Department of Psychophysiology, Helfgott Research Institute, National College of Natural Medicine, 049 SW Porter Street, Portland, OR 97201-4848, USA.
Appl Psychophysiol Biofeedback. 2011 Dec;36(4):251-64. doi: 10.1007/s10484-011-9165-y.
Insomnia is an epidemic in the US. Neurofeedback (NFB) is a little used, psychophysiological treatment with demonstrated usefulness for treating insomnia. Our objective was to assess whether two distinct Z-Score NFB protocols, a modified sensorimotor (SMR) protocol and a sequential, quantitative EEG (sQEEG)-guided, individually designed (IND) protocol, would alleviate sleep and associated daytime dysfunctions of participants with insomnia. Both protocols used instantaneous Z scores to determine reward condition administered when awake. Twelve adults with insomnia, free of other mental and uncontrolled physical illnesses, were randomly assigned to the SMR or IND group. Eight completed this randomized, parallel group, single-blind study. Both groups received fifteen 20-min sessions of Z-Score NFB. Pre-post assessments included sQEEG, mental health, quality of life, and insomnia status. ANOVA yielded significant post-treatment improvement for the combined group on all primary insomnia scores: Insomnia Severity Index (ISI p<.005), Pittsburgh Sleep Quality Inventory (PSQI p<.0001), PSQI Sleep Efficiency (p<.007), and Quality of Life Inventory (p<.02). Binomial tests of baseline EEGs indicated a significant proportion of excessively high levels of Delta and Beta power (p<.001) which were lowered post-treatment (paired z-tests p<.001). Baseline EEGs showed excessive sleepiness and hyperarousal, which improved post-treatment. Both Z-Score NFB groups improved in sleep and daytime functioning. Post-treatment, all participants were normal sleepers. Because there were no significant differences in the findings between the two groups, our future large scale studies will utilize the less burdensome to administer Z-Score SMR protocol.
失眠在美国是一种流行疾病。神经反馈（NFB）是一种使用较少的心理生理治疗方法，已被证明对治疗失眠有效。我们的目的是评估两种不同的 Z 分数 NFB 方案，即改良感觉运动（SMR）方案和顺序、定量脑电图（sQEEG）指导的个体化设计（IND）方案，是否会缓解失眠患者的睡眠和相关日间功能障碍。这两种方案都使用即时 Z 分数来确定清醒时给予奖励的条件。12 名无其他精神和未控制的身体疾病的失眠成年人被随机分配到 SMR 或 IND 组。8 名参与者完成了这项随机、平行组、单盲研究。两组均接受 15 次 20 分钟的 Z 分数 NFB 治疗。治疗前后评估包括 sQEEG、心理健康、生活质量和失眠状况。方差分析得出，综合组在所有原发性失眠评分上均有显著的治疗后改善：失眠严重程度指数（ISI p<.005）、匹兹堡睡眠质量指数（PSQI p<.0001）、PSQI 睡眠效率（p<.007）和生活质量量表（p<.02）。对基线 EEG 的二项式检验表明，有相当比例的 Delta 和 Beta 功率过高（p<.001），治疗后降低（配对 z 检验 p<.001）。基线 EEG 显示过度嗜睡和过度兴奋，治疗后改善。两种 Z 分数 NFB 组的睡眠和日间功能均得到改善。治疗后，所有参与者都成为正常的睡眠者。由于两组之间的发现没有显著差异，因此我们未来的大规模研究将使用管理负担较小的 Z 分数 SMR 方案。
