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Insomnia Treatment Using Neurofeedback: EEG Beta Decrease Protocol

Abstract

According to the "hyper-arousal" model of primary insomnia (PI), insomnia patients experience heightened physiological and cognitive arousal compared to normal people during both sleep and wakefulness. Previous studies have reported that insomnia patients show more high frequency electroencephalogram (EEG) signals than normal people. This suggests that hyper- arousal in insomnia, reflected in the high frequency EEG pattern, results in non-restorative sleep. Specifically, hyperarousal in PI results in increased beta activity that is associated with cortical arousal, resulting in non-restorative sleep. This study aimed to verify the efficacy of a beta-decrease neurofeedback (NF) protocol for insomnia. Participants were randomly assigned to an NF treatment or a wait-list control group. The NF treatment group received 10 sessions of NF (n=5), and the wait-list control group (n=9) group received no treatment. We compared the following parameters pre-and post-treatment, as well as 2-weeks following the final treatment: resting state EEG (eye-open, EO; eye-closed, EC), heart rate variability (HRV), sleep scales, sleep diaries, and Smart Wearable Device data. Results showed significantly decreased beta power, HRV, SL (sleep latency), sleep scale scores, increased alpha power, TST (total sleep time), SE (sleep effectiveness), and sleep satisfaction in the wait-list control group compared with the NF group. This study is the first neurofeedback protocol using “Beta power” as a marker of neurophysiological arousal in insomnia. Our findings provide new evidence for the efficacy of Beta in decreasing insomnia symptoms and add to the range of non-pharmacological insomnia intervention choices for pregnant, psychopharmacotherapy-resistant, and older people. Neurofeedback not only provides control of insomnia symptoms but also results in a decreased risk of psychological comorbidities. This study found improved insomnia symptoms after only 10 sessions of NF. Fast remission of insomnia symptoms may reinforce patients’ motivations for treatment, is more cost-effective, and can result in reduced treatment times.

keywords
불면장애 치료, 뉴로피드백, 비약물 치료, 스마트 웨어러블 기기, 과각성, treatment, neurofeedback, non-pharmacological treatment, smart wearable device, hyper-arousal

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