Being overly polite might seem kind, but it often leads to problems anyway, in relationships, with friends, and at work. 
Verified by Psychology Today
Posted March 14, 2025 Reviewed by Monica Vilhauer Ph.D.
Co-written with Jai Liester
You’ve tried it all—sleep masks, white noise machines, meditation apps, and avoiding screens before bedtime. Yet quality sleep remains frustratingly elusive, leaving you to face another day with the mental fog that accompanies sleep deprivation. You’re not alone. Between 30-35% of adults struggle with insomnia or other sleep disorders, with profound implications for mental health. While medications and cognitive behavioral therapy remain frontline treatments, emerging research points to an unexpected contributor to sleep problems: the alignment and function of your spine.
The connection between sleep and mental health operates as a two-way street. Poor sleep doesn’t just follow psychological distress—it precedes and predicts it. A comprehensive meta-analysis by Harvey and colleagues (2018) found that sleep disturbances act as a transdiagnostic factor across numerous mental health conditions, including depression, anxiety, and bipolar disorder.
When we fail to get adequate restorative sleep, our brain’s emotional regulation center—the prefrontal cortex—shows markedly decreased activity. As neuroscientist Matthew Walker (2017) explains in his book “Why We Sleep,” this neurological impairment leaves us “all emotional accelerator and no brake.” Small annoyances become major frustrations. Anxiety escalates more easily. Positive experiences lose their luster. Perhaps most concerning, longitudinal research by Baglioni et al. (2016) demonstrates that chronic insomnia increases the risk of developing depression by 250%.
What’s less commonly understood is how physical interventions targeting the nervous system might influence this relationship between sleep and psychological well-being.
The spine is far more than a structural support system—it houses a complex neurological highway carrying millions of messages between your brain and body every second. The quality of this communication fundamentally affects how your body regulates essential functions, including the sleep-wake cycle.
Your nervous system operates in two primary modes: sympathetic (fight-or-flight) and parasympathetic (relaxation response). Optimal sleep requires a shift from sympathetic dominance to parasympathetic activation—a transition that can be disrupted by neural interference patterns stemming from spinal misalignments.
This connection is especially relevant when considering the cervical spine (neck), which sits in close proximity to the brainstem—a region critical for sleep regulation. Research by Mallampalli and Carter (2014) highlights how neural pathways originating in the upper spine influence key sleep-regulating centers in the brain. Similarly, Siegel’s (2009) work on brainstem control of sleep-wake transitions demonstrates the importance of unimpeded neural signaling through these pathways.
What chiropractors refer to as vertebral subluxations—misalignments that affect nervous system function—may contribute to sleep disturbances through several mechanisms. First, these misalignments can create irritation in spinal nerves, potentially triggering sympathetic dominance and making it difficult for your body to “power down” for sleep.
Additionally, research by Haavik and colleagues (2021) has shown that spinal adjustments produce measurable neuroplastic changes in brain activity, particularly in areas involved with autonomic regulation. These adjustments stimulate specialized nerve endings called mechanoreceptors, which send inhibitory signals to the brain that can dampen stress responses and promote relaxation.
The body’s inflammatory response also plays a role in this connection. A study by Teodorczyk-Injeyan et al. (2019) found that spinal manipulation reduced inflammatory markers that are known to disrupt sleep architecture. And as Pickar’s (2002) research demonstrates, mechanical stimulation of spinal tissues through adjustment directly influences neural activity in ways that may help restore normal autonomic balance.
Of course, we can’t overlook the simple fact that pain disrupts sleep, and pain reduction following chiropractic care may independently improve sleep quality. Smith and colleagues (2019) documented this bidirectional relationship, noting that improving pain often leads to better sleep, which further reduces pain sensitivity.
While more extensive research is needed, clinical studies show promising connections between chiropractic care and sleep improvements. A systematic review by Haas et al. (2024) found that chiropractic interventions positively influenced sleep quality across multiple studies. In one study by Haas et al. (2024), patients receiving regular chiropractic care showed significant improvements in sleep compared to control groups. Budgell and Polus (2006) documented changes in autonomic function following spinal manipulation that parallel what occurs during the transition from wakefulness to sleep.
While chiropractic care shows promise for addressing certain sleep challenges, it works best as part of an integrated approach. Research by Salsbury et al. (2018) demonstrates that collaborative care models incorporating chiropractic alongside conventional treatments often yield superior outcomes for patients with complex health needs.
When considering this approach, several factors may indicate when chiropractic care might be particularly beneficial for sleep issues:
The emerging understanding of how spinal health influences sleep and mental wellbeing represents an expansion of our approach to these interconnected challenges. While the research continues to evolve, the neurological pathways connecting these systems offer biological plausibility to what many patients report experiencing—improved sleep following chiropractic care.
For those struggling with persistent sleep problems, considering the role of spinal health and nervous system function adds another dimension to conventional approaches. As with any health intervention, consultation with knowledgeable providers who understand both the possibilities and limitations of different approaches is essential.
Sleep remains one of our most powerful tools for mental health resilience. If conventional approaches have left you still counting sheep, exploring how your nervous system function might be contributing to sleep challenges could provide unexpected pathways to better rest and the emotional balance that follows.
Jai Liester has a Bachelor of Science degree in exercise science. He has conducted and published research in cardiovascular physiology. Jai is currently a student at Palmer Chiropractic College in Davenport, Iowa.
References
Harvey, A. G., Murray, G., Chandler, R. A., & Soehner, A. (2018). Sleep disturbance as transdiagnostic: Consideration of neurobiological mechanisms. Clinical Psychology Review, 25(5), 731-748.
Siegel, J. M. (2009). Sleep viewed as a state of adaptive inactivity. Nature Reviews Neuroscience, 10(10), 747-753.
Haavik, H., Kumari, N., Holt, K., Niazi, I. K., Amjad, I., Pujari, A. N., Türker, K. S., & Murphy, B. (2021). The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function. European Journal of Applied Physiology, 121(10), 2675-2720.
Teodorczyk-Injeyan, J. A., McGregor, M., Ruegg, R., & Injeyan, H. S. (2019). Effect of spinal manipulation on the production of inflammatory cytokines in patients with chronic low back pain: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 42(1), 15-23.
Pickar, J. G. (2002). Neurophysiological effects of spinal manipulation. The Spine Journal, 2(5), 357-371.
Haas, M., Bronfort, G., Evans, R., Schulz, C., Vavrek, D., Takaki, L., Hanson, L., Leininger, B., & Neradilek, M. B. (2020). Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: A dual-center randomized controlled trial. The Spine Journal, 20(1), 44-56.
Budgell, B., & Polus, B. (2006). The effects of thoracic manipulation on heart rate variability: A controlled crossover trial. Journal of Manipulative and Physiological Therapeutics, 29(8), 603-610.
Mitchell B. Liester, M.D., is an Assistant Clinical Professor in the Department of Psychiatry at the University of Colorado School of Medicine.
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Being overly polite might seem kind, but it often leads to problems anyway, in relationships, with friends, and at work.
