Impact of Cranial Electrostimulation on Sleep: A Systematic Review

Aseem, Anam; Hussain, M. Ejaz

doi:10.1007/s41782-019-00075-3

Cited by 5 publications

(7 citation statements)

References 36 publications

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“…In conclusion, about half of the relatively high-quality studies examining CES for insomnia treatment showed improvement in symptoms; these included improvement in latency to sleep onset, sleep quality, and sleep duration. It is important to note that while some studies showed no effects of CES, we did not find any studies suggesting a worsening of insomnia symptoms (Aseem and Hussain, 2019).…”

Section: Ces For Clinical Applications: Conclusioncontrasting

confidence: 79%

A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

Brunyé

Patterson

Wooten

et al. 2021

Front. Hum. Neurosci.

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Cranial electrotherapy stimulation (CES) is a neuromodulation tool used for treating several clinical disorders, including insomnia, anxiety, and depression. More recently, a limited number of studies have examined CES for altering affect, physiology, and behavior in healthy, non-clinical samples. The physiological, neurochemical, and metabolic mechanisms underlying CES effects are currently unknown. Computational modeling suggests that electrical current administered with CES at the earlobes can reach cortical and subcortical regions at very low intensities associated with subthreshold neuromodulatory effects, and studies using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) show some effects on alpha band EEG activity, and modulation of the default mode network during CES administration. One theory suggests that CES modulates brain stem (e.g., medulla), limbic (e.g., thalamus, amygdala), and cortical (e.g., prefrontal cortex) regions and increases relative parasympathetic to sympathetic drive in the autonomic nervous system. There is no direct evidence supporting this theory, but one of its assumptions is that CES may induce its effects by stimulating afferent projections of the vagus nerve, which provides parasympathetic signals to the cardiorespiratory and digestive systems. In our critical review of studies using CES in clinical and non-clinical populations, we found severe methodological concerns, including potential conflicts of interest, risk of methodological and analytic biases, issues with sham credibility, lack of blinding, and a severe heterogeneity of CES parameters selected and employed across scientists, laboratories, institutions, and studies. These limitations make it difficult to derive consistent or compelling insights from the extant literature, tempering enthusiasm for CES and its potential to alter nervous system activity or behavior in meaningful or reliable ways. The lack of compelling evidence also motivates well-designed and relatively high-powered experiments to assess how CES might modulate the physiological, affective, and cognitive responses to stress. Establishing reliable empirical links between CES administration and human performance is critical for supporting its prospective use during occupational training, operations, or recovery, ensuring reliability and robustness of effects, characterizing if, when, and in whom such effects might arise, and ensuring that any benefits of CES outweigh the risks of adverse events.

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Section: Ces For Clinical Applications: Conclusioncontrasting

confidence: 79%

A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

Brunyé

Patterson

Wooten

et al. 2021

Front. Hum. Neurosci.

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“…The evidence from previous studies demonstrated mixed results regarding the efficacy of CES in sleep problems. A recent RCT 30 showed that stimulation with 60 minutes of CES for 3 weeks improved sleep quality in 60 fibromyalgia patients with sleep dysfunction as measured by self-rating questionnaire. Another study 34 assessed sleep onset latency, nocturnal arousals, sleep efficiency, sleep duration, and awakening time in 21 insomniacs as a result of drug abstinence syndrome using subjective questionnaires.…”

Section: Discussionmentioning

confidence: 99%

“…The evidence from previous studies demonstrated mixed results regarding the efficacy of CES in sleep problems. A recent RCT 30 Note: one participant from CES group and 2 from control group dropped-out from the present study. However, in accordance with the intention to treat analysis, all the subjects who were randomized to the study and received at least one session of training were included in the final analysis.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a revival of this technique nowadays, due to increasing statistics showing sleep irregularities in modern society. In essence, a recent report from systematic review 30 identified 23 studies, which addressed modulation in sleep with CES in healthy and diseased individuals. Findings illustrated that CES has positive effects on sleep, however, due to heterogeneity in the participants and outcome measures, authors suggested to interpret the results with caution.…”

Section: Introductionmentioning

confidence: 99%

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Cranial electrostimulation improves slow wave sleep in collegiate population: a polysomnographic study

Aseem¹,

Chaudhry²,

Hussain³

2022

Sleep Sci

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Objective Sleep disturbance is quite prevalent among students, which leads to deleterious consequences on health. Cranial electrostimulation (CES) has been speculated to entrain cortical slow waves; therefore, we investigated the efficacy of cranial electrostimulation to improve slow wave sleep in collegiates. Methods Twenty-eight students with Pittsburgh sleep quality index (PSQI) score >5 were randomly assigned into two groups: CES and control. Participants in CES group completed 60 minutes of CES intervention for 12 weeks with 100 µA microcurrent and 0.5 Hz frequency parameters during night. Pre- and post-intervention measures were taken for sleep architecture using over-night polysomnography (PSG) and sleep quality using PSQI. Participants were instructed to report to the laboratory at 10:00 p.m. and PSG was performed with electroencephalograms (EEG), chin electromyography (EMG) and bilateral electrooculogram (EOG) in place. Sleep stages were scored manually in accordance with the new AASM guidelines. PSG variables reported in the present study are sleep latency (SL), total sleep time (TST), percentage of N1, N2, N3, NREM (non-rapid eye movement), REM (rapid eye movement) and sleep efficiency (SE%). Results After ascertaining the comparability of demographic and sleep variables at baseline for both the groups, a 2X2 mixed model ANOVA was employed. Significant between-group differences were obtained for N1% and N3% such that N1% decreased and N3% increased post CES. However, other PSG variables, along with PSQI score did not demonstrate statistically significant between-group difference. Discussion The present study demonstrated that 12-weeks of CES improved N3% and reduced N1%. Future researches should be undertaken to build upon the findings of present study.

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“…A few studies have tested the effects of CES on insomnia as can be seen from several review articles (Aseem & Hussain, 2019; Brunye et al, 2021; Kirsch & Gilula, 2007). However, most of the studies were not designed with sham controls.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of cranial electrotherapy stimulation on mood and sense of well‐being in people with subclinical insomnia

Hong

Yoon

2023

Journal of Sleep Research

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SummaryCranial electrotherapy stimulation is a non‐invasive brain stimulation method characterised by using a microcurrent. The objective of the study was to investigate whether a novel device with a stable supplement of electronic stimulation would improve sleep and the accompanying mood symptoms in people with subclinical insomnia. People who had insomnia symptoms without meeting the criteria for chronic insomnia disorder were recruited and randomly assigned to an active or a sham device group. They were required to use the provided device for 30 min each time, twice a day for 2 weeks. Outcome measures included questionnaires for sleep, depression, anxiety, and quality of life, 4 day actigraphy, and 64‐channel electroencephalography. Fifty‐nine participants (male 35.6%) with a mean age of 41.1 ± 12.0 years were randomised. Improvement of depression (p = 0.032) and physical well‐being (p = 0.041) were significant in the active device group compared with the sham device group. Anxiety was also improved in the active device group, although the improvement was not statistically significant (p = 0.090). Regarding sleep, both groups showed a significant improvement in subjective rating, showing no significant group difference. The change in electroencephalography after the 2 week intervention was significantly different between the two groups, especially for occipital delta (p = 0.008) and beta power (p = 0.012), and temporo‐parieto‐occipital theta (p = 0.022). In conclusion, cranial electrotherapy stimulation can serve as an adjunctive therapy to ameliorate psychological symptoms and to alter brain activity. The effects of the device in a clinical population and an optimal set of parameters of stimulation should be further investigated.

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Impact of Cranial Electrostimulation on Sleep: A Systematic Review

Cited by 5 publications

References 36 publications

A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

Cranial electrostimulation improves slow wave sleep in collegiate population: a polysomnographic study

Efficacy of cranial electrotherapy stimulation on mood and sense of well‐being in people with subclinical insomnia

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