Effect of Transcranial Alternating Current Stimulation for the Treatment of Chronic Insomnia: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Clinical Trial

Abstract

<b><i>Background:</i></b> Not all adults with chronic insomnia respond to the recommended therapeutic options of cognitive behavioral therapy and approved hypnotic drugs. Transcranial alternating current stimulation (tACS) may offer a novel potential treatment modality for insomnia. <b><i>Objectives:</i></b> This study aimed to examine the efficacy and safety of tACS for treating adult patients with chronic insomnia. <b><i>Methods:</i></b> Sixty-two participants with chronic primary insomnia received 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas in the laboratory on weekdays for 4 consecutive weeks, followed by a 4-week follow-up period. The primary outcome was response rate measured by the Pittsburgh Sleep Quality Index (PSQI) at week 8. Secondary outcomes were remission rate, insomnia severity, sleep onset latency (SOL), total sleep time (TST), sleep efficiency, sleep quality, daily disturbances, and adverse events at the end of the 4-week intervention and at the 4-week follow-up. <b><i>Results:</i></b> Of 62 randomized patients, 60 completed the trial. During the 4-week intervention, 1 subject per group withdrew due to loss of interest and time restriction, respectively. Based on PSQI, at 4-week follow-up, the active group had a higher response rate compared to the sham group (53.4% [16/30] vs. 16.7% [5/30], <i>p</i> = 0.009), but remission rates were not different between groups. At the end of the 4-week intervention, the active group had higher response and remission rates than the sham group (<i>p</i> < 0.001 and <i>p</i> = 0.026, respectively). During the trial, compared with the sham group, the active group showed a statistically significant decrease in PSQI total score, a shortened SOL, an increased TST, improved sleep efficiency, and improved sleep quality (<i>p</i> < 0.05 or <i>p</i> < 0.001). Post hoc analysis revealed that, in comparison with the sham group, the active group had improved symptoms, except for daily disturbances, at the end of the 4-week intervention, and significant improvements in all symptoms at the 4-week follow-up. No adverse events or serious adverse responses occurred during the study. <b><i>Conclusion:</i></b> The findings show that the tACS applied in the present study has potential as an effective and safe intervention for chronic insomnia within 8 weeks.

Prevalence and Correlation of Anxiety, Insomnia and Somatic Symptoms in a Chinese Population During the COVID-19 Epidemic

“…The government and psychologists should constantly focus on the mental health of the public during this unique period. Furthermore, our study found that anxiety was associated with economic loss, a history of physical disease, and increased ISI scores, which is in line with previous studies ( 8 , 29 , 30 ). Interestingly, our study also demonstrated that anxious people were likely to have more somatic symptoms than people without anxiety symptoms.…”

“…The government and psychologists should constantly focus on the mental health of the public during this unique period. Furthermore, our study found that anxiety was associated with economic loss, a history of physical disease, and increased ISI scores, which is in line with previous studies (8,29,30).…”

Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China

“…Our report found potential risk factors for medical health workers to develop insomnia, anxiety, depression, obsessive-compulsive symptoms, and somatization. Undoubtedly, these risk factors might endure allostatic overload and favor the development of psychopathology, including chronic insomnia [29]. Independent factors (i.e., currently having organic disease, living in rural areas, being at risk of contact with COVID-19 patients in hospitals, or being female) were common risk factors for insomnia, anxiety, depression, and obsessive-compulsive symptoms among medical health workers.…”

Transcranial direct current stimulation and attention skills in burnout patients: a randomized blinded sham-controlled pilot study

“…The percentage of employees experiencing burnout is dramatically increasing in Europe (Eurofound, 2018), which has a significant socio-economic impact. Burnout consists of three components: (1) exhaustion at the physical level (energy loss, fatigue, weakness, physical and psychosomatic complaints), the mental level (negative behavior towards oneself, work, or life in general), or the emotional level (feelings of being trapped in a situation, helplessness, or hopelessness); (2) depersonalization or alienation towards the actual work, towards patients or pupils, etc. (Demerouti et al, 2001;Schaufeli & Enzmann, 1998); (3) and reduced professional performance, which can be attributed to depersonalization and alienation (Demerouti et al,2001).…”