sleep problems
Research Papers
Evaluation of the URGOnight Tele-neurofeedback Device: An Open-label Feasibility Study with Follow-up
SMR neurofeedback shows potential as a therapeutic tool for reducing sleep problems. It is hypothesized that SMR neurofeedback trains the reticulo-thalamocortical-cortical circuit involved in sleep-spindle generation. As such, strengthening this circuit is hypothesized to reduce sleep problems. The current study aims to investigate the effectiveness of a home-based device that uses SMR neurofeedback to help reduce sleep problems. Thirty-seven participants reporting sleep problems received the SMR neurofeedback-based program for 40 (n = 21) or 60 (n = 16) sessions. The Pittsburgh Sleep Quality Index (PSQI) and Holland Sleep Disorders Questionnaire (HSDQ) were assessed at baseline, session 20, outtake, and follow-up (FU). Actigraphy measurements were taken at baseline, session 20, and outtake. Significant improvements were observed in PSQI Total (d = 0.78), PSQI Sleep Duration (d = 0.52), HSDQ Total (d = 0.80), and HSDQ Insomnia (d = 0.79). Sleep duration (based on PSQI) increased from 5.3 h at baseline to 5.8 after treatment and 6.0 h. at FU. No effects of number of sessions were found. Participants qualified as successful SMR-learners demonstrated a significantly larger gain in sleep duration (d = 0.86 pre-post; average gain = 1.0 h.) compared to non-learners. The home-based SMR tele-neurofeedback device shows the potential to effectively reduce sleep problems, with SMR-learners demonstrating significantly better improvement. Although randomized controlled trials (RCTs) are needed to further elucidate the specific effect of this device on sleep problems, this is the first home-based SMR neurofeedback device using dry electrodes demonstrating effectiveness and feasibility.
View Full Paper →Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency
Recent studies suggest a role for sleep and sleep problems in the etiology of attention deficit hyperactivity disorder (ADHD) and a recent model about the working mechanism of sensori-motor rhythm (SMR) neurofeedback, proposed that this intervention normalizes sleep and thus improves ADHD symptoms such as inattention and hyperactivity/impulsivity. In this study we compared adult ADHD patients (N = 19) to a control group (N = 28) and investigated if differences existed in sleep parameters such as Sleep Onset Latency (SOL), Sleep Duration (DUR) and overall reported sleep problems (PSQI) and if there is an association between sleep-parameters and ADHD symptoms. Secondly, in 37 ADHD patients we investigated the effects of SMR and Theta/Beta (TBR) neurofeedback on ADHD symptoms and sleep parameters and if these sleep parameters may mediate treatment outcome to SMR and TBR neurofeedback. In this study we found a clear continuous relationship between self-reported sleep problems (PSQI) and inattention in adults with- and without-ADHD. TBR neurofeedback resulted in a small reduction of SOL, this change in SOL did not correlate with the change in ADHD symptoms and the reduction in SOL only happened in the last half of treatment, suggesting this is an effect of symptom improvement not specifically related to TBR neurofeedback. SMR neurofeedback specifically reduced the SOL and PSQI score, and the change in SOL and change in PSQI correlated strongly with the change in inattention, and the reduction in SOL was achieved in the first half of treatment, suggesting the reduction in SOL mediated treatment response to SMR neurofeedback. Clinically, TBR and SMR neurofeedback had similar effects on symptom reduction in ADHD (inattention and hyperactivity/impulsivity). These results suggest differential effects and different working mechanisms for TBR and SMR neurofeedback in the treatment of ADHD
View Full Paper →Efficacy of EMG- and EEG-Biofeedback in Fibromyalgia Syndrome: A Meta-Analysis and a Systematic Review of Randomized Controlled Trials
Objectives . Biofeedback (BFB) is an established intervention in the rehabilitation of headache and other pain disorders. Little is known about this treatment option for fibromyalgia syndrome (FMS). The aim of the present review is to integrate and critically evaluate the evidence regarding the efficacy of biofeedback for FMS. Methods . We conducted a literature search using Pubmed, clinicaltrials.gov (National Institute of Health), Cochrane Central Register of Controlled Trials, PsycINFO, SCOPUS, and manual searches. The effect size estimates were calculated using a random-effects model. Results . The literature search produced 123 unique citations. One hundred sixteen records were excluded. The meta-analysis included seven studies (321 patients) on EEG-Biofeedback and EMG-Biofeedback. In comparison to control groups, biofeedback (BFB) significantly reduced pain intensity with a large effect size (; 95% CI: 0.22–1.36). Subgroup analyses revealed that only EMG-BFB and not EEG-BFB significantly reduced pain intensity in comparison to control groups (; 95% CI: 0.11–1.62). BFB did not reduce sleep problems, depression, fatigue, or health-related quality of life in comparison to a control group. Discussion . The interpretation of the results is limited because of a lack of studies on the long-term effects of EMG-BFB in FMS. Further research should focus on the long-term efficacy of BFB in fibromyalgia and on the identification of predictors of treatment response.
View Full Paper →The LENS (Low Energy Neurofeedback System): A Clinical Outcomes Study on One Hundred Patients at Stone Mountain Center, New York
Introduction. The Low Energy Neurofeedback System (LENS) developed by Dr. Len Ochs (2006a) uses feedback in the form of a radio frequency carrier wave, administered at a positive offset frequency from the person's own dominant EEG frequency. Although it is an unusual biofeedback procedure, the feedback being invisible and the subject passive, clinical evidence supports the efficacy of the LENS across a spectrum of conditions. Published research studies (Schoenberger, Shifflet, Esty, Ochs, & Matheis, 2001; Donaldson, Sella, & Mueller, 1998; Mueller, Donaldson, Nelson, & Layman, 2001) have shown the effectiveness of the LENS method with traumatic brain injury (TBI) and with fibromyalgia. No study to date has evaluated LENS treatment across the spectrum of disorders and with a significantly large sample. This study was devised to address these issues. The study hypotheses were that the LENS treatment would be effective in reducing both systematic symptom ratings and measurements of EEG amplitudes, and that the therapeutic effect would produce the most rapid improvements in early sessions of treatment. Method. "Blinded" research associates selected the first 100 patients from approximately 300 case files that met the following inclusion criteria: the person had received at least 10 treatment sessions, completed an initial CNS questionnaire, and that session-by-session subjective symptom ratings (SSRF) had been obtained. Patients ranged from 6 to 80 years old, almost evenly divided between male and female, with a wide range of symptoms and comorbid DSM-IV diagnoses. Results. Data were statistically analyzed for significance and corelational variables. Average symptom ratings across 15 major problem areas (e.g., anxiety, mood disturbance, attentional problems, fatigue, pain, sleep problems, etc.) showed significant improvements (p < .0001) from beginning to end of treatment. After an average of only 20 treatments the mean average of patient symptom ratings (0-10) declined from 7.92 to 3.96, a 50% improvement. Equally significant was the drop in EEG amplitude at the highest amplitude electrode site (HAS; p < .0001) as well as a lesser but still significant decrease at Cz (p < .002). A final analysis of the average symptom score with the HAS score showed them to be highly correlated. All hypotheses were confirmed. Conclusions. LENS treatment appears to be very efficient and effective in rapidly reducing a wide range of symptoms. It particularly produces rapid improvements in the first five to six sessions. Recommendations for future research are provided. Copyright © by The Haworth Press, Inc. All rights reserved.
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