When it comes to quality of life, very few things rate as highly and as regularly as that of sleep and energy. Ask any child what it means to be an adult, and they’ll likely tell you, “It means you’re tired.” While that might be common, it’s not physiologically normal. But, the factors that make sleep difficult vary from person to person. Sleep disorders of varying types are becoming increasingly prevalent and one of the most common is obstructive sleep apnea (OSA). This condition is characterised by repeated episodes of airway collapse during sleep, leading to decreased oxygen levels in the blood.
OSA can be associated with a range of health issues, including obesity, diabetes, cardiovascular disease, and cognitive impairment. [1] Obesity is a significant risk factor for sleep apnea, particularly due to the accumulation of adipose tissue (body fat) around the airway. Poor sleep quality can negatively impact brain function, learning, and memory. [2] It’s estimated that about 5% of Australians have the disorder, and around 1 in 4 men over the age of 30 years have some degree of sleep apnoea. [3] The exact reasons for this trend are not fully understood.
Current treatments for OSA include lifestyle modifications, CPAP therapy, oral appliances, and surgery. However, predicting the best treatment option for each individual remains challenging. [4] Given the prevalence of the condition, there is a need for non-invasive and effective treatments to improve the quality of life for people with OSA and reduce their risk of long-term health complications. This, of course, presents the question: what can chiropractic do beyond health promotion in cases where obesity or other health conditions are present?
That’s where a recent case report steps in, this time looking at the case of a young, fit male who presented for chiropractic care for another condition. But along the way, something notable shifted.
The recent case report, published in the Asia Pacific Chiropractic Journal, details the effective management of obstructive sleep apnea with chiropractic care in a 26-year-old male. The patient presented to a clinic seeking chiropractic care for chronic pain affecting his ankles, shoulders, and elbows, resulting from previous sports injuries.
As always, he underwent a comprehensive medical history and chiropractic examination, during which he told the chiropractor about his OSA several years prior. Since that time, he had been using a CPAP machine, which recorded approximately 30 episodes of sleep apnea per night, each lasting between 3 and 49 seconds. Despite sleeping for 7-8 hours nightly, he reported difficulty falling asleep and a lack of restful sleep. Understandably, this created some pressure on his level of energy and quality of life.
During his chiropractic examination, the chiropractor found several postural imbalances, spinal subluxations, and extremity dysfunctions. He received 19 chiropractic adjustments over seven weeks, using a variety of techniques to address spinal subluxations. The goal of the care plan was to alleviate chronic pain from sports injuries and improve overall spinal health.
After seven weeks of chiropractic care, he experienced significant improvements. Unsurprisingly, the patient’s musculoskeletal pain was reduced, and physical performance improved. However, the most surprising for the patient was that the CPAP machine data revealed a 50% reduction in apnea episodes, and he reported better sleep quality.
Was it surprising for the chiropractor though? Not so much.
This case is not isolated. Previous case studies have demonstrated similar improvements in individuals with obstructive sleep apnea following chiropractic care and lifestyle modifications.
A 40-year-old female presented for chiropractic care with a history of sleep apnea, insomnia, lower blood oxygen levels during sleep and exhaustion. Initial examination revealed multiple asymmetries and imbalances, and treatment included sacro occipital technique, cranial work, muscle therapy, and laser therapy. As treatment continued, the patient reported significant improvements in her sleep, anxiety, and balance. She also experienced reduced spinal and hip tension and fewer headaches overall. [5]
Another case discusses the positive outcome of a 42-year-old man with obesity and OSA who sought chiropractic care to reduce snoring. After 90 days of chiropractic care, orofacial myofunctional therapy, nutritional modifications, postural/ergonomic corrections, and exercise, the patient experienced significant improvements. His sleep apnea episodes decreased by 94%. [6]
While the exact mechanisms behind the improvements observed in these cases are not fully understood, the findings add to the existing body of data showing the positive effects of chiropractic care on OSA symptoms. Preliminary research has shown that chiropractic treatment may offer therapeutic benefits for managing obstructive sleep apnea. However, there is limited large-scale evidence to support the efficacy of chiropractic care for sleep disorder management, as no extensive studies have been conducted.
Additional research, including case studies and clinical trials, is necessary to validate these findings further and explore the full potential of chiropractic care in managing sleep disorders. In the meantime, this case report, that the others listed above, shows that a visit to your chiropractor may just surprise you when it comes to the improvements in function and quality of life – perhaps even including OSA.
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References
- Altevogt, B. M., & Colten, H. R. (2006). Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. National Academies Press (US)
- Donlea, J., & Weiss, J. (2022). Roles for Sleep in Neural and Behavioral Plasticity: Reviewing Variation in the Consequences of Sleep Loss. Frontiers in Behavioral Neuroscience. Vol. 15, DOI: https://doi.org/10.3389/fnbeh.2021.777799
- Better Health Channel; Sleep Apnoea (2024). https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-apnoea#bhc-content
- Eckert, D. J., & Malhotra, A. (2008). Pathophysiology of Adult Obstructive Sleep Apnea. Proceedings of the American Thoracic Society, 5(2), 144–153.
- Erickson J. Treatment of a 40-year-old female with a history of sleep apnœa, insomnia, and airway compromise symptoms: A case report. [Abstract]. Asia-Pac Chiropr J. 2024;5.1 apcj.net/SOT-Abstracts-2024/#EricksonSleepApnoea
- Cramer, G., & Hopper, D. E. (2023). Conservative Treatment Using Chiropractic Care and Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Case Report. Journal of Chiropractic Medicine, 22(3), 234–238.
