Insomnia

Case Studies supporting PEMF benefits for Insomnia

Efficacy of cranial electric stimulation for the treatment of insomnia: A randomized pilot study

Abstract

Objectives: This pilot study examined the potential efficacy of cranial electric stimulation for the treatment of insomnia.

Design: The researchers tested the hypothesis through a randomized, double-blind, and placebo controlled clinical trial. The researchers approached eligible subjects who scored 21 or above on the Pittsburgh Insomnia Rating Scale. The researchers then randomly assigned the subjects to receive either an active or sham device. Each study subject received 60 min of active or sham treatment for five days. Following each intervention the subjects completed a sleep log, as well as three and ten days later.

Setting: The researchers conducted the study among active duty service members receiving mental health care on the Psychiatry Continuity Service (PCS), Walter Reed National Military Medical Center in Bethesda, MD.

Main outcome measures: The study’s primary outcome variables were the time to sleep onset, total time slept, and number of awakenings as reported by the subjects in the serial sleep logs. The researchers identified a nearly significant increase in total time slept after three cranial electric stimulation treatments among all study subjects. A closer examination of this group revealed an interesting gender bias, with men reporting a robust increase in total time slept after one treatment, decay in effect over the next two interventions, and then an increase in total time slept after the fourth treatment. The researchers speculate that the up and down effect on total time slept could be the result of an insufficient dose of cranial electric stimulation.

Efficiency of Transcranial Electrostimulation on Anxiety and Insomnia Symptoms During a Washout Period in Depressed Patients A Double-Blind Study

Abstract

In order to test the efficacy of cerebral electrostimulation (electrosleep) as an alternative to drug therapy for the treatment of anxiety and insomnia, we conducted a double-blind study in a sample of 21 depressed inpatients submitted to a 5-day period of drug washout on admission to the psychiatric department. During this withdrawal period, anxiety and insomnia were exacerbated in the placebo group, whereas anxiety decrease~ and sleep duration improved in the active treatment group, with a divergent evolution during the 5-day washout period. The depressive criteria did not respond differentially to treatment, however. Thus, the effects of this drug washout period are markedly attenuated by cerebral electrostimulation, which is of possible interest in the management of psychotropic drug withdrawal.

Electrosleep-A Clinical Trial

Electrosleep is a technique of psychiatric treatment that has been undergoing development in the USSR for approximately 20 years, with a great flurry of interest in the past five years. The authors report briefly on a clinical evaluation of electrosleep in the United States to alert other investigators in this country to a new area of possible interest.

ELECTROSLEEP” refers to the technique of inducing sleep or a relaxed state by the transcranial application of a low intensity electrical current. It has been in the process of development in Russia for the past 20 years, and a series of recent reviews describes the intensification of activity and investigation in the areas of electrosleep and electroanesthesia in the past four years (1-4). The Soviet bloc and the USSR in particular seem to have allocated a good deal of time, energy, and human resources for research and development in this area. In spite of this, there has been little effort at investigation in the United States, probably in part because of a traditional distrust in the use of electrical devices in psychiatry by a large portion of the psychiatric population. We have attempted to give electrosleep a clinical trial in a university setting in the United States and through this paper to alert other investigators in this country to a new area of investigation.

We have been treating a group of more than 40 outpatients with chronic anxiety, depressive states, and associated insomnia. Most patients who were selected had not responded to the usual antianxiety and antidepressive medications.

We have employed the Electrosone 50 machine, which is an American-made instrument modeled after the Russian machine. It is about the size of a table model portable radio and does not run on wall current but on batteries. The treatment involves a course of five to ten half-hour treatments given on consecutive days. The machine is set at a frequency of 100 pulses per second and a duration of one millisecond, the zero baseline bias current and current amplitude adjusted so that the patient feels a slight, but not uncomfortable, tingling over his eyes. This is usually produced by an amplitude of 12 to 20 volts and a current reading of 0.1 to 0.2 milliamps.

With this population of patients who were previously refractory to standard medication therapy, we found, to our surprise, that approximately two-thirds showed a rapid and relatively complete remission of symptoms. The most immediate effect was an almost total and complete improvement in the nighttime insomnia; the patients reported sleeping through the night following the first, second, or third treatment. Improvements in anxiety and depressive symptoms were usually seen by the fifth treatment. We are quite aware that this study was uncontrolled and that there was a tremendous potential for possible effects of suggestion. Further controlled studies are anticipated.

It is to be noted that electrosleep avoids many of the conditions that make electroconvulsive therapy aesthetically unattractive to some people. In electrosleep therapy, the patient does not feel any discomfort at any time, is not unconscious at any time (indeed he may remain awake throughout the entire treatment), and does not experience any convulsion of any kind. It seems to be a humane treatment, and no significant side effects have been reported.

Electrosleep Therapy A Double-Blind Trial

Twenty-eight patients participated in a controlled double-blind study to determine the effectiveness of electrosleep as a treatment modality. To our knowledge this is the first study in the English literature in which the peripheral rhythmic electrical stimulation has been eliminated, thereby allowing the results of the current effect on the brain to be independently evaluated. Both global ratings by patients and physicians on the fifth day of treatment and on two-week follow-up indicate that current effect is not associated with significant improvement, although patient global ratings on day 5 indicate a trend in this direction. Self-rating scales by patients indicate no significant improvement for anxiety, insomnia, or somatic complaints. Depressive self-rating scales do show a significant improvement on day 5 of treatment, but no carry over effect to the two-week follow-up.

Case Study Reference Source:

  • 1. Efficacy of cranial electric stimulation for the treatment of insomnia: A randomized pilot study
    (Authors: R. Gregory Landea, Cynthia Gragnanib)

  • 2. Efficiency of Transcranial Electrostimulation on Anxiety and Insomnia Symptoms During a Washout Period in Depressed Patients A Double-Blind Study
    (Authors: P. Philip, J. Demotes-Mainard, M. Bourgeois, and J.D. Vincent)

  • 3. Electrosleep-A Clinical Trial
    (Authors: SALL H. ROSENTHAL, M.D., AND NORMAN L. WLLFSOHN, M.D.)

  • 4. Electrosleep Therapy A Double-Blind Trial
    (Authors: "Earl D. Hearst, MD", "C. Robert Cloninger, MD", "Eugene L. Crews, MD", "Remi J. Cadoret, MD", "St. Louis")