Greetings, I am Dr. Lee, the principal investigator overseeing a randomized control trial study focused on utilizing OMT cervical techniques to enhance sleep quality for first-year medical students. I will be presenting a concise overview of our research. For a more comprehensive understanding, please refer to our poster. Recent research revealed that about 56% of medical students experience suboptimal sleep with an average of 6.5 hours of sleep. The well-documented impact of sleep on learning and academic performance is significant. Stress, common in medical school, can increase the sympathetic activity, leading to sleep disorders like excessive daytime sleepiness and insomnia. It is hypothesized that medical students may experience autonomic dysfunction due to being in a hyper-sympathetic state throughout their medical education. One potential factor contributing to the sleep issue is the heightened state of sympathetic activity, which can be exacerbated by stress. Medical students, in particular, are known to face significant stressors throughout their educational journey, leading to autonomic dysfunction and disruption in sleeping pattern. Vagal nerve stimulation has been shown to regulate the autonomic system by balancing sympathetic and parasympathetic activity. While cervical non-invasive vagal nerve stimulation has proven effective in managing sleep-related issues, the use of OMT for autonomic dysfunction in medical students has not been thoroughly explored. To address this gap in research, we conducted a randomized clinical trial to investigate the potential benefits of OMT in modulating the autonomic system and improving sleep quality among first-year medical students at ATSU in Arizona. The study involved a cohort of 41 participants who underwent OMT sessions three times a week over a six-week period. The treatment group received specific OMT intervention incorporating cervical soft tissue therapy and OA decompression, while the control group maintained a supine position for a equivalent duration. A sham trial for a control group was considered impractical due to evidence supporting touch intervention for stress relief in adults and the ability of DO students to recognize a sham trial. The Comprehensive Pittsburgh Sleep Quality Index scores for both the treatment and control groups significantly decreased from the baseline at Week 0 to the assessment at Week 6. Although the treatment group exhibited a more pronounced reduction in Pittsburgh Sleep Quality Index scores compared to the control, the Mann-Whitney U test did not yield statistical significance results. Despite the lack of statistical significance, there was a trend towards significance, suggesting that an expanded sample size or duration might achieve greater results. When stratifying participants by body mass index, individuals with a body mass index of less than 25 showed a significant response to OMT intervention. This subgroup experienced a noticeable decrease in Pittsburgh Sleep Quality Index scores compared to the control. Conversely, participants with a body mass index greater than 25 did not exhibit significant response compared to the control. The data indicates promising outcomes in enhancing sleep quality. The less favorable trends in individuals with a body mass index greater than 25 may be due to the presence of obstructive sleep apnea, which is more prevalent in overweight or obese individuals. OSA affects approximately 1 in 20 adults, leading to sleep, behavioral, and cardiovascular complications. Addressing OSA may require a longer treatment duration. The current intervention may not have fully addressed OSA, and additional measurements such as weight management with OMT could be considered to achieve statistical significance. Hence, further research supported by funding could utilize smart devices to monitor sleep patterns and academic stress, providing insights into autonomic dysfunction caused by medical education stressors. Previous studies have shown that academic stress could increase sympathetic activities, as evidenced by changes in heart rate variability and saliva alpha-amylase levels. Heart rate variability's electrodermal activity and respiratory rate could serve as indicators of stress and anxiety over time, which can aid in optimizing treatment protocols with adjustments to duration, frequency, and intensity. Nevertheless, the current studies demonstrate a standardized OMT regimen over six weeks can improve sleep qualities for students with a body mass index of less than 25.

OMT cervical techniques

sleep quality

medical students

autonomic function

obesity