The journal, Brain, published new research suggesting that insomnia treatment may not need to include neurofeedback, or training of the brain functions. Instead, researchers found that patients experienced the same benefits if they just believed they were receiving neurofeedback training.
Approximately 10% to 35% of the world’s population suffers from insomnia. Very few studies have addressed insomnia treatments using non-pharmaceutical measures, despite the condition being a major health concern in our culture. For this study, scientists recruited 30 patients with a diagnosis of primary insomnia. All patients underwent neurofeedback training and then a placebo training over the course of several weeks.
The goal of this research was to investigate findings from an earlier study that showed positive effects on sleep quality and memory using neurofeedback. Researchers wanted to determine if these effects could be replicated in a double-blind placebo study. All participants underwent 12 sessions of neurofeedback and placebo feedback training in a laboratory.
The focus of the study was on mapping the EEG response to neurofeedback, while also looking at quality of life and sleep habits in insomnia patients. Because of this, patients underwent EEG before and after both the real and the placebo feedback trainings. In between the first and second, as well as the third and fourth visits, patients went through 12 sessions each of neurofeedback and placebo feedback training, all with real EEG feedback on different frequency bands. The order of trainings was counterbalanced, so all 12 sessions were finished within four weeks for each intervention. Sleep-wake cycles were monitored and analyzed using data from eight nights in a sleep lab, as well as actigraphy and diaries over the entire study period.
Both forms of feedback training were shown to cause equally effective results, which were reflected in patient measures of any sleep complaints. This suggests that the improvements were more likely due to immeasurable factors such as trusting the experimenter, as well as receiving empathy and care from them. The improvements, however, were not seen on EEG measures of sleep quality.
For primary insomnia, scientists note that neurofeedback treatment is not more or less efficacious than the placebo. There was no noticeable advantage of neurofeedback over that of the placebo intervention.
Ultimately, these results indicate that patients would have subjective improvements in sleep and life quality from any form of treatment if they believed it would help. Scientifically speaking, however, there is no verifiable evidence on EEG brain activity that would suggest real improvement.
Lead author of the study, Manuel Schabus, noted that these results bring up the question of how much of the published data on neurofeedback results are due to patient expectations or unspecified placebo effects.
The symptom improvement reported by patients was not specific to the neurofeedback training. Instead, the improvement seems to be brought on by immeasurable factors, such as feeling cared for. Therefore, it must raise the question of whether or not neurofeedback should be promoted as an alternative treatment method for primary insomnia. This research will stimulate discussions surrounding the usefulness and efficacy of neurofeedback on a broader level. It may be difficult to achieve positive neurofeedback effects on an objective level due to the patient population having various complaints surrounding insomnia, including learning difficulties.
Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include reading, traveling, and cooking.
© 2020 American Sleep Association.