October is National Chiropractic Month. This observance offers an excellent opportunity for doctors of chiropractic nationwide to educate their communities about chiropractors' role as health and wellness experts, and how they are improving people's health every day.

Each year, the American Chiropractic Association (ACA) identifies a particular health topic of interest to the public. This year will focus on the importance of quality sleep, and how the mattress and pillow you sleep on can affect the amount of restful sleep you get each night.

An estimated 70 million Americans complain of sleeplessness. Daily stress and worries, pressures from job and family, body aches and pains caused by uncomfortable beds or pillows, and a host of other issues can keep a person from getting enough quality sleep.

Lack of sleep affects the immune and nervous systems, memory, judgment, attention, patience, and thinking and reading abilities. Preliminary research also shows that lack of sleep can affect musculoskeletal pain. According to a recent study in the journal Sleep, poor-quality sleep can raise the risk for pain in women. Researchers found that disrupted sleep, marked by multiple prolonged awakenings, impaired natural pain-control mechanisms that are thought to play a key role in the development, maintenance, and exacerbation of chronic pain.

Mattresses and Back Pain

While there are many options for the treatment of back pain, many people may not realize that the reason for their pain is literally right underneath them—the age and condition of their mattress.

A study published out of Canada in the winter 2006 issue of the Journal of Chiropractic Medicine showed that sleeping on a new mattress can significantly reduce stiffness and back pain.¹ Researchers looked at a control group of 59 healthy participants (30 women and 29 men) who slept on their own 5-plus-year-old mattresses for 4 weeks and then slept on a new bedding system for the same time period. They then analyzed the difference in lower back discomfort, spine stiffness, sleep quality, comfort, and efficiency.

The results showed that the volunteers reported immediate and sustained benefits in all areas of measurement after sleeping on a new mattress, regardless of their age or weight. This was especially true of participants who entered the study with high back pain complaints, as they reported a 63% improvement in back discomfort with a new mattress.

During National Chiropractic Month, discuss with your patients the following tips, which will help them achieve the highest-quality sleep with their current mattress:

• A mattress should provide uniform support from head to toe. If there are gaps between your body and your mattress (such as at the waist), you're not getting the full support you need.
• Be aware that changes in your life can signal the need for a new mattress. Examples would include if you've lost or gained a lot of weight, if a medical condition has changed the way you sleep, or even if you have changed partners.
• Every few months, turn your mattress clockwise so that body indentations are kept to a minimum.
• Generally, your mattress should be replaced every 5 to 8 years to ensure proper support and comfort. If you're waking up uncomfortable, it may be time for a new mattress.
• A 2003 study published in The Lancet found that people who slept on mattresses of medium firmness were twice as likely to report improvement in low-back pain symptoms than those who slept on firm mattresses.²

For patients who decide it's time to purchase a new mattress, ACA recommends they look for one that is

• designed to conform to the spine's natural curves and to keep the spine in alignment when you lie down;
• designed to distribute pressure evenly across the body to help circulation, decrease body movement, and enhance sleep quality; and
• designed to minimize the transfer of movement from one sleeping partner to the other.

When mattress shopping, it's best to give each option a good trial run before you buy; lie down on a mattress for 10 to 15 minutes to get a good feel of its firmness - sitting on it simply won't do. Also, don't hesitate to toss and turn, and always shop with your sleep partner to get the best idea of how the mattress will feel at night.

Pillows

In my practice, I've found that most patients are unaware of what to look for when selecting a pillow. Too many people choose a pillow based solely on price.

Encourage your patients to be selective when choosing a pillow, because the wrong pillow can exacerbate pain in the upper back, neck, shoulders, and head.

I frequently share with my patients the following ACA suggestions:

• When lying on your side, your head, neck, and shoulders should remain level with your mid and lower spine. When you lie on your back, your head and neck should remain level with your upper back and spine.
• Avoid pillows that are so thick or thin that they angle your head and neck away from your body.
• Choose firm foam and materials that press back and support the head.
• There is no such thing as a universal fit when it comes to pillows. Find one that is consistent with the shape and size of your body.
• If you find yourself sleeping on your side with one hand propped under your pillow, that's a clue that you're not getting the support you need from that pillow.

Planning Kit, Promotional Products Available

In preparation for October's observance of National Chiropractic Month, ACA released an online planning tool kit designed to assist chiropractic offices in the development and implementation of observance-related activities. The comprehensive online tool kit includes resources such as

• sample news releases and public service announcements, along with helpful tips for working with the media;
• sample print advertisements;
• a speaker's kit and other educational materials to facilitate the spread of positive chiropractic messages in local communities; and
• activity ideas and materials to help individuals and organizations plan their own National Chiropractic Month event.

Several of the items within the tool kit are available as Microsoft Word templates that can be easily personalized before sending to the media or local government officials.

Doctors of chiropractic can access the tool kit online from the ACA Web site: www.ACAtoday.org/NCM. An ACA membership ID and password is necessary to access the kit.

In addition to its planning tool kit, ACA is offering for sale two inexpensive promotional products. ACA's custom-designed tri-clip stopwatch and sleep-themed stress ball will give you the opportunity to discuss the importance of quality sleep with your patients. And they will have a fun, lasting reminder of how stress reduction and regular exercise will make them stop counting sheep and get a good night's sleep. To download an order form, visit www.ACAtoday.org

It is my hope that through National Chiropractic Month efforts the public will gain a greater understanding of chiropractic's role in helping people achieve a greater level of health. I encourage you to use the ready-made tools available and to participate in this year's observance.

Wesley Merritt, DC, serves as the chairman of ACA's public relations and marketing committee, and is the association's delegate to New Hampshire. For questions or comments, e-mail .

References

1. Jacobson B, Wallace T, Gemmell H. Subjective rating of perceived back pain, stiffness and sleep quality following introduction of medium-firm bedding system. J Chiropr Med. Winter 2006(5:4):128-134.
2. Kovacs FM Abraira V, Pena, A et al. Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. The Lancet. 2003 Nov 15;362(9396):1599-1604.