{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:19:19Z","timestamp":1759796359185,"version":"build-2065373602"},"reference-count":69,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health & Welfare, Republic of Korea","award":["RS-2023-KH139336"],"award-info":[{"award-number":["RS-2023-KH139336"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Life"],"abstract":"<jats:p>Many individuals suffer from sleep disorders associated with chronic pain, neuroendocrine diseases, and primary sleep disorders. Although cervical manual therapy (CMT) is frequently presumed to enhance sleep quality in clinical settings, evidence regarding its effects on sleep remains inconclusive. We aimed to evaluate the therapeutic effect of CMT and clinical patterns, providing novel insights into its applicability for sleep disorders and further mechanism studies. Methods: A comprehensive literature survey was conducted by using 6 databases through February 2025, to identify randomized controlled trials (RCTs) assessing the effect of CMT on sleep quality as clinical outcome, regardless of primary diseases. Results: Among 1220 initial studies, a total of 10 RCTs involving 552 participants were included. All included RCTs assessed sleep quality using patient-reported outcome measures, while only one study utilized objective assessment via polysomnography. Among them, seven RCTs (70.0%) reported significant improvements in sleep quality that were not dependent on alleviating the primary diseases, with notable enhancements in subjective sleep depth and efficiency rather than sleep duration or latency. Sleep benefits were pronounced in primary sleep disorders, such as obstructive sleep apnea and bruxism, and in sleep disturbances secondary to other conditions, with limited effects in fibromyalgia (FM). Conclusions: With the dysregulated hypothalamic\u2013pituitary\u2013adrenal axis and aberrant serotonergic activity in FM, in this review, we formed a hypothesis and explored the potential effects of CMT on sleep-related serotonergic activity and HPA axis regulation. This scoping review underscores the need for further research to clarify the neuroendocrinological mechanisms underlying CMT\u2019s role in sleep modulation and its potential applications in sleep-related disorders.<\/jats:p>","DOI":"10.3390\/life15101557","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T08:10:51Z","timestamp":1759738251000},"page":"1557","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Cervical Manual Therapy on Sleep Quality: A Scoping Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7293-5396","authenticated-orcid":false,"given":"Do-Young","family":"Kim","sequence":"first","affiliation":[{"name":"Jaseng Korean Medicine Hospital, Seoul 06110, Republic of Korea"},{"name":"Department of Public Health Science, Seoul National University, Seoul 08826, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Hyun","family":"Go","sequence":"additional","affiliation":[{"name":"Jaseng Korean Medicine Hospital, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hak-Jae","family":"Kim","sequence":"additional","affiliation":[{"name":"Jaseng Korean Medicine Hospital, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5944","authenticated-orcid":false,"given":"Nam-Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Jaseng Korean Medicine Hospital, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1532-0942","authenticated-orcid":false,"given":"Yoon Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-3621","authenticated-orcid":false,"given":"Sook-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-6723","authenticated-orcid":false,"given":"In-Hyuk","family":"Ha","sequence":"additional","affiliation":[{"name":"Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.smrv.2015.08.005","article-title":"Sleep function: Toward elucidating an enigma","volume":"28","author":"Krueger","year":"2016","journal-title":"Sleep Med. 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