Progressive relaxation, EMG biofeedback and biofeedback placebo in the treatment of sleep-onset insomnia.

This paper describes a study in which progressive relaxation, EMG frontalis biofeedback, and a biofeedback placebo manipulation were compared in the treatment of severe insomnia with 40 chronically sleep-disturbed adult patients. Progressive relaxation and EMG biofeedback led to significant reductions in both reported sleep-onset latency and depressive symptomatology. However, when compared individually with the biofeedback placebo group, neither progressive relaxation nor EMG biofeedback emerged as significantly more effective on the sleep-onset latency measure. The clinical improvement in the biofeedback placebo group suggests that expectancies related to the ability to relax may contribute to the therapeutic effectiveness of relaxation strategies, even with chronic, severely disturbed insomniacs. Improvement in sleep-onset latency was not significantly related to reductions in frontalis EMG activity either within or between groups, a finding which raises questions concerning the clinical role and importance of physiological relaxation in the treatment of sleep-onset disturbance.