Neurofeedback for Insomnia: A Pilot Study of <Emphasis Type="Italic">Z</Emphasis>-Score SMR and Individualized Protocols |
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Authors: | Barbara U Hammer Agatha P Colbert Kimberly A Brown Elena C Ilioi |
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Institution: | (1) Department of Psychophysiology, Helfgott Research Institute, National College of Natural Medicine, 049 SW Porter Street, Portland, OR 97201-4848, USA;(2) Helfgott Research Institute, National College of Natural Medicine, 049 SW Porter Street, Portland, OR 97201-4848, USA;(3) Department of Psychology, McGill University, Montreal, QC, Canada |
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Abstract: | Insomnia is an epidemic in the US. Neurofeedback (NFB) is a little used, psychophysiological treatment with demonstrated usefulness
for treating insomnia. Our objective was to assess whether two distinct Z-Score NFB protocols, a modified sensorimotor (SMR) protocol and a sequential, quantitative EEG (sQEEG)-guided, individually
designed (IND) protocol, would alleviate sleep and associated daytime dysfunctions of participants with insomnia. Both protocols
used instantaneous Z scores to determine reward condition administered when awake. Twelve adults with insomnia, free of other mental and uncontrolled
physical illnesses, were randomly assigned to the SMR or IND group. Eight completed this randomized, parallel group, single-blind
study. Both groups received fifteen 20-min sessions of Z-Score NFB. Pre-post assessments included sQEEG, mental health, quality of life, and insomnia status. ANOVA yielded significant
post-treatment improvement for the combined group on all primary insomnia scores: Insomnia Severity Index (ISI p < .005), Pittsburgh Sleep Quality Inventory (PSQI p < .0001), PSQI Sleep Efficiency (p < .007), and Quality of Life Inventory (p < .02). Binomial tests of baseline EEGs indicated a significant proportion of excessively high levels of Delta and Beta power
(p < .001) which were lowered post-treatment (paired z-tests p < .001). Baseline EEGs showed excessive sleepiness and hyperarousal, which improved post-treatment. Both Z-Score NFB groups improved in sleep and daytime functioning. Post-treatment, all participants were normal sleepers. Because
there were no significant differences in the findings between the two groups, our future large scale studies will utilize
the less burdensome to administer Z-Score SMR protocol. |
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