What does Sympathetic Dominance mean? 

Ross Hauser, M.D.

The autonomic nervous system is divided into two nervous systems. These two nervous systems counteract each other. One speeds you up, the other slows you down.

  • It is the sympathetic nervous system that speeds you up. It is more famously described as the “fight or flight repsonse.”
  • It is the parasympathetic nervous system that slows you down.

A state of Sympathetic Dominance means you are constantly being sped up and the parasympathetic nervous system cannot “bring you down.”

These are the signs and symptoms of Sympathetic Dominance (your body reacting to constant stress).

Structural stress

Many problems in the patients we see are caused by a structural stress or problem in the cervical spine. Typically this problems is a loss of the natural cervical curve causing pressure, compression  and decreased nerve impulses in the vagus nerve. Problems include your adrenaline system being too high and then ultimately you end up getting circadian dysrhythmias where your body doesn’t know if it’s night time it’s daytime.

  • When you have increased intracranial pressure in the brain, the brain senses this pressure is too high because the brain knows that the cerebrospinal fluid is not draining out of the brain normally. The body then through autoregulation (a system in which blood vessels manage blood flow) dilates the blood vessels in the brain so now all the sudden the speed of the blood flow to the arteries in the brain might be twice normal increasing pressure.

What are we seeing in this image?

Let’s start with the caption: Typical nervous system imbalance.

When there is a greater amount of sympathetic nervous system activity (your body is in a state of stress awareness) than parasympathetic (your body’s attempt to bring itself down from stress awareness) and this is occurring over a long period of time, systematic inflammation, neuropathic pain, and other long-term health problems occur.

Below we see a see-saw

On one side of the see-saw, we see sympathetic overdrive a constant state of:

  • Fight or Flight
  • Tissue breakdown
  • Chronic inflammation

And on the other side of the see-saw, we see decreased parasympathetic activity

  • Reduced ability to relax
  • Reduced ability to repair and restore damaged tissue
  • Reduce the ability for health to be restored

The Long terms effects of sympathetic overdrive 

  • Small fiber neuropathy can cause symptoms of burning pain, shooting pain, allodynia (over-sensitization to pain and pain from stimuli that should not cause pain), and hyperesthesia (over sensation of the skin).
  • Neuropathy pain
  • Inflammatory physiology
  • Chronic disease

The Long terms effects of  decreased parasympathetic activity

  • Damage or impacts on nerve tissue health
  • Reduced state of calmness or peace
  • Reduced ability to have restorative health.

Treatment guidelines

Blood velocity measurements 

In patients that we assess and suspect that blood flow velocity is a concern, we offer testing to help confirm our assessments. Motion transcranial Doppler examination is a test where we ask the patient to go through a series of neck and head movements to assess if blood flow and velocity is impacted in the different ways the patient holds their head. We do this because, in some patients, they can be laying down at night, no specific worrying thoughts and anything that should keep them awake, yet they cannot go to sleep or if they do go to sleep they wake up in the middle of the night and cannot go back to sleep because their heart is racing.

What we do measure their blood velocities while they’re laying down in the various positions. In many people we find that certain positions will cause a rapid increase in blood velocity causing their brain to be in “hyper-alert” and causing them the inability to go to sleep or return to sleep. This of course will cause insomnia. In this “hyper-alert” state, you can have too much adrenaline and the vagus nerve and the parasympathetic nervous system cannot calm you down you will be in a state of stress.

Blood velocity – when you are going too fast sleep is disturbed

In this section, I will be touching on the phenomena of accelerated blood velocity.

Let’s focus on sleep apnea. Many people who contact our center tell us about the many conditions that they face including sleep apnea. Sleep apnea in and of itself is not the main symptomology these people suffer from but one among many.

Sleep apnea causes people to have altered or paused or halted breathing during sleep. Many people are diagnosed with obstructive sleep apnea (something is blocking the airways or the airways themselves are narrowed by an inflammatory problem.) Then there is central sleep apnea. In central sleep apnea, the same symptoms of problem breathing during sleep are said to be caused by a communication problem (neurology) between the brain and the respiratory system or nerves and muscles.

In the image, we will focus on sleep apnea (as it can be caused by cervical spine instability). Explanation notes are given below.

Carbon dioxide reactivity (C02 reactivity) to help assess anxiety and potential for panic attacks.

This is a measure of the amount of Carbon dioxide in the blood and brain. Why is this important? Because it has to do with levels of stress and can predict future problems in people who have too much carbon dioxide in the blood and brain. There was a recent study which gives dramatic evidence to the problem of Carbon dioxide reactivity. Published in the Journal of the American Medical Association (4) and produced by researchers at the Departments of Psychology, The University of Texas at Austin, Southern Methodist University, and University of Wisconsin-Milwaukee, researchers examined soldiers before their deployment into war zones to try to predict who would suffer from post-traumatic stress syndrome.

Fear and panic

Many patients we see suffer from anxiety disorders, fear disorders, and disorders that make their heart race and their blood flow accelerate. When the researchers subjected the soldiers to a CO2 challenge (C02 was introduced at 35% levels into their system) the results of this increased C02 were similar to that seen in civilian or non-military subjects.

  • The 3 most frequently reported physical reactions to the CO2 challenge were:
    • lightheadedness,
    • feelings of faintness,
    • and breathlessness—all expected reactions to acute hypercapnia (the excessive buildup of carbon dioxide in the bloodstream – something that happens during sleep in patients with disturbed sleep patterns).
    • Soldiers’ reacted differently to fear and panic. Some had no fear (32%) to panic (11%), with the average soldier reporting mild fear. This is in sharp contrast to those observed for patients with panic disorder, who report extreme fear, with more than 60% experiencing panic in response to the CO2 challenge.


Hypoxia is simply you are oxygen deprived or oxygen-starved. This drop-in oxygen level is not typically caused by carbon dioxide reactivity nor is Hypoxia usually considered a primary condition but rather the result of breathing or respiratory disorders or problems related to compression of injury to the cervical spine.

Internal jugular vein stenosis

We have been helping people with “mystery symptoms” and “mystery diagnosis” for approaching three decades. When we sit in the examination room with new patients, even after a careful screening process to assess their candidacy for the treatments we offer, we still sometimes get the look of confusion in patients’ eyes when we suggest a problem that has not been suggested to them before. Sometimes such is the case with internal jugular vein stenosis. I have a very extensive article on the problems of internal jugular vein stenosis. Please see Symptoms and conditions of cervical spine compression causing internal jugular vein stenosis.

Any of the treatments or guidelines presented here will not overcome uncorrected poor posture (a cervical spine that has lost its natural curve)  or poor dietary and lifestyle habits. If a person is continually sleep-deprived, stressed-out, nutritionally starved (a coffee and doughnut diet), and types on a computer all day, treatments will not be effective other than prolonged and increased painkiller use to suppress pain syndromes and medications to suppress the neurologic-type symptoms discussed above. Even then, the point of non-responsiveness to these medications may be reached.

Our treatment methods

On our website, we have published very extensive articles on solving the various problems discussed above.

In our article Cervical Curve Correction – Caring Cervical Realignment Therapy, we describe Caring Cervical Realignment Therapy (CCRT) or what we call “Curve Correction” which combines individualized protocols to objectively document degrees of spinal instability and cervical dysstructure and re-establish normal biomechanics and encourage restoration of lordosis. Curve Correction can be a beneficial treatment in providing long-term pain relief and symptom resolution in patients looking to avoid spinal surgery or who have already failed surgery.

In my article Cervical Myelopathy – Cervical Degenerative Disc Disease – Cervicovagopathy – Cervical Dysstructure Broken neck structure, I discuss treatments for the progression of degenerative or impact injury that will eventually distort the cervical spine and cause some people many neurologic-like, cardiovascular-like, and psychological-like issues including problems with sleep.

The Horrific Progression of Neck Degeneration with Unresolved Cervical Instability


Understanding the broken neck structure problem can help you understand why you have problems such as cervical spinal stenosis, cervical spine arthritis, cervical degenerative disc disease,  and bulging and herniated discs. Understanding the broken neck structure problem may also explain why you have the many symptoms described here.

We hope you found this article informative and it helped answer many of the questions you may have surrounding your problems.  If you would like to get more information specific to your challenges please email us: Get help and information from our Caring Medical staff

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1 Tan DX, Manchester LC, Reiter RJ. CSF generation by pineal gland results in a robust melatonin circadian rhythm in the third ventricle as an unique light/dark signal. Medical hypotheses. 2016 Jan 1;86:3-9. [Google Scholar]
2 Aulinas A. Physiology of the pineal gland and melatonin. Endotext [Internet]. 2019 Dec 10. [Google Scholar]
3 Chaudhry SR, Stadlbauer A, Buchfelder M, Kinfe TM. Melatonin Moderates the Triangle of Chronic Pain, Sleep Architecture and Immunometabolic Traffic. Biomedicines. 2021 Aug;9(8):984. [Google Scholar]
4 Telch MJ, Rosenfield D, Lee HJ, Pai A. Emotional reactivity to a single inhalation of 35% carbon dioxide and its association with later symptoms of posttraumatic stress disorder and anxiety in soldiers deployed to Iraq. Archives of general psychiatry. 2012 Nov 1;69(11):1161-8. [Google Scholar]


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