungry for fats and sugars and the body increases fat storage. Poor sleep leads to caffeine and donuts. Good sleep at the right time of night regulates hormone production to increase muscle mass and reduce fat storage. It is easier to maintain a healthy diet if food cravings are in order and quality sleep will do that. Remember to include a sleep plan in any diet.

For athletes sleep is critical in repairing muscle and learning coordinated movement after training and exercise. For everyone, sleep is a critical part of the healing process after injury. Pain can interfere with sleep and delays this rebuilding and healing process.

So how do we achieve quality sleep? It is important to have good sleep habits. From our years of sleep research, the following principles have been shown to be the most important for healthy adults starting a program of sleep improvement.

iSleep Five Principles of Healthy Sleep

1. Wake up at the same time every day.

2. Make it a priority to sleep eight hours every night.

3. Have a quiet, dark, and peaceful sleep environment.

4. No caffeine or alcohol after dinner.

5. Sleep on a comfortable, posture correcting mattress.

Your Doctor can also advise you about techniques to improve your sleep. Even if you are sleeping the recommended eight hours per night already, you might not be achieving the full benefit of deep, restful, sleep. It is one of the challenges to a good night’s sleep that we are not aware of and cannot completely asses the true quality of our sleep because we are not conscious at the time. Is usually only after symptoms of poor sleep become so extreme that we seek help. This can be too late.

Best time for peak performance
Night owls nervous systems function differently Researchers at the University of Alberta have found that there are significant differences in the way our nervous systems function depending on whether we're early birds or night owls. Neuroscientists divided the study subjects into two groups: those who wake up early and felt most productive in the morning, and those who typically felt livelier at night. Muscle torque and the excitability of pathways through the spinal cord and brain were tested using magnetic resonance imaging-guided brain stimulation. It was found that morning people's brains were most excitable at 9 a.m. This slowly decreased through the day and it was shifted 12 hours later for evening people, their brains were most excitable at 9 p.m. Other reported major findings: * Evening people became physically stronger throughout the day, but the maximum amount of force morning people could produce remained the same. * The excitability of reflex pathways that travel through the spinal cord increased over the day for both groups. These findings show that nervous-system functions are different and have implications for maximizing human performance. This could also influence the optimum time of day for treatment or adjustment. Are your various patients morning or evening oriented? Helping your patients understand the importance of sleep and how to achieve it naturally is a critical part of their care.

Night owls report more insomnia symptoms
People who are considered "night owls" tend to report more insomnia symptoms, even though they have the opportunity to gain more sleep time, according to a study published in the Journal of Clinical Sleep Medicine (JCSM). The study was authored by Jason C. Ong, PhD, and researchers at Stanford University. It consisted of 312 patients, who were categorized as morning, intermediate and evening chronotypes based upon scores on the Morningness-Eveningness Composite Scale. Comparing people with insomnia who prefer evening activities, the "night owls," to the morning and intermediate types, the night owls reported the most sleep/wake irregularities and waking distress, even after adjusting for severity of sleep disturbance. "Our findings indicate that further research should investigate the relationship between circadian rhythms and insomnia, especially with the severity of the 'night owl' group," said Ong. "These factors may serve to perpetuate the insomnia disorder, and might be particularly important to consider when treating this subgroup of insomniacs."

Being a Night Owl is genetic
All of our body's processes follow a daily cycle controlled by our circadian clock. A common gene variant that affects virtually the entire population has been found that is responsible for up to an hour a day of our tendencies to be an early bird or night owl. "The internal 'biological clock' regulates many aspects of human biology and behavior, such as preferred sleep times, times of peak cognitive performance, and the timing of many physiological processes. It also influences the timing of acute medical events like stroke and heart attack," says first author Andrew Lim, MD, who conducted the work as a postdoctoral fellow in the Department of Neurology at Beth Israel Deaconess Medical Center (BIDMC). "This particular genotype affects the sleep-wake pattern of virtually everyone walking around, and it is a fairly profound effect so that the people who have the A-A genotype wake up about an hour earlier than the people who have the G-G genotype, and the A-Gs wake up almost exactly in the middle," explains Saper, who is also the James Jackson Putnam Professor of Neurology and Neuroscience at Harvard Medical School. This same genotype predicted six hours of the variation in the time of death: those with the AA or AG genotype died just before 11 a.m., like most of the population, but those with the GG genotype on average died at just before 6 p.m. "Also, working out which causes of death are influenced by gene variants like the one we identified may eventually lead to rational timed interventions - such as taking heart medications at particular times depending on which version of the gene variant one carries - to provide protection during an individuals' period of greatest risk," says Lim. The potential clinical applications may be as diverse as the many processes that the circadian clock controls.

Night owls are not as motivated to exercise
People who are "night owls" have a tendency to spend more minutes sitting and are less motivated to regularly exercise, according to a new study from researchers in the Behavioral Sleep Medicine Program at the Feinberg School of Medicine at Northwestern University in Chicago, IL. Glazer Baron provides: "We found that even among healthy, active individuals, sleep timing and circadian preference are related to activity patterns and attitudes toward physical activity. Waking up late and being an evening person were related to more time spent sitting, particularly on weekends and with difficulty making time to exercise." A patient's daily sleeping schedule should be considered when giving exercise advice, especially for less active adults, the study suggests.

Neutral sleep posture allows the body to heal properly and prevent future injury.
Why neutral is important: Neutral posture reduces strain and pressure on joints and muscle, allowing good circulation and movement. With pressure on joints and muscle scar tissue can develop. Adhesions bind up tissue that needs to move - muscles become shorter and weaker, tension on tendons can lead to tendonitis, and nerves can become trapped. Range of motion and strength are affected. Pain can result. How to achieve neutral sleep posture: Start with a mattress that supports neutral posture. Because the human body has variation in mass and shape, a good mattress must have differentiated support from head to foot. Mattresses that do not have the ability to support differing body sections often mask that defect with extra firmness, this causes too much pressure on soft tissue and reduces compliance for shoulders and hips. It is not possible to achieve a neutral sleep posture on many beds, especially air beds, because of their tendency to "hammock." The iSleep bed overcomes this problem with additional zoned support that is custom tailored to each patient. The two best sleep positions are lateral (side) or supine (back). Avoid prone (stomach) sleeping to avoid torsion in the neck and lower back that can create compression of the discs, degeneration and muscle strain. Side Position Lay on your side with a pillow under your head that is as thick as the distance between your ear and the bed when your neck is straight. Your head should not be elevated or sinking. You might have someone observe your neck while in this position in bed. Back Position Lay on your back with a one pillow under your head and neck that supports the natural cervical curve. Focus on the curve of your spine and adjust the bed to support the lumbar curve. On some beds it might be necessary to place a small pillow under your knees to achieve proper lumbar support. The goal is to have the EAR - SHOULDER - PELVIS - ANKLE all in alignment. Exploding Head Syndrome With a name that sounds like an urban legend it is hard to take it seriously, but this is a real sleep disorder. The syndrome experience is described as hearing abrupt, loud noises when going to sleep or waking up. Sometimes with mild pain, explosions in one or both ears and flashes of light. Considered harmless, the episodes can be frightening. The term "exploding head syndrome" dates to a 1988 article in Lancet. Brian Sharpless, a Washington State University assistant professor and director of the university psychology clinic reviewed the scientific literature on the disorder for Sleep Medicine Reviews. "I've worked with some individuals who have it seven times a night, so it can lead to bad clinical consequences as well." "Some people start to become anxious when they go into their bedroom or when they try to go to sleep," said Sharpless. "Daytime sleepiness can be another problem for people."

Lack of sleep can affect concussion tests
At the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Chicago, IL researchers reported that athletes who didn't get enough sleep the night before undergoing baseline concussion testing didn't perform as well as expected. Lead author, Jake McClure, MD from Vanderbilt University: "Our results indicate athletes sleeping less than 7 hours the night prior to baseline concussion testing did not do as well on 3 out of 4 ImPACT scores and showed more symptoms. Because return-to-play decisions often hinge on the comparison of post-concussion to baseline concussion scores, our research indicates that healthcare providers should consider the sleep duration prior to baseline neurocognitive testing as a potential factor in assessing recovery." The study included 3,686 non-concussed athletes with baseline symptom and ImPACT neurocognitive scores. Subjects were grouped by self reported sleep duration the night before testing. Reaction Time, Verbal Memory, Visual Memory, and total number of reported symptoms were significantly different in the group sleeping less than 7 hours.

Sleep when on a diet or lose muscle mass.
Sleepers and non-sleepers will lose about the same weight on a low-calorie diet. The weight lost will be mostly muscle and not fat without adequate sleep. Dieters sleeping 8.5 hours per night will lose much more fat, while those on 5.5 hours lose mainly muscle, instead of fat. According to research from the University of Chicago published in the peer-reviewed journal Annals of Internal Medicine. The authors concluded: The amount of human sleep contributes to the maintenance of fat-free body mass at times of decreased energy intake. Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction. During sleep the body is producing new bone, muscular and nervous tissue, it is a period when growth and repairs occur - it is a heightened anabolic state.

Sleep quality improvement in chiropractic patients: a pilot study.
American Sleep Research Institute, Lincoln, Nebraska, USA March 1, 2010

STUDY DESIGN: A cross-sectional descriptive study of self-reported quality of sleep in individuals. OBJECTIVES: To assess and describe subjective quality of sleep in subjects, with and without chiropractic treatments. SETTING: Private Practice. METHODS: A total of 80 Chiropractors, patients, and non-patients were sent and responded to a questionnaire containing queries about chiropractic care, pain intensities, pain timing, mood, and sleep quality and completed the Epworth Sleepiness Scale survey to assess quality of sleep. RESULTS: The 80 questionnaires that were returned were analyzed. Respondents were divided into two groups: (1) those who reported receiving chiropractic care, and (2) those who reported to not have had chiropractic care for at least six months. Group(1) Patients of chiropractors reported fewer sleep problems, better quality of sleep and had superior scores on the Epworth Sleepiness Scale compared with Group(2). CONCLUSIONS: Improved subjective sleep quality was associated with chiropractic care. It is possible that the benefit of chiropractic treatments serves as a modulator of sleep factors. SPONSORSHIP: This study was made possible by grants from iSleep.

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