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By admin 0 Comments Sleep Hygiene, Therapy , , , , , , , , , , , , , , , , , ,

Maximizing the Benefits of Napping: Optimal Duration and Effects

Could regular daytime naps help individuals slow the aging process from natural brain shrinkage?

Taking Naps

Research and experts suggest that a short nap between 10 to 40 minutes provides the most benefits, including:

  • Improved mood
  • Cognitive performance
  • Alertness

A study suggests that daytime napping might prevent the brain from shrinking with age. (Paz V., Dashti H. S., & Garfield V. 2023)

Optimal Nap Time

A small study of young adults found that naps lasting 10 to 60 minutes immediately improved mood and alertness. However, most research shows that naps under 30 minutes offer the most benefit because individuals are less likely to enter the deep sleep stage or experience sleep inertia – a period of impaired alertness right after waking.  A meta-analysis also suggested that short naps reduce fatigue, increase productivity, and enhance physical performance. (Dutheil F. et al., 2021) A 10-minute nap is the most effective at improving:

  • Sleep latency or sleep onset latency (SOL)
  • Fatigue
  • Vigor
  • Cognitive performance

Some sleep specialists recommend that patients not take naps longer than 40 minutes, as too much napping could be unhealthy. Studies have shown that excessive daytime sleepiness and napping for over 60 minutes might increase the risk of type 2 diabetes and heart problems. (Yamada T, Nobuhiro S, Takashi K. 2016)

Health

In the study published in Sleep Health, researchers used data from over 30,000 participants aged 40 to 69 from the U.K. Biobank. Researchers examined genetic variants associated with taking naps regularly. (Paz V., Dashti H. S., & Garfield V. 2023) The researchers found a link between regular daytime napping and larger brain volume. The difference in brain volume between individuals who nap regularly and those who don’t was equivalent to 2.6 to 6.5 years of aging. However, no association was found between napping and cognitive performance reaction time or visual memory. The brain naturally shrinks with age, but this process is accelerated in individuals with neurodegenerative diseases and cognitive decline.

How To Avoid Napping for Too Long

Taking naps is good for you. But there’s a difference between healthy daytime sleep and counterproductive excessive sleeping.

  • Sleep specialists recommend setting an alarm for a nap or asking a family member, friend, or coworker to wake you up.
  • Individuals can try placing their phones or alarm clocks far away so they have to move to turn them off.
  • Individuals are recommended to stand up immediately to wake the body through movement and light exposure to avoid feeling groggy after a nap.
  • One study suggests consuming caffeine before a nap may be an effective countermeasure for sleep inertia. (Hilditch C. J., Dorrian J., & Banks S. 2016)
  • Engaging in physical activities before and after naps can also help promote wakefulness.

Sometimes, people feel exhausted for various reasons, such as stress and nutrition, rather than a lack of sleep. In these cases, sleeping more than the body needs will only worsen sleep quality at night. When individuals are experiencing daytime fatigue, rather than lying back down or sitting in bed, sleep specialists suggest walking around. This allows the fatigue to pass, and the patient can sleep better at night.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic’s goals are to help individuals enhance movement with less pain due to a condition after injury or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body heal itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Secrets of Optimal Wellness

References

Paz, V., Dashti, H. S., & Garfield, V. (2023). Is there an association between daytime napping, cognitive function, and brain volume? A Mendelian randomization study in the UK Biobank. Sleep health, 9(5), 786–793. https://doi.org/10.1016/j.sleh.2023.05.002

Dutheil, F., Danini, B., Bagheri, R., Fantini, M. L., Pereira, B., Moustafa, F., Trousselard, M., & Navel, V. (2021). Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(19), 10212. https://doi.org/10.3390/ijerph181910212

Yamada T, N. S., Takashi K. (2016). Daytime napping, daytime sleepiness and the risk of metabolic diseases: dose-response meta-analysis using restricted cubic spline model. J Am Coll Cardiol., 67(13), 1951. https://doi.org/https://doi.org/10.1016/S0735-1097(16)31952-0

Hilditch, C. J., Dorrian, J., & Banks, S. (2016). Time to wake up: reactive countermeasures to sleep inertia. Industrial health, 54(6), 528–541. https://doi.org/10.2486/indhealth.2015-0236

By admin 0 Comments Diet , , , , , , , , , , , , , , , , , ,

Beyond Shakes: Innovative Ways to Enjoy Protein Powder

Can protein powder be used in different ways to effectively support nutrition goals for individuals who aim to build muscle, maintain weight, or acquire more protein in their diet?

Different Ways To Use Protein Powder

Protein powder is a quick and easy way to get protein before or after a workout. Add a scoop to a shaker bottle, mix with water, and you’re ready. However, having the same shake daily can become boring. Finding different ways to use protein powder can be a welcome change in workout nutrition habits. It is versatile, making it a great addition to smoothies, baked goods, oatmeal, yogurt, and more.

Health Benefits

How to Use

Learning different ways to use protein powder can help create an exciting and diversified menu, from meals to snacks. Individuals can use conventional or organic powder. Here are a few ideas:

Oatmeal

  • Adding protein powder to overnight oats or stovetop oatmeal is a great way to increase protein content.
  • Protein powder mixes well with oats and milk.

Baked Goods

  • Protein powder goes well with many baked goods.
  • Another way to use protein powder is to add it to brownie, muffin, cupcake, or cookie recipes.

Yogurt

  • Combine with yogurt and fruit for a nutrient and calorie-dense breakfast or snack to fuel the body.
  • It’s also a great post-workout snack.

Coffee

  • Adding protein powder to coffee makes it easy to increase daily protein intake.
  • Stir with a spoon, like adding powdered cream, or blend or froth hot coffee with protein powder to make it like a cappuccino.

Pancakes

  • Adding to a batch of pancakes is a great way to use protein powder.

How much protein powder per day?

Consuming one to two scoops (between 25 to 50 grams) daily is generally safe, which is what most recipes call for. Following the recommended dosage on the product label is highly recommended. The Recommended Dietary Allowance of protein for a healthy adult, regardless of age, is 0.8 grams per kilogram of body weight per day. (Wu G. 2016)

How long after a workout should protein powder be taken?

Whether running or lifting weights, consuming protein within the anabolic window approximately 30 minutes to two hours after a workout enhances muscle recovery, repair, and growth. (Aragon A. A., & Schoenfeld, B. J. 2013) Daily protein intake is recommended for improved performance, muscle growth, and optimal recovery. (Cintineo H. P. et al., 2018) Muscle building is 25 percent higher when protein intake is evenly spaced throughout the day. (Mamerow M. M. et al., 2014) 

Protein Shake Side Effects

Consuming the recommended amount of one to two scoops daily is generally safe and doesn’t have side effects. However, exceeding recommended daily intake can cause unwanted side effects that include:

  • Bloating
  • Flatulence
  • Increased bowel movements
  • Acne
  • Nausea
  • Thirst
  • Fatigue
  • Headache
  • Lack or loss of appetite

Studies have found that excess whey protein supplementation is associated with increased aggression, acne, and disturbance of the gut microbiota. (Vasconcelos Q. D. J. S. et al., 2021)

For individuals who want to get more out of their pre- or post-workout supplements, choose high-quality organic protein powders that contain all essential amino acids and wholesome ingredients with no fillers or additives. Consult a healthcare provider if considering supplementing with protein powder or looking to increase protein intake along with a registered dietitian to help determine how much protein is needed based on personal needs, activity, and fitness levels and goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Benefits of a Healthy Diet and Chiropractic Care

References

Cintineo, H. P., Arent, M. A., Antonio, J., & Arent, S. M. (2018). Effects of Protein Supplementation on Performance and Recovery in Resistance and Endurance Training. Frontiers in nutrition, 5, 83. https://doi.org/10.3389/fnut.2018.00083

Gorissen, S. H. M., Crombag, J. J. R., Senden, J. M. G., Waterval, W. A. H., Bierau, J., Verdijk, L. B., & van Loon, L. J. C. (2018). Protein content and amino acid composition of commercially available plant-based protein isolates. Amino acids, 50(12), 1685–1695. https://doi.org/10.1007/s00726-018-2640-5

Batsis, J. A., Petersen, C. L., Cook, S. B., Al-Nimr, R. I., Driesse, T., Pidgeon, D., & Fielding, R. (2021). Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study. Clinical nutrition ESPEN, 45, 426–432. https://doi.org/10.1016/j.clnesp.2021.07.006

West, D. W. D., Abou Sawan, S., Mazzulla, M., Williamson, E., & Moore, D. R. (2017). Whey Protein Supplementation Enhances Whole Body Protein Metabolism and Performance Recovery after Resistance Exercise: A Double-Blind Crossover Study. Nutrients, 9(7), 735. https://doi.org/10.3390/nu9070735

Fekete, Á. A., Giromini, C., Chatzidiakou, Y., Givens, D. I., & Lovegrove, J. A. (2018). Whey protein lowers systolic blood pressure and Ca-caseinate reduces serum TAG after a high-fat meal in mildly hypertensive adults. Scientific reports, 8(1), 5026. https://doi.org/10.1038/s41598-018-23333-2

Ha, D. J., Kim, J., Kim, S., Go, G. W., & Whang, K. Y. (2021). Dietary Whey Protein Supplementation Increases Immunoglobulin G Production by Affecting Helper T Cell Populations after Antigen Exposure. Foods (Basel, Switzerland), 10(1), 194. https://doi.org/10.3390/foods10010194

Wu G. (2016). Dietary protein intake and human health. Food & function, 7(3), 1251–1265. https://doi.org/10.1039/c5fo01530h

Aragon, A. A., & Schoenfeld, B. J. (2013). Nutrient timing revisited: is there a post-exercise anabolic window?. Journal of the International Society of Sports Nutrition, 10(1), 5. https://doi.org/10.1186/1550-2783-10-5

Mamerow, M. M., Mettler, J. A., English, K. L., Casperson, S. L., Arentson-Lantz, E., Sheffield-Moore, M., Layman, D. K., & Paddon-Jones, D. (2014). Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. The Journal of nutrition, 144(6), 876–880. https://doi.org/10.3945/jn.113.185280

Vasconcelos, Q. D. J. S., Bachur, T. P. R., & Aragão, G. F. (2021). Whey protein supplementation and its potentially adverse effects on health: a systematic review. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 46(1), 27–33. https://doi.org/10.1139/apnm-2020-0370

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Exploring the Importance of Planes of Motion

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane.  Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint
  • Extension – An extending movement that increases the angle at a joint
  • Hyperextension – Extending the angle at a joint beyond neutral
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin
  • Plantarflexion – Pushing the foot down and away from the body

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Difference of Using Custom Foot Orthotics

References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. https://blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000

By admin 0 Comments Chiropractic Care, Exercises , , , , , , , , , , , , , , , , , ,

Improve Your Health with Bed Pilates: Try These Adapted Exercises

Can Pilates exercise movements be performed in bed for individuals recovering from illness or injury?

Bed Pilates

Pilates exercises can be practiced in bed. Joseph Pilates’ exercises and equipment, such as his patented V-shape bed, were designed to help rehabilitate injured individuals who had to stay on or near a bed. After a healthy night’s sleep, Pilates exercises dynamically stimulate circulation and the nervous system. They can also be used to calm the mind and body before going to bed.

  • Those with health concerns should check with their healthcare provider before starting any exercise program to ensure safety.
  • Beginners are recommended to learn the Pilates principles and movement fundamentals.

Here are a few Pilates mat exercises adapted for individuals who need or prefer to exercise in bed. A firm mattress is recommended, as a soft mattress will mess up the correct form, making the exercise ineffective.

Spine Twist

This exercise helps improve the flexibility of the spine and core, making it easier to move around, and supports healthy posture. (Geremia J. M. et al., 2015) Pilates exercises like the spine twist have been found to reduce low back pain and disability. (Notarnicola A. et al., 2014) To perform:

  • Sit up in bed, torso straight, abs engaged, and inhale.
  • Exhale as you turn your head and shoulders to the right.
  • Keep your torso straight, and imagine growing taller through the turn.
  • Inhale as you return to the starting position.
  • Exhale and turn to the other side.
  • Repeat five times on each side.

Tendon Stretch

The tendon stretch helps by improving flexibility in the hamstrings and calves. (Chinnavan E., Gopaladhas S., & Kaikondan P. 2015) To perform:

  • Sit up straight, legs straight out.
  • Bring heels together and use a towel to pull your feet towards you while pushing your heels away.
  • Hold for three seconds.
  • Next, without the towel, point your toes away.
  • Hold for another three seconds.
  • Do ten reps.

Double-Leg Stretch

The double-leg stretch is an intermediate exercise that works the abdominals and the core. If this move feels difficult, start with one leg at a time. Another option is to keep the knees slightly bent instead of extending the legs fully. To perform:

  • Bring both knees to your chest and, with your hands, press down on the ankles to stretch the lower back.
  • Pull in the abdomen.
  • Exhale and extend the arms up and the leg or legs as far out in front as possible.
  • Hold the position for ten seconds and then release.
  • Do ten reps.

Pelvic Curl

The pelvic curl builds strength in the lower back and core. To perform:

  • Bend knees and place feet on the bed hip-distance apart.
  • Curl your pelvis, squeeze the glutes, and lift your body.
  • Hold for five seconds.
  • Slowly count five seconds while lowering back down, imprinting the spine into the mattress.
  • Do ten reps.

Hip-Opening Exercise

A hip-opening exercise, or frog, can be done while lying down or sitting in bed. Hip openers help keep the spine and hips flexible and in alignment. To perform:

  • Bring the soles of your feet together and as close to the torso as possible.
  • Let the knees open up as far as possible, and that feels comfortable.
  • While in the stretch, breathe in and out as deep as possible.
  • If sitting, place hands on ankles and use forearms to push down on the knees for added stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Home Exercises for Pain Relief

References

Geremia, J. M., Iskiewicz, M. M., Marschner, R. A., Lehnen, T. E., & Lehnen, A. M. (2015). Effect of a physical training program using the Pilates method on flexibility in elderly subjects. Age (Dordrecht, Netherlands), 37(6), 119. https://doi.org/10.1007/s11357-015-9856-z

Notarnicola, A., Fischetti, F., Maccagnano, G., Comes, R., Tafuri, S., & Moretti, B. (2014). Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study. European journal of physical and rehabilitation medicine, 50(1), 59–66.

Chinnavan, E., Gopaladhas, S., & Kaikondan, P. (2015). Effectiveness of pilates training in improving hamstring flexibility of football players. Bangladesh Journal of Medical Science, 14(3), 265–269. https://doi.org/10.3329/bjms.v14i3.16322

By admin 0 Comments Exercises , , , , , , , , , , , , , , , , , ,

Mastering the Hip Hinge: A Key Movement for Back Health

Can performing the hip hinge exercise movement help individuals with lower back pain?

Hip Hinge Exercise

A hip hinge is a controlled movement that involves bending forward from the hips while keeping the spine neutral. The thoracic, lumbar, and pelvis stay neutral while bending forward. The movement comes from the hips, preventing the thoracic and lumbar spine from flexing or rounding. It is a fundamental movement that helps prevent back injuries and strengthens the glutes. It’s used in everyday activities, like picking up objects and sitting down.

The hip hinge exercise targets the posterior chain or back muscles, including the lower back, the glutes, and the hamstrings. It also strengthens the core or abdominal muscles to assist in the movement. When the body hinges at the hips, the bend occurs at the hips, and the spine stays neutral. When the lower back hinges or bends, this causes pain and reduces the range of motion.

Performing the Movement

A wooden dowel, broom handle, or PVC pipe can be used as a guide to help achieve the proper positioning and learn the correct form. Place the dowel or pipe vertically on your back, anchoring it to the head, shoulder blades, and tailbone.

Grasp one end with your right hand in the natural curve of your neck and the other with your left hand in the small of your back. Ensure the dowel touches the back of your head, upper back, and the area where the lower back meets the sacrum. To perform the hip hinge:

  • Stand with your feet shoulder-width apart
  • Shift your weight to your heels and
  • Push your hips back while hinging your torso forward
  • Keep your chest open and back flat
  • Slightly bend your knees
  • Visualize sticking the butt out
  • The dowel should not lose contact with the three points as you hinge. If it does, the movement is incorrect.
  • Lower your torso until it’s midway between vertical and parallel to the floor.
  • Pause when your torso is about 45 degrees
  • Keep a slight bend in your knees during the downward and upward phases.
  • Reverse the movement by contracting your glutes and pushing your hips forward and upward to return to the starting position.
  • Repeat

Benefits

The hip hinge is a fundamental movement pattern that helps the body perform essential tasks such as bending over and picking things up without worry of pain or injury. It’s also required in strength training exercises like the deadlift, kettlebell swing, power clean, and more. The exercise can help strengthen the core, reduce back pain, improve balance, and improve flexion, extension, and trunk rotation. (Michaud F. et al., 2021) Stronger core muscles can increase fitness and athletic performance. (Clark D. R. et al., 2018)

Variations

It is a challenging movement that requires plenty of practice. Individuals who can’t perform it correctly after a few tries may need to modify the movement.

Wall Variation

  • Using a wall as a guide is an easy way to make the movement easier.
  • To do this, stand with your back to a wall, about three inches away.
  • Start hinging at the hips by sticking your butt out touching the wall.
  • Keep a neutral spine and a flat back.

Once you can do this several times, try stepping out another inch or two and perform the same modified motion. Stick with this until you are away from the wall and can do a full hinge without the wall.

With A Kettlebell

  • Once you master the basic hinge, you can elevate it using a kettlebell to make this move more difficult.
  • Start with the kettlebell swing exercise and progress to more challenging moves with the kettlebell.

Common Mistakes

Be aware of common mistakes to keep the move effective and reduce the risk of injury.

Treating the Move Like a Squat

  • The hip hinge is not the same as a squat.
  • This is a common misconception. When squatting, the knee joint determines the movement pattern.
  • But when hip hinging, the movement starts at the hips.

Not Engaging the Core Muscles

  • This exercise requires core engagement throughout the entire movement.
  • If these muscles relax, there is an increased risk of dipping the hips during the hinge, which can cause the lower back to dip and cause pain.

Using the Lower Back

  • Bending or hinging with the lower back rather than letting the hips generate the movement.
  • Using the wall as a guide can help reduce and eliminate excessive bending at the waist.

Lost Dowel Contact 

  • If the dowel loses contact with one or more set-up positions on the back, the hinge is not being executed correctly.
  • If your head loses contact with the dowel, the neck is flexing too far forward.
  • If you lose contact with the sacrum or lower back area, the spine is flexing too much.
  • If you lose contact with the mid-back, the knees are bending rather than the hips.

Safety

Stop and check your form if you feel back pain during any part of the movement. The movement may need to be modified further or decrease how far the hinge is at the hips. If the pain continues, discontinue the exercise and talk with a doctor or a physical therapist before reattempting the exercise. The dowel is a great tool to help maintain a neutral spine. If you cannot perform the hip hinge while keeping the dowel in contact with the body, you might benefit from working with a personal trainer or physical therapist who can walk you through the steps with the correct form.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Chiropractic: The Secret to Unlocking Mobility 

References

Michaud, F., Pérez Soto, M., Lugrís, U., & Cuadrado, J. (2021). Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises. Sensors (Basel, Switzerland), 21(16), 5487. https://doi.org/10.3390/s21165487

Clark, D. R., Lambert, M. I., & Hunter, A. M. (2018). Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners. Sports medicine – open, 4(1), 32. https://doi.org/10.1186/s40798-018-0150-3

By admin 0 Comments Therapy , , , , , , , , , , , , , , , ,

Customize Your Meditation Practice to Fit Your Personality

Do different meditation techniques work according to an individual’s personality type?

Meditation Techniques According To Personality Type

Meditation techniques come in many forms. The traditional practice of sitting cross-legged with eyes closed and hands in prana mudra form is just one technique. From loving-kindness meditation to sound baths, the Breethe App, and walking meditations, each type offers its way of calming and focusing the mind, reducing stress, and enhancing well-being.

Meditation for All

Meditation is about observing individual thoughts without judgment and staying in the present. Learning not to focus on every negative or hurtful thought that passes builds emotional regularity and a healthier relationship with the mind. However, no one-size-fits-all technique exists, and meditation relies on individual personality. Some feel more at peace sitting alone, while others find music soothing. Still others find peace of mind in taking a walk. Discovering the answers will help determine which meditation technique works best for you and your mind.

Choosing a Technique

There is no exact science to finding the best meditation technique for each personality. How one meditates is a personal decision. But for those new to meditation and unsure where to start or which practice works best, here are a few meditation techniques for every personality type.

Introverted

Mindfulness Meditation

Introverts harness energy alone and spend energy in social situations. Based on this, mindfulness meditation can work in a quiet, calm, and familiar setting. This type of meditation involves paying attention to the present moment and focusing on the breath, body sensations, and sounds. It helps relieve stress, generates mental clarity, enhances self-awareness, and improves emotional regulation. To practice mindfulness meditation:

  • Sit comfortably in a quiet space and close your eyes.
  • Focus on your breath as you slowly inhale and exhale.
  • Observe your thoughts without judgment, and try to redirect your breathing as you let the thought pass.

Introverts often find satisfaction in the structured approach, which helps them gain insight into their thoughts and behaviors. Research has found that those who participate in mindfulness-based stress reduction/MBSR benefit from decreased stress levels. (Chiesa A. & Serretti A. 2009)

Extroverts

Group Meditation

Extroverts love being in the mix of the world and fuel themselves through social interactions. They still benefit from meditation to calm and ground them, but in a group or class setting. Group meditation practices with a group, usually in-person or a virtual class led by an instructor. This type of meditation strengthens the sense of community and can deepen an extrovert’s meditation experience through the group’s energy.

Creative and Artistic

Artful Meditation

Creative individuals often create things through painting, sculpting, cooking, sewing, or other trades and crafts. The creative process creates a therapeutic atmosphere for this personality type, and engaging in creative activities can help them focus their minds and forget outside stressors. Artful meditation, or meditative art, combines this creativity with mindfulness. It involves engaging in artistic activities while meditatively concentrating on the process. The practice increases relaxation, provides self-expression, and encourages mindfulness. Individuals do not have to be artists to benefit, as it’s accessible and enjoyable for all skill levels.

Music Personality

Sound Bath Meditation

Individuals drawn to music appreciate and enjoy the combination of sounds that create harmonies, rhythms, and vibrations. Consider sound baths, which can provide a deep and emotional experience. A sound bath is a meditative experience where participants are “bathed” in sound waves produced by instruments like gongs, singing bowls, and chimes. Research has found that sound vibrations help reduce stress, enhance mental clarity, and improve emotional well-being. (Bartel L. & Mosabbir A. 2021) Classes are often led by an instructor and involve lying or sitting down with closed eyes while sounds and vibrations cascade. The music guides the experience and keeps the listener focused on the journey. The immersive musical meditation experience can help individuals process emotions, reduce stress, and cultivate connections with themselves and others.

Type A Personalities

Breathwork Meditation

Type A personalities strive for order and are ready to accomplish any challenge, which often leads to perfectionism burnout. Breathwork meditation can help avoid these pitfalls. This meditation focuses on controlling and manipulating one’s breath to calm the body, mind, and emotions. It’s very structured and orderly, which appeals to type-A individuals. One technique is box breathing, which involves breathing in for six seconds, holding for six seconds, exhaling for six seconds, holding for six seconds, and repeating.

Type B Personalities

Walking Meditation

Type B personalities are relaxed, easy-going, patient, and adaptable. These individuals benefit from flexible, open-ended meditation techniques that allow exploration and creativity. Walking meditation around nature or the block offers this as it combines movement with mindfulness. It focuses on the sensations of walking, like the feel of the ground under the feet and the rhythm of the steps. This creates a deeper connection with one’s surroundings. It also takes the practice of meditation into the world, helping integrate mindfulness into daily activities.

Pessimistic

Loving-Kindness Meditation

Pessimists typically have a glass-is-half-empty mentality, often focusing on the negative versus the positive. This form of meditation involves cultivating feelings of compassion, kindness, and goodwill toward oneself and others. For pessimists who struggle with negative self-talk and skepticism, loving-kindness meditation offers a structured practice for cultivating positive emotions and empathy. It can help soften inner criticism, foster resilience, and promote a compassionate worldview. To practice, sit quietly, focus on feelings of love and compassion, and repeat phrases like May I be healthy, may I have mental happiness, and may others be safe, happy, and peaceful. With practice, these sentiments are allowed to grow.

Optimistic

Affirmation Meditation

Optimists tend to see the brighter side of situations, expect favorable outcomes, and maintain a can-do attitude. Affirmation meditation, which involves repeating positive statements aloud or silently, can help reinforce positive beliefs and cultivate optimism. These may be phrases like “I am confident, grounded, or grateful for today.” Consciously affirming, uplifting statements strengthen optimists’ positive mindsets, increase their self-esteem, and sustain their natural inclination to see possibilities and opportunities.

Easily Distracted

Guided Meditation

Guided meditation may benefit individuals who are easily distracted or find it difficult to sit still. This structured approach allows individuals to show up and follow instructions. A narrator guides the practitioner by focusing on relaxation, visualization, or themes like gratitude or compassion. Guided voice meditation provides a clear framework and can be easier to follow, making it accessible for individuals new to meditation or those who find it difficult to focus.

Injury Medical Chiropractic and Functional Medicine Clinic

Ultimately, the best type of meditation technique is the one that works for you. Individuals may find that having a few variations can keep things interesting in your day-to-day life. A healthcare provider can determine the most effective treatment strategies. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Transform Your Body

References

Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. Journal of alternative and complementary medicine (New York, N.Y.), 15(5), 593–600. https://doi.org/10.1089/acm.2008.0495

Bartel, L., & Mosabbir, A. (2021). Possible Mechanisms for the Effects of Sound Vibration on Human Health. Healthcare (Basel, Switzerland), 9(5), 597. https://doi.org/10.3390/healthcare9050597

By admin 0 Comments Arthritis, Sleep Hygiene , , , , , , , , , , , , , , , , , ,

The Importance of a Supportive Mattress for Arthritis

Getting a good night’s sleep can be difficult for individuals suffering from arthritis. Can finding a mattress that fits an individual’s needs help relieve aches and pains and provide restful sleep?

Mattress For Arthritis

Quality sleep can be difficult for those managing arthritis. Joint pain, stiffness, and tenderness can make falling and staying asleep feel impossible. A mattress for arthritis should be firm, provide comfortable support, and relieve joint pressure. (Sleep Foundation, 2024)

How Mattresses Affect Arthritis?

  • Not adequate support or cushioning can exacerbate arthritis pain and stiffness.
  • Individuals not sleeping well at night can experience significant physical and mental fatigue, increase the risk of injury, and perceive a higher level of pain.
  • Zoned mattresses provide targeted pressure relief to areas of arthritis pain, like the neck and lower back.
  • Mattresses that don’t support the body are more likely to disrupt sleep and exacerbate nighttime and daytime pain symptoms.
  • The body needs time to recover and repair during sleep, so the right mattress for arthritis will allow sound rest throughout the night.
  • A joint-supporting mattress can alleviate pain and stiffness.

What to Look For Mattress Types

Mattresses fall into three basic categories.

Foam or Latex

  • These mattresses are often recommended for individuals with chronic pain because they conform to the body and alleviate pressure points without being too firm that they aggravate existing injuries or inflammation.
  • Not all foam is the same; some mattresses are too soft to support someone with arthritis.
  • Latex is a more reliable material for support and durability, but it’s also more expensive than memory foam.

Innerspring

  • Innerspring mattresses are often long-lasting and provide firm support.
  • However, they are not recommended for individuals with arthritis because they can be hard on joints and pressure points.
  • The innerspring system doesn’t mold or conform to the body, so getting and staying comfortable can be difficult, if not impossible.
  • They’re not as heat-retaining as foam mattresses so that hot sleepers may prefer them.

Hybrid

  • A hybrid mattress typically consists of individually wrapped springs topped with one or more layers of memory foam.
  • Hybrid mattresses are often recommended for arthritis patients because they meet the expert-recommended balance between support and cushioning.

Firmness Levels

Mattress firmness is rated on a scale of 1 to 10, with firmer mattresses scoring higher, often 6 or 7 and above. However, no one firmness rating works for all individuals with arthritis. Finding the right firmness for arthritis symptoms is highly individualized. For some, a super firm sleep surface can aggravate symptoms. In determining what firmness number is needed, consider weight. For example, a person weighing 400 pounds will have a different experience on a soft mattress than a person weighing 150 pounds. Typically, larger bodies need a firmer mattress to avoid sinking too far into the mattress’s core. Petite individuals may be perfectly supported on a mattress rated 5 or 6 for firmness, but taller or heavier individuals should look for a mattress rated seven or eight.

Support and Pressure Relief

Individuals will want to look for a mattress that targets specific areas for relieving aches and pains, such as the shoulders, hips, and lower back. Foam helps relieve pressure points in the body without feeling too soft, which is helpful when managing joint pain. There is debate over whether latex or memory foam is better for relieving sensitive pressure points. A Journal of Chiropractic Medicine study suggests that latex foam may outperform traditional memory foam as it reduces body pressure and evenly distributes weight along pressure points. (Low F. Z. et al., 2017)

Motion Transfer

Motion transfer refers to a mattress’s ability to isolate body movement.  It’s helpful to consider how much you and your partner are affected by each other’s movement throughout the night. This may not be necessary for individuals who don’t sleep with a partner. So, if you or a partner disrupt sleep throughout the night, a mattress with better motion absorption is recommended.

Sleep Position Can Affect Arthritis and Joint Pain

Mattress manufacturers often design mattresses to accommodate back, side, or stomach sleepers, as different sleeping positions usually require different types of support. One study suggests that sleeping-related pain can be reduced in those with lower back pain when they choose the right sleeping surface for their preferred sleep position. (Jacobson B. H. et al., 2010) Therefore, purchasing a mattress for the preferred position is important.

Durability

A mattress’s expected lifespan depends on the materials it’s made from. A mattress that immediately loses some of its features and benefits won’t last very long. This is why it is recommended to know how long the trial period is for the mattress and keep track of its performance. Count on at least six to seven years, but latex and hybrid mattresses can last longer.

Trial Period

Considering the trial period on the mattress is important when buying online. Determining if it’s right for your body can take a little while as it takes a while to break in a new mattress, so look for a longer trial period to see and feel if it is the right choice. (Mattress Firm, 2023) Most online mattress retailers offer at least a 100-day trial period, while some offer 365 days to send it back. However long the trial period, looking into the terms and conditions of any return policy is recommended. A company can say you can return it if it doesn’t meet expectations; however, restrictions or exclusions may apply to your purchase.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Fighting Inflammation Naturally

References

Sleep Foundation. Noyed D. (2024). How to Choose a Mattress. https://www.sleepfoundation.org/mattress-information/how-to-choose-a-mattress

Low, F. Z., Chua, M. C., Lim, P. Y., & Yeow, C. H. (2017). Effects of Mattress Material on Body Pressure Profiles in Different Sleeping Postures. Journal of Chiropractic Medicine, 16(1), 1–9. https://doi.org/10.1016/j.jcm.2016.09.002

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. https://doi.org/10.1016/j.apergo.2010.05.004

Mattress Firm. (2023). Breaking In a New Mattress: Tips for a Comfortable Night’s Sleep. Mattress Firm Blog. https://www.mattressfirm.com/blog/sleep-tips/break-in-a-new-mattress

By admin 0 Comments Sleep Hygiene , , , , , , , , , , , , , , , , ,

Primary Insomnia Explained: Symptoms and Solutions

Could learning to apply healthy sleep hygiene habits help improve sleep and overall health for individuals with sleeping difficulties?

Primary Insomnia

Insomnia affects most adults at some point in their lives. Primary insomnia is a fairly common condition characterized by difficulty sleeping, and sometimes, it can resolve without treatment. A diagnosis of primary insomnia means that there is no need to worry that a medical or psychological issue is causing sleep problems. Secondary insomnia is the result of medication side effects or medical or psychological issues. However, individuals may need a diagnostic evaluation, including blood tests or an overnight sleep study, to determine an underlying cause for persistent insomnia. Managing lifestyle habits is usually effective for the relief of primary insomnia. If that doesn’t work, medical treatment may be recommended.

Symptoms

Primary insomnia means not getting enough sleep. Individuals with primary insomnia average six hours of sleep per night (Flynn-Evans E. E. et al., 2017). They often toss and turn or get out of bed frequently. Typically, primary insomnia makes it hard to fall asleep and/or stay asleep. Individuals can wake up easily by triggers like noises or even without triggers. Sleep deprivation can lead to several health problems when awake. Symptoms of insomnia fatigue include: (Salisbury-Afshar E. 2018)

  • Trouble waking up in the morning
  • Constant yawning
  • Feeling tired and sleepy throughout the day
  • Lack of energy for physical activity
  • Lack of motivation
  • Hunger
  • Difficulty concentrating
  • Irritability
  • Headaches
  • Hypersomnia or falling asleep during the day
  • Sensitivity to noise or lights when awake
  • Bouts of hyperactivity
  • Jumpiness
  • Being easily alarmed or frightened

Individuals can experience these symptoms for a few days in a row and resolve the day after a restful night of sleep or after a nap. There are times when fatigue can help with falling asleep, which helps to resolve insomnia.

Complications

Individuals can develop severe anxiety and distress about the fact that they are not getting enough sleep. This anxiety is usually more severe before going to bed or in the middle of the night, but the worry can continue during the day as well. Persistent insomnia and chronic lack of sleep can lead to depression and predispose the mind and body to health complications. (Sun, Q., & Tan, L. 2019) Insufficient sleep is associated with lowered immune system function, obesity, and heart disease. (Hung C. M. et al., 2018)

Causes

The conundrum of primary insomnia is that it does not have an identifiable cause, but certain risk factors predispose individuals to have primary insomnia. The condition persists throughout a person’s life, often worsening or improving for months or years. Primary insomnia can be more common among those who have family members with insomnia. Research has found that, while primary insomnia isn’t caused by psychiatric issues, tending to stress or a worry-prone personality might be predisposing factors. (Hung C. M. et al., 2018)

Circadian Rhythm

Research has found that primary insomnia is associated with circadian rhythm irregularities. Primary insomnia can result from individuals falling into deeper sleep phases earlier than those who don’t have the condition. (Flynn-Evans E. E. et al., 2017) However, it can be challenging to know whether early deep sleep is a cause or an effect of primary insomnia. This is because sleep deprivation can also lead to deep sleep’s abrupt or rapid onset.

Diagnosis

Getting enough sleep is a common concern throughout life. Diagnosing primary insomnia involves various steps. One of the main components of identifying insomnia is determining whether the individual needs more sleep than they are getting. For individuals who are unable to get the proper amount of sleep, the second aspect of primary insomnia diagnosis is focused on finding the reason for their lack of sleep. Diagnostic tests measure insomnia and its effects and include:

Sleep Study

  • A polysomnogram is an overnight sleep study measuring brain activity, muscle activity, and breathing.
  • The polysomnogram is expected to show decreased sleep and normal breathing patterns if it is primary insomnia. (Sun, Q., & Tan, L. 2019)

Pittsburgh Sleep Quality Index 

  • The PSQI is a questionnaire that includes a self-assessment of sleep.
  • It helps identify sleep patterns and issues like using the bathroom frequently at night.

Multiple Sleep Latency Test

  • An MSLT is a daytime nap study in which participants are monitored to determine how fast they fall asleep.
  • The test results are a reflection of your sleep deprivation.

These studies help assess whether an individual is not getting enough sleep and what type of sleep interruption is experienced. Other tests might include screening questionnaires or other assessments of emotional issues like depression and anxiety. Sometimes, individuals are aware of these problems but may dismiss symptoms of depression and anxiety, and they instead manifest as insomnia.

Ruling Out Underlying Causes

Medical causes of insomnia can include: (Guo H. M. et al., 2017)

  • Thyroid disease
  • Liver disease
  • Dementia
  • Restless leg syndrome
  • Breathing problems. 

Individuals might need to have tests to determine whether any of these underlying issues are contributing to their insomnia. Individual medical symptoms and physical examination would guide the diagnostic testing.

Sleep Hygiene Habits

Individuals can start making small lifestyle adjustments to help regulate their sleep. The key is to avoid things that prevent falling asleep when you want to. Healthy habits include:

  • Avoid caffeine in the afternoon or evening.
  • Avoid alcohol.
  • Avoid napping during the day.
  • Don’t turn on a phone, computer, or television screen in the bedroom before going to bed.
  • Staying away from bright lights for several hours before sleep.
  • Scheduling tasks so you feel caught up before going to sleep.
  • Getting enough to eat so you aren’t hungry before going to bed.
  • Not eating so much that you feel bloated before going to bed.
  • Doing some light exercise several hours before going to bed.

Medical Treatment

If lifestyle habits don’t help alleviate insomnia, talk to a healthcare provider about medical therapy. Some notice a benefit from treatment with non-prescription-based strategies like counseling, cognitive behavioral therapy for insomnia (CBT-I), or acupuncture. These approaches can have a longer-lasting effect without the risk of side effects. (Salisbury-Afshar E. 2018) A healthcare provider might recommend melatonin or may prescribe medication such as antidepressants, antihistamines, or benzodiazepines.

Injury Medical Chiropractic and Functional Medicine Clinic

Navigating insomnia can be challenging, but understanding the treatment process can significantly help the individual. A healthcare provider can determine the most effective treatment strategies. This can include physical therapy, rest, health coaching, and medication. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Building a Stronger Body

References

Flynn-Evans, E. E., Shekleton, J. A., Miller, B., Epstein, L. J., Kirsch, D., Brogna, L. A., Burke, L. M., Bremer, E., Murray, J. M., Gehrman, P., Rajaratnam, S. M. W., & Lockley, S. W. (2017). Circadian Phase and Phase Angle Disorders in Primary Insomnia. Sleep, 40(12), 10.1093/sleep/zsx163. https://doi.org/10.1093/sleep/zsx163

Salisbury-Afshar E. (2018). Management of Insomnia Disorder in Adults. American Family Physician, 98(5), 319–322.

Sun, Q., & Tan, L. (2019). Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder. Psychiatry Research, 282, 112514. https://doi.org/10.1016/j.psychres.2019.112514

Hung, C. M., Li, Y. C., Chen, H. J., Lu, K., Liang, C. L., Liliang, P. C., Tsai, Y. D., & Wang, K. W. (2018). Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study. BMC psychiatry, 18(1), 38. https://doi.org/10.1186/s12888-018-1623-0

Guo, H. M., Liu, M., Xiang, Y. T., Zhao, J., Ungvari, G. S., Correll, C. U., Ng, C. H., Chiu, H. F., & Duan, Z. P. (2017). Insomnia in Adults With Chronic Hepatitis B, Liver Failure, and Cirrhosis: A Case-Control Study. Perspectives in psychiatric care, 53(1), 67–72. https://doi.org/10.1111/ppc.12138