Efficacy of Live Z-Score Neurofeedback Training for Chronic Insomnia: A Single-Case Study

Abstract

Objective/Background: Insomnia is the most common sleep disorder in the general population. Pharmacological treatments have shown efficacy in the short term, yet the symptoms return once the treatment has been withdrawn. In the search for treatment options with long-lasting effects, neurofeedback (NF) has arisen as a therapeutic option. Neurofeedback is the application of operant conditioning to brain activity. The aim of this work is to show the effectiveness of Live Z-Score NF training (LZT), a paradigm within the field of NF, in a case of insomnia. Participants: A 32-year-old male with chronic insomnia since his adolescence. Methods: Thirty 35-min sessions of qEEG-guided LZT using patient's highly preferred feedback. The main outcomes of this study were the patient's qEEG metrics and a visual analog scale of sleep quality throughout the intervention. Results: qEEG-guided LZT showed an improvement of 90.63% of the patient's qEEG metrics and an 82.55% relief of the clinical symptoms after 30 NF sessions. Conclusions: Although more research is needed to establish that NF based on Live Z-Score is effective for insomnia, our results suggest that NF might be a therapeutic alternative for the treatment of insomnia.

Individual Alpha Peak Frequency, an Important Biomarker for Live Z-Score Training Neurofeedback in Adolescents with Learning Disabilities

“…No significant LZT-NF-related side effects have been reported in 15 years since the technique’s development [ 33 , 35 , 36 ]. Our previous reports [ 73 , 74 ], in several cases using the Wigton and Krigbaum method [ 38 , 39 ], and the current study further strengthen this idea.…”

“…For example, Fernández et al reduced theta/alpha ratios using power training through 20 sessions [ 21 ], and Breteler et al [ 81 ] trained power and coherence through 20 sessions. However, when using LZT-NF, it has been suggested that positive clinical outcomes can be achieved within an average of 10 to 20 sessions [ 33 , 37 , 82 , 83 ], as has been reported by our group in a patient with insomnia [ 74 ]. Then another limitation might be the wide age range in this study, but we based our approach on the i-APF maturation reports [ 20 ].…”

Advances in Electrical Neuroimaging, Brain Networks and Neurofeedback Protocols

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Enhancing the Effects of Neurofeedback Training: The Motivational Value of the Reinforcers

“…One of the approaches that has received much interest in the last decades is neurofeedback (NF) [ 3 ], a therapeutic approach based on operant conditioning applications to the electroencephalographic (EEG) activity control [ 4 ]. NF has proven to be effective in several disorders such as ADHD [ 5 , 6 , 7 ], insomnia [ 8 , 9 ], learning disabilities [ 10 , 11 ], migraine [ 12 ], depression [ 13 , 14 , 15 ], or anxiety [ 15 , 16 ]. However, for a number of subjects, the response to the NF intervention has not produced the expected results.…”

“…To our knowledge, the effects that the value of the reinforcers on the success of NF have never been tested. Since it has been reported that positive results are achieved when the subjects choose the reinforcers with individual and personal value for them [ 9 , 10 ], the aim of the present work was to analyze whether the effects of NF on brain waves differ when reinforcers are chosen by the subject. Having this information would be a major contribution to the field of NF, since the effects of NF that are limited in some subjects could be improved by selecting a relevant stimulus according to the individuals’ expectations and preferences.…”