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PILOT STUDY   by Sarah Stevens

Thesis summary, presented before a jury. March 29, 2017. Canadian School of Osteopathy, Manual Practice, Vancouver, Canada.

“It is no exaggeration to say that some of the most pressing problems we face as a society may be linked to poor sleep” (Phillips & Geleula, 2006, p. 1).  Primary insomnia affects a person’s concentration, physical health, energy level, motor skills, emotional stability and overall quality of life (Kraus & Rabin, 2012).

Primary insomnia is a condition which has no attributable secondary factors, and therefore originates through a disruption of the primary sleep mechanisms (American Psychiatric Association, 1994).  Primary sleep mechanisms are physiologic processes of circadian rhythm and homeostatic drive (Westerman, 2015).  Osteopathy assessment and treatment techniques can help normalize the body’s physiologic processes (World Health Organization, 2010).


The researcher found a trend to significance at p=0.09 in the PSQI  (Pittsburgh Sleep Quality Index) outcome measure which measures sleep quality. There were three subjects in the experimental group who started the study with a PSQI score in the insomnia range and ended the study with a score in the normal sleeper range. This result shows a trend to normalizing symptoms of insomnia with manual osteopathic treatment.

Research has found that a common mechanism of primary insomnia is hyperarousal and dysfunction with the inhibition of cortisol secretion at night (Levenson et al., 2015).  Therefore, the adrenals were targeted for the assessment and treatment.  It was found that all subjects in both treatment and control group had significant restriction around the adrenal glands which was treated.

The researcher also found that there was a small group whose digestive dysfunction had an impact on sleep quality.  This can be treated through osteopathic techniques, although other measures may be necessary to assess if there are any food sensitivities.


This research thesis looked at osteopathic manual therapy treatment and its effect on symptoms of primary insomnia in women.  Through this research, it can be postulated that there is an anatomic dysfunction perpetuating insomnia, which can be influenced using osteopathic manual therapy techniques to regain function in the body.  This research found trends to the significance of osteopathic manual therapy treatment in women with primary insomnia to regain normality and have an influence on better sleep function. 


Kraus, S.S., Rabin, L.A. (2012) Sleep America: Managing the crisis of adult chronic insomnia and associated conditions. Journal of Affective Disorders, 138, 192-212.

Levenson, J.C., Kay, D.B., & Buysse, D.J. (2015). The Pathophysiology of Insomnia.  CHEST, 147(4), 1179-1192.

Phillips, B.A. & Gelula, R.L. (2006) Sleep-Wake Cycle: Its physiology and impact on health.

Westerman, D.E. (2015) The Concise Sleep Medicine Handbook.  Atlanta: GSSD Publishers.

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