Simons Stephen B, Provo Maria, Yanoschak Alexandra, Schmidt Calvin, Gerrard Isabel, Weisend Michael, Anderson Craig, Shimizu Renee, Connolly Patrick M
Intelligent Systems Laboratory, Teledyne Scientific & Imaging, Durham, NC, United States.
Front Neurosci. 2024 Oct 23;18:1427462. doi: 10.3389/fnins.2024.1427462. eCollection 2024.
The normal transition to sleep is characterized by a reduction in higher frequency activity and an increase in lower frequency activity in frontal brain regions. In sleep onset insomnia these changes in activity are weaker and may prolong the transition to sleep.
Using a wearable device, we compared 30min of short duration repetitive transcranial electric stimulation (SDR-tES) at 0.75Hz, prior to going to bed, with an active control at 25Hz in the same individuals.
Treatment with 0.75Hz significantly reduced sleep onset latency (SOL) by 53% when compared with pre-treatment baselines and was also significantly more effective than stimulation with 25Hz which reduced SOL by 30%. Reductions in SOL with 25Hz stimulation displayed order effects suggesting the possibility of placebo. No order effects were observed with 0.75Hz stimulation. The decrease in SOL with 0.75Hz treatment was proportional to an individual's baseline wherein those suffering from the longest pre-treated SOLs realized the greatest benefits. Changes in SOL were correlated with left/right frontal EEG signal coherence around the stimulation frequency, providing a possible mechanism and target for more focused treatment. Stimulation at both frequencies also decreased perceptions of insomnia symptoms measured with the Insomnia Severity Index, and comorbid anxiety measured with the State Trait Anxiety Index.
Our study identifies a new potential treatment for sleep onset insomnia that is comparably effective to current state-of-practice options including pharmacotherapy and cognitive behavioral therapy and is safe, effective, and can be delivered in the home.
正常的睡眠过渡特征是额叶脑区高频活动减少,低频活动增加。在入睡性失眠中,这些活动变化较弱,可能会延长睡眠过渡时间。
我们使用可穿戴设备,让同一批个体在睡前接受30分钟、频率为0.75Hz的短时长重复经颅电刺激(SDR-tES),并与频率为25Hz的主动对照进行比较。
与治疗前基线相比,0.75Hz的治疗使入睡潜伏期(SOL)显著缩短了53%,并且也比25Hz的刺激显著更有效,后者使SOL缩短了30%。25Hz刺激导致的SOL缩短显示出顺序效应,提示存在安慰剂效应的可能性。0.75Hz刺激未观察到顺序效应。0.75Hz治疗导致的SOL缩短与个体基线成比例,即治疗前SOL最长的个体受益最大。SOL的变化与刺激频率附近的左右额叶脑电图信号相干性相关,为更有针对性的治疗提供了一种可能的机制和靶点。两种频率的刺激还降低了用失眠严重程度指数测量的失眠症状感知,以及用状态特质焦虑指数测量的共病焦虑。
我们的研究确定了一种针对入睡性失眠的新潜在治疗方法,其效果与包括药物治疗和认知行为疗法在内的当前实践方法相当,且安全、有效,可在家中进行。