http://www.mycentraljersey.com/story/life/wellness/2017/02/13/jfk-johnson-rehabilitation-side-sleeping/97349016/
A new study by researchers at Edison’s JFK Johnson Rehabilitation Institute suggests a possible link between side sleeping and a heightened risk of stroke
Killing
one American every four minutes, stroke is also a leading cause of
serious long-term disability that costs the nation some $34 billion
annually in healthcare expenses, not to mention the havoc it wreaks on
the lives of those who have a stroke and their loved ones/caregivers.
While
the medical community has long known that strokes are typically caused
by either a blocked artery (known as an ‘ischemic’ stroke) or the
leaking or bursting of a blood vessel (known as a ‘hemorrhagic’ stroke),
a new study being conducted by researchers at JFK Johnson’s Center for
Brain Injuries in Edison suggests that there may be
a correlation between sleeping on your side and the risk of having a
stroke.
Based on data collected from dozens of stroke
patients studied over the past two years, evidence is mounting to
suggest that a potential risk factor for stroke “might be as simple as
the side you sleep on,” said Joanne Azulay, Ph.D., clinical
neuropsychologist and researcher within JFK Johnson’s Center for Brain
Injuries.
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Testing a theory
Azulay
said that she’s been fascinated with the sleep-stroke connection ever
since she reviewed a book called "Side Sleeper Syndrome" by author
and homeopathic practitioner George Swearington in 2012.
“I
found it so intriguing — I was astounded by the information he shared
on the range of potentially devastating side effects that can result
from sleeping on your side and it made so much sense to me,” said
Azulay, who sees hundreds of stroke patients annually through her
practice and found that Swearington’s theory made her see her patients
in a different way.
“In 2014, I started asking patients
who’d had a stroke what side they sleep on and found that their answers
correlated very strongly to the opposite side of the brain that
their stroke had occurred on and the same side their weakness was on,
known as ‘hemiparesis,’” she said, noting the medical fact that the side
of the stroke in the brain impacts the opposite side of the body. “I
also asked them to notice any swelling in their body and found a similar
relationship between unnoticed progressive swelling and habitual ways
of positioning their bodies for extended periods of time.”
After
collecting data from 50 to 75 patients, Azulay and her colleagues
decided to launch an official study to investigate a theory which she
believes is “so simple and intrinsic that it’s almost insulting,” she
said. “We spend one-third of our lives sleeping — why would we think
that this process wouldn’t potentially impact our health and vascular system?
“The
medical community believes that stroke initiates in the brain, but it
might actually initiate in the body and result in the brain as a
function of habitual activities that affect our vascular system and
cause either a lack or sudden surge of blood flow,” Azulay explained.
Among
the patients she’s studied so far (and with another 25 to 30 to go
before she publishes her findings), Azulay said she’s documented “a 95
percent correlation between the side the stroke patient sleeps on and
the side that experiences the weakness or paralysis” — the potential
result of vascular changes that this repetitive behavior causes in the
body over a long period of time which contribute to swelling, lack
of sufficient blood circulation, or a surge of vascular flow with
positional changes.
Azulay also has found that
right-hand and left-hand-dominant side sleepers tend to prefer the
passive (opposite) side of their body for sleeping and confirmed that
she can often determine the side a patient sleeps on as soon as they
walk into her exam room based on visible asymmetries in their
musculature.
In addition to potentially causing or
exacerbating one’s risk of stroke, the act of side sleeping, she said,
can lead to a range of other common medical issues as well, including
carpel tunnel syndrome, sciatica mimickers, neck and shoulder
issues, and hip degeneration, all of which might be avoided or minimized
by sleeping on one’s back or stomach instead.
“Dr.
Azulay is a brilliant and out-of-the-box thinker with an interesting,
back-to-basics theory and this is how many medical breakthroughs take
place,” said colleague Brian Greenwald, M.D., medical director of the
JFK Johnson Rehabilitation Center for Brain Injuries and a
co-investigator on this research with Azulay. “Stroke is a devastating
occurrence that leaves people debilitated, so anything we can do to help
decrease the risk of stroke will benefit so many people while reducing
national healthcare costs,” he said.
“There’s very little
in the medical literature on this topic and much more analysis remains
to be done, but this type of study poses no risk to patients and is
something very interesting that’s absolutely worth investigating,” he
added.
Modifying behavior
Based
on the data she’s collected and its implications, Azulay shared her
best tips to help optimize your sleep and reduce your risk of stroke and
other health issues potentially caused by side sleeping:
- Change Your Position: A left-side sleeper herself who understands how attached people can become to sleeping a certain way, “I noticed things like the numbing of my hand in the middle of the night or the swelling of my facial muscles when I woke up, so I trained myself to get off my side,” she said. “Unless you have a sleep disorder, I tell all of my patients to sleep on their back if at all possible or else on their stomach — both of which are positions which distribute weight more equally on all parts of the body. This is the way we were designed to sleep and can actually help us sleep better once we get used to it.”
- Assess Your Mattress: “Mattresses have become so soft, fluffy, and comfortable today that they often make us sink into ourselves, which is dangerous,” Azulay said. “Ensure that you have a solid mattress and that you flip it every six months for even support.”
- Be Observant: “Pay attention to long-term positions you hold, such as leaning on one side while commuting to work or resting in a chair or on a couch in a certain way for years and be aware of things that aren’t symmetric on your body,” Azulay said, noting that these can cause or reflect uneven pressure on the vascular system.
- Take Control: “We have more power over our health than we realize,” Azulay said. “By being aware of and in greater control of our behavior, we can impact the length and quality of our lives more than we know.”
For more information
JFK
Johnson’s Center for Brain Injuries is at 2048 Oak Tree Road in Edison
and can be reached by calling 732-906-2640 or by visiting www.jfkmc.org. JFK’s
Stroke Center was the first in the tri-state area to receive the Joint
Commission Comprehensive Stroke Centers designation.
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