The effect of EEG biofeedback on patients with insomnia: an open- label study

Abstract Insomnia is the most prevalent clinical sleep disorder and is usually accompanied by some affective symptoms. As traditional interventions for insomnia have certain limitations, novel interventions such as biofeedback therapy can be of great clinical significance. Here, we aimed to explore the clinical efficacy of biofeedback for insomnia and its potential mechanisms of action. We recruited 82 patients with insomnia from the insomnia clinic at the Xuanwu Hospital. Electroencephalography (EEG) and electromyography (EMG) biofeedback training was conducted for 30 minutes. EEG data of two minutes were also recorded each before and after training. Intervention was performed once every alternate day and included 10 biofeedback treatments session and measured three times before, after fifth, and after tenth biofeedback treatment session. Scores on the Pittsburgh Sleep Quality Index (PSQI) scale after one trial of biofeedback treatment were significantly lower than those before treatment (p < 0.001) and continued to lower after subsequent trials (p < 0.001). Specifically, patients experienced a significant reduction in insomnia, an easier transition to natural sleep, a shorter time to fall asleep, fewer awakenings during sleep, and a much better quality of sleep. Additionally, the scores on the Beck Depression Inventory Scale (BDI) and State-Trait Anxiety Scale (S-STAI, and T-STAI) after treatment were significantly lower than those before treatment (p < 0.001). Our findings suggest that biofeedback therapy is effective in relieving insomnia symptoms for insomnia patients and biofeedback therapy likely relaxes the patients’ minds (reflected by the alpha wave) and muscles (reflected by frontal EMG) and reduces alertness states (reflected by beta waves), which finally promotes deep sleep (reflected by the theta wave).