An Exploratory Study on the Effects of Tele-neurofeedback and Tele-biofeedback on Objective and Subjective Sleep in Patients with Primary Insomnia

Abstract

Insomnia is a sleeping disorder, usually studied from a behavioural perspective, with a focus on somatic and cognitive arousal. Recent studies have suggested that an impairment of information processes due to the presence of cortical hyperarousal might interfere with normal sleep onset and/or consolidation. As such, a treatment modality focussing on CNS arousal, and thus influencing information processing, might be of interest. Seventien insomnia patients were randomly assigned to either a tele-neurofeedback (n = 9) or an electromyography tele-biofeedback (n = 8) protocol. Twelve healthy controls were used to compare baseline sleep measures. A polysomnography was performed pre and post treatment. Total Sleep Time (TST), was considered as our primary outcome variable. Sleep latency decreased pre to post treatment in both groups, but a significant improvement in TST was found only after the neurofeedback (NFB) protocol. Furthermore, sleep logs at home showed an overall improvement only in the neurofeedback group, whereas the sleep logs in the lab remained the same pre to post training. Only NFB training resulted in an increase in TST. The mixed results concerning perception of sleep might be related to methodological issues, such as the different locations of the training and sleep measurements.

Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

“…Although feedback can also be based on magnetic (magnetoencephalogram) or on near real-time hemodynamic measures of brain activity (near infrared spectroscopy, real-time functional magnetic resonance imaging) apart from 1 study using tomographic neurofeedback (tNF) [10], only the low cost EEG-based neurofeedback has been used for ADHD treatment. Through operant conditioning, individuals can be trained to control brain electric activity and a growing body of evidence shows that this can be helpful for the treatment of mental/ neurological conditions, such as epilepsy [11], brain injury [12], chronic pain [13], ADHD [14], insomnia [15], and others.…”

EEG-Biofeedback as a Tool to Modulate Arousal: Trends and Perspectives for Treatment of ADHD and Insomnia

“…With ongoing developments towards ever more powerful and cost-effective computational equipment, it is feasible that future research should focus on the opportunities these advances can offer EBF, possibly in combination with tools from the field of BCI (e.g., more sophisticated algorithms, spatial filtering allowing feedback on localized anatomical structures and less artefacts). Despite some (methodological) issues that have subjected the field to scepticism, recent developments give rise to optimism, as stricter guidelines are increasingly being adhered to and new avenues continue to be explored (e.g., SCP feedback and tele-neurofeedback as in Cortoos et al, 2009). Overall, from the studies reviewed here we conclude that EBF is a promising tool for treating disorders of arousal, which offers many opportunities for future research.…”

“…Alternative treatment options that have been met with success are cognitive-behavioural therapy (CBT) (Ebben & Spielman, 2009;Espie, 1999;Morin et al, 1994;Murtagh & Greenwood, 1995;Siebern & Manber, 2010) or treatments www.intechopen.com increasing body temperature (e.g., physical exercise, hot bath before bed), which has recently been shown to hasten sleep onset (Van Someren, 2006). Whereas CBT causes sustained improvements and reduces sleep complaints, one fifth of the patients does not respond to the intervention (Cortoos et al, 2010;Harvey & Payne, 2002;Morin, 2006). EBF therapy for insomnia could be a safer alternative to medication and may offer treatment where CBT fails.…”

“…www.intechopen.com individual strategies (Berner et al, 2006;Cortoos et al, 2009;Hauri et al, 1982;Hoedlmoser et al, 2008). Training sessions (Table 3) are usually blocked (e.g., 3 minute intervals) during which a threshold of activity expressed as a percentage of, or within a predefined band around the baseline, must be maintained for 250-500 ms (Berner et al, 2006;Cortoos et al, 2010;Hoedlmoser et al, 2008).…”

“…deficit/hyperactivity disorder, autism (Coben & Padolsky, 2007;Pineda et al, 2008), depression (Baehr et al, 1997;Hammond, 2005), post-traumatic stress disorder (Peniston & Kulkosky, 1991), and sleep disorders (Cortoos et al, 2009). More recently, research has explored the potential of biofeedback to enhance normal cognition, e.g.…”