<% Response.Status="301 Moved Permanently" Response.AddHeader "Location","http://www.erinelster.com/ConditionsDetail.aspx?ConditionID=14" Response.End %> Insomnia, Sleep Disorders, Sleep Apnea - Alternative Treatment for Insomnia and Sleep Apnea
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Case Studies: Insomnia, Sleep Apnea, Sleep Disorders

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Types of sleep disorders include insomnia, hypersomnia, sleep apnea, and narcolepsy, to name a few.

  • Insomnia is the perception or complaint of inadequate or poor-quality sleep because of one of more of the following: difficulty falling asleep, waking up frequently during the night with difficulty returning to sleep, waking up too early in the morning, and/or unrefreshing sleep.

  • Hypersomnia is extreme sleepiness with excessive periods of sleep and difficulty awakening.

  • Patients with sleep apnea stop breathing repeatedly during sleep, causing them to awaken frequently. Once awakened, breathing resumes.

  • Narcolepsy is excessive and overwhelming daytime sleepiness even after adequate nighttime sleep hours where a person may require many naps throughout the day lasting a few minutes or hours.


Evidence supports that trauma (in particular mild concussive injury to the head, neck or upper back) precedes the onset of sleep disorders, such as insomnia, hypersomnia, sleep apnea, and narcolepsy, in certain cases.1-16 Following the trauma, sleep disorders can be triggered immediately or can take months or years to develop. Insomnia is frequently associated with depression, which is also linked to head trauma in medical literature.17-57

The purpose of IUCCA upper cervical care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the injured nerves in the central nervous system (brain and spinal cord). While many sleep disorder sufferers recall specific traumas such as head injuries, auto accidents or falls, some do not. An upper cervical examination utilizing Laser-aligned Radiography and Digital Infrared Imaging is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from IUCCA upper cervical care can be achieved.


Insomnia / Sleep Disorders Case Studies


"Treatment of Bipolar, Seizure, and Sleep Disorders and Migraine Headaches Utilizing a Chiropractic Technique" by Erin L. Elster, DC. Journal of Manipulative and Physiological Therapeutics. March 2004.

"Upper Cervical Chiropractic Care for a Nine-Year-Old Male with Tourette Syndrome, Attention Deficit Hyperactivity Disorder, Depression, Asthma, Insomnia, and Headaches: A Case Report" by Erin Elster, DC. Journal of Vertebral Subluxation Research. July 2003.

1. Tobe EH, Schneider JS, Mrozik T. Persisting insomnia following traumatic brain injury. J Neuropsychiatry Clin Neurosci 1999 Fall; 11(4): 504-6.
2. Patten SB, Lauderdale WM. Delayed sleep phase disorder after traumatic brain injury. J Am Acad Child Adolesc Psychiatry 1992 Jan; 31(1): 100-2.
3. Fictenberg NL, Putnam SH, Mann NR. Insomnia screening in postacute traumatic brain injury: utility and validity of the Pittsburgh Sleep Quality Index. Am J Phys Med Rehabil 2001 May; 80(5): 339-45.
4. Fichtenberg NL, Millis SR, Mann NR. Factors associated with insomnia among post-acute traumatic brain injury survivors. Brain Inj 2000 Jul; 14(7): 659-67.
5. Quinto C, Gellido C, Chokroverty S. Posttraumatic delayed sleep phase syndrome. Neurology 2000 Jan 11; 54(1): 250-2.
6. Schreiber S, Klag E, Gross Y. Beneficial effect of risperidone on sleep disturbance and psychosis following traumatic brain injury. Int Clin Psychopharmacol 1998 Nov; 13(6): 273-5. 7. Beetar JT, Guilmette TJ, Sparadeo FR. Sleep and pain complaints in symptomatic traumatic brain injury and neurologic populations. Arch Phys Med Rehabil 1996 Dec; 77(12): 1298-302. 8. Landau-Ferey J, George B, Benoit O. Polygraphic study of nocturnal waking in patients with traumatic brain stem injuries. Rev Electroencephalogr Neurophysiol Clin 1981 Sep; 11(1): 116-22.
9. Webb M, Kirker JG. Severe post-traumatic insomnia treated with L-5-hydroxytryptophan. Lancet 1981 Jun 20; 1(8234): 1365-6.
10. George B, Landau-Ferey J, Benoit O. Night sleep disorders during recovery of severe head injuries. Neurochirurgie 1981; 27(1): 35-8.
11. Henry GK, Groos HS, Herndon CA. Nonimpact brain injury: neuropsychological and behavioral correlates with consideration of physiological findings. Appl Neuropsychol 2000; 7(2): 65-75.
12. Guilleminault C, Yuen KM, Gulevich MG. Hypersomnia after head-neck trauma: a medicolegal dilemma. Neurology 2000 Feb 8; 54(3): 653-9.
13. Smed A. Cognitive function and distress after common whiplash injury. Acta Neurol Scand 1997 Feb; 95(2): 73-80.
14. Webster JB, Bell KR, Hussey JD. Sleep apnea in adults with traumatic brain injury: a preliminary investigation. Arch Phys Med Rehabil 2001 Mar; 82(3): 316-21.
15. Nemoto M, Akino M, Abe H. Atlantoaxial dislocation with ventilatory insufficiency-report of two cases. No To Shinkei 1996 Feb; 48(2): 155-60.
16. Amico G, Pasquali F, Pittaluga E. Pickwickian-narcoleptic disorders after brain concussion. Riv Sper Freniatr Med Leg Alien Ment 1972 Feb 29; 96(1): 74-85.
17. McAllister TW. Neuropsychiatric sequelae of head injuries. Psychiatr Clin North Am 1992 Jun; 15(2): 395-413.
18. Sayal K, Ford T, Pipe R. Case study: bipolar disorder after head injury. J Am Acad Child Adolesc Psychiatry 2000 Apr; 39 (4): 525-8.
19. Gupta S, Sharan P. Seasonal recurrent mania following head injury. Natl Med J India 1998 Nov-Dec; 11(6): 300-1.
20. Hibbard MR, Uysal S, Kepler K. Axis I psychopathology in individuals with traumatic brain injury. J Head Trauma Rehabil 1998 Aug; 13(4): 24-39.
21. Mitrovic D, Misic-Pavkov G, Ivanovic S. A manic syndrome after cerebral trauma: case report. Med Pregl 1997 Sep-Oct; 50(9-10): 391-3.
22. Lim LC. Mania following left hemisphere injury. Singapore Med J 1996 Aug; 37(4): 448-50.
23. Van Reekum R, Bolago I, Finlayson MA. Psychiatric disorders after traumatic brain injury. Brain Inj 1996 May; 10(5): 319-27.
24. Mas F, Prichep LS, Alper K. Treatment resistant depression in a case of minor head injury: an electrophysiological hypothesis. Clin Electroencephalogr 1993 Jul; 24(3): 118-22. 25. Jorge RE, Robinson RG, Starkstein SE. Secondary mania following traumatic brain injury. Am J Psychiatry 1993 Jun; 150 (6): 916-21.
26. Burstein A. Bipolar and pure mania disorders precipitated by head trauma. Psychosomatics 1993 Mar-Apr; 34(2): 194-5.
27. Zwil AS, McAllister TW, Cohen I, Halpern LR. Ultra-rapid cycling bipolar affective disorder following a closed-head injury. Brain Inj 1993 Mar-Apr; 7(2): 147-52.
28. Miller LS, Garde IB, Moses JA. Head injury and mood disturbance. J Clin Psychiatry 1992 May; 53(5): 171-2.
29. Starkstein SE, Fedoroff P, Berthier ML. Manic-depressive and pure manic states after brain lesions. Biol Psychiatry 1991 Jan 15; 29(2): 149-58.
30. Bamrah JS, Johnson J. Bipolar affective disorder following head injury. Br J Psychiatry 1991 Jan; 158: 117-9.
31. Starkstein SE, Mayberg HS, Bertheir ML. Mania after brain injury; neuroradiological and metabolic findings. Ann Neurol 1990 Jun; 27(6): 652-9.
32. Hunt N, Silverstone T. Seasonal affective disorder following brain injury. Br J Psychiatry 1990 Jun; 156: 884-6.
33. Nizamie SH, Nizamie A, Borde M. Mania following head injury: case reports and neuropsychological findings. Acta Psychiatr Scand 1988 Jun; 77(6): 637-9.
34. Yatham LN, Benbow JC, Jeffers AM. Acta Psychiatr Scand 1988 Mar; 77 (3): 359-60.
35. Robinson RG, Boston JD, Starkstein SE. Comparison of mania and depression after brain injury: causal factors. Am J Psychiatry 1988 Feb; 145(2): 172-8.
36. Starkstein SE, Boston JD, Robinson RG. Mechanisms of mania after brain injury. 12 case reports and review of the literature. J Nerv Ment Dis 1988 Feb; 176(2): 87-100.
37. Stewart JT, Hemsath RH. Bipolar illness following traumatic brain injury: treatment with lithium and carbamazepine. J Clin Psychiatry 1988 Feb; 49(2): 74-5.
38. Pope HG, McElroy SL, Satlin A. Head injury, bipolar disorder, and response to valproate. Compr Psychiatry 1988 Jan-feb; 29(1): 34-8.
39. Bell CC, Thompson B, Shakoor B. Mania and head trauma. Am J Psychiatry 1987 Oct: 144(10): 1378-9.
40. Starkstein SE, Pearlson GD, Boston J. Mania after brain injury. A controlled study of causative factors. Arch Neurol 1987 Oct; 44(10): 1069-73.
41. Yatham LN. Mania following head injury. Br J Psychiatry 1987 Oct; 151: 558.
42. Wilcox JA, Nasrallah HA. Childhood head trauma and psychosis. Psychiatry Res 1987 Aug; 21(4): 303-6.
43. Clark AF, Davison K. Mania following head injury. A report of two cases and a review of the literature. Br J Psychiatry 1987 Jun; 150: 841-4.
44. Bracken P. Mania following head injury. Br J Psychiatry 1987 May; 150: 690-2.
45. Riess H, Schwartz CE, Klerman GL. Manic syndrome following head injury: another form of secondary mania. J Clin Psychiatry 1987 Jan; 48(1): 29-30.
46. Shukla S, Cook BL, Mukherjee S. Mania following head trauma. Am J Psychiatry 1987 Jan; 144(1): 93-6.
47. Khanna S, Srinath S. Symptomatic mania after minor head injury. Can J Psychiatry 1985 Apr; 30(3): 236-7.
48. Gregersen B, Hagen S. Secondary mania after brain injury. Ugeskr Laeger 1983 Nov 21; 145(46): 3661.
49. Lishman WA. The psychiatric sequelae of head injury: a review. Psychol Med 1973 Aug; 3(3): 304-18.
50. Cote P, Hogg-Johnson S, Cassidy JD. The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. J Clin Epidemiol 2001 Mar; 54(3): 275-86.
51. Cote P, Cassidy JD, Carroll L. Is a lifetime history of neck injury in a traffic collision associated with prevalent neck pain, headache and depressive symptomatology? Accid Anal Prev 2000 Mar; 32(2): 151-9.
52. Soderlund A, Lindberg P. Long-term functional and psychological problems in whiplash associated disorders. Int J Rehabil Res 1999 Jun; 22(2): 77-84.
53. Taylor AE, Cox CA, Mailis A. Persistent neuropsychological deficits following whiplash: evidence for chronic mild traumatic brain injury? Arch Phys Med Rehabil 1996 Jun; 77(6): 529-35.
54. Barrett K, Buxton N, Redmond AD. A comparison of symptoms experienced following minor head injury and acute neck strain (whiplash injury). J Accid Emerg Med 1995 Sep; 12(3): 173-6.
55. Mayou R, Bryant B, Duthie R. Psychiatric consequences of road traffic accidents. BMJ 1993 Sep 11; 307(6905): 647-51.
56. Di Stefano G, Radanov BP. Neuropsychological and psychosocial findings in follow-up of cervical vertebrae dislocations: a prospective clinical study. Z Unfallchir Versicherungsmed 1993; 86(2): 97-108.
57. Ettlin TM, Kischka U, Reichmann S. Cerebral symptoms after whiplash injury of the neck: a prospective clinical and neuropsychological study of whiplash injury. J Neurol Neurosurg Psychiatry 1992 Oct; 55(10): 943-8.

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