CF 220: Sleep, Energy, and Pain & Depression and Rehab Today we’re going to talk about Sleep, Energy, and Pain & Depression and Rehab But first, here’s that sweet sweet bumper music

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and your patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #220 Now if you missed last week’s episode, we talked about how Neurodynamic Moves Solve Problems and we talked about some new research focused on The Inversion Table. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Looks like business may be coming back. If you’ve been listening for some time, you’ll remember that it was probably November into early December that I was seeing 180-200 or so per week. about 75-85 new patients per month. Then 2022 started, deductibles RE-set, omicron went bananas, and business slowed. Down to about 115 on one particular week. Ouch. That’s pretty bleak. That makes me want to punt baby bun yes with steel-toed boots like the dudes with hard hats wear. As an entrepreneur, you only want to see things growing and expanding. And COVID has taught me not to have expectations.  And for damn sure, don’t plan on growth because you never know right now. But, the week before last we saw 145, and last week we saw 155.

It’s trending in the right direction and I’ll take it. And today is booming pretty darn good as well! Still working to grow the NP’s practice. That’s been a slow growth. slower than I had expected honestly. But I’m a hard-headed bastard. Always have been. I like to win and I plan on winning with regards to making medical services successful in our clinic.  Several listeners have emailed me about the short-term rental I opened up recently in Lubbock, TX. Just asking about the process and my experience.

Evidently, a lot of you are considering real estate investing as well. So far, it’s been hell for my family and me to make the 1 hr 45 min drive one way a couple of times per week to put furniture together, hang pictures and hang shelves, build a fire pit, assembly a ping pong table and things if that nature. It’s been ridiculous. BUT…..it is set up and a traveling nurse immediately rented it out for a month. Then one of her nurse buddies came in and rented. Now another moves in next week.  Then we just got listed on Airbnb and VRBO and boom, we have a booking for a weekend in May that will cover the whole property overhead plus some all in three nights. It’s pretty crazy. Our new front desk staffer starts soon and I can’t wait because we’ve been short-staffed for about a month.

Ugh. Here we go

Item #1

The first one today is called “Patients with Clinically Elevated Depressive Symptoms Report Improvements in Mood, Pain, and Functioning Following Participation in Interdisciplinary Pain Rehabilitation” by Craner et. al. (Julia R Craner 2022) and published in Pain Journal in February 2022 so it’s ssssmmmmokin’ hot.

Why They Did It

Chronic pain and depression frequently co-occur and exacerbate one another; therefore, it is important to treat both conditions to improve patient outcomes. The current study evaluates an interdisciplinary pain rehabilitation program (IPRP) with respect to the following questions: 

  1. How do clinically elevated depressive symptoms impact pain-related treatment outcomes? and 
  2. To what extent does interdisciplinary pain rehabilitation program participation yield reliable and clinically significant change in depressed mood?

So what the hell is this? Well, let me tell you….because I did my reading and I like to keep you all smart. Interdisciplinary pain rehabilitation programs typically emphasize functional restoration through physical reconditioning, graded increase in activity, and self-management skills for pain and emotional distress. The treatment approach targets biopsychosocial contributions to both pain and depressed mood, including lack of physical exercise, activity avoidance, social isolation, negative thinking styles, and functional impairment.

This is part of what I teach in my Chronic Pain and the Up-regulated Central Nervous System course. It’s pretty fascinating stuff and it’s the way to approach chronic pain and all of its associated issues and comorbidities. 

How They Did It

The study included 425 adults  10-week interdisciplinary pain rehabilitation program Subjects completed self-report measures of pain, mood, and functioning at intake and discharge.  Participants were categorized into 4 groups

  • within normal limits 
  • Mild
  • Moderate and 
  • Severe

What They Found

Participants reported significant improvement in pain, pain-related life interference, health-related quality of life, pain catastrophizing, and depressed mood regardless of initial symptom level.  In addition, 43.4% of patients with Mild, Moderate, or Severe depressed mood reported reliable and clinically significant improvement in depressive symptoms and 30.3% were in remission at the end of treatment.

Wrap It Up

These findings support the assertion that interdisciplinary pain rehabilitation programs represent an effective treatment for patients with comorbid chronic pain and depression and that participation is associated with improvement in both conditions.

Item #2

Number 2 today is called, “Effect of Sleep Extension on Objectively Assessed Energy Intake Among Adults With Overweight in Real-life Settings” by Tasali et. al. (Tasali E 2022) and published in JAMA Internal Medicine on February 7, 2022. It’s like fajitas, lookout. 

Why They Did It To determine the effects of a sleep extension intervention on objectively assessed energy intake, energy expenditure, and body weight in real-life settings among adults with overweight who habitually curtailed their sleep duration. So basically, in you and me speak, does sleep have an effect on weight. Essentially. 

How They Did It

  • Single-center, randomized clinical trial
  • conducted from November 1, 2014, to October 30, 2020
  • Participants were adults aged 21 to 40
  • BMI between 25.0 and 29.9
  • Had habitual sleep duration of less than 6.5 hours per night
  • After a 2-week habitual sleep period at baseline, participants were randomized to either an individualized sleep hygiene counseling session to extend their bedtime to 8.5 hours (sleep extension group) or to continue their habitual sleep (control group).

What They Found

  • Data from 80 randomized participants were analyzed. 
  • Sleep duration was increased by approximately 1.2 hours per night in the sleep extension group vs the control group. 
  • The sleep extension group had a significant decrease in energy intake compared with the control group
  • The change in sleep duration was inversely correlated with the change in energy intake
  • No significant treatment effect in total energy expenditure was found, resulting in weight reduction in the sleep extension group vs the control group.

Wrap It Up

  • This trial found that sleep extension reduced energy intake and resulted in a negative energy balance in real-life settings among adults with overweight who habitually curtailed their sleep duration. 
  • Improving and maintaining healthy sleep duration over longer periods could be part of obesity prevention and weight loss programs.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography

  • Julia R Craner, P., Lindsay G Flegge, PhD, Eric S Lake, MA, Arianna E A Perra, PsyD, (2022). “Patients with Clinically Elevated Depressive Symptoms Report Improvements in Mood, Pain, and Functioning Following Participation in Interdisciplinary Pain Rehabilitation.” Pain Med 23(2): 362-374.  
  • Tasali E, W. K., Kahn E, Kilkus J, Schoeller DA, (2022). “Effect of Sleep Extension on Objectively Assessed Energy Intake Among Adults With Overweight in Real-life Settings: A Randomized Clinical Trial.” JAMA Intern Med.    

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