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Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Biofeedback Therapies for Chronic Insomnia: A Systematic Review.

Denise Lima Medeiros Melo1, Luciane Bizari Coin Carvalho2, Lucila Bizari Fernandes Prado2

  • 1Department of Neurology, Neuro-Sono Sleep Center, Federal University of Sao Paulo-UNIFESP, R. Cláudio Rossi, 394, São Paulo, SP, CEP 01547-000, Brazil. denise_med79@yahoo.com.

Applied Psychophysiology and Biofeedback
|May 25, 2019
PubMed
Summary

Biofeedback may offer some benefits for chronic insomnia by reducing sleep onset latency and awakenings, but evidence is conflicting. Further high-quality trials are needed to confirm its effectiveness compared to other treatments.

Keywords:
BiofeedbackDisorders of initiating and maintaining sleepInsomniaNeurofeedback

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Area of Science:

  • Sleep Medicine
  • Behavioral Therapy

Background:

  • Chronic insomnia presents a significant clinical challenge.
  • Biofeedback techniques are explored as a potential treatment modality.

Purpose of the Study:

  • To systematically review randomized and quasi-randomized trials on biofeedback for chronic insomnia.
  • To evaluate biofeedback's effectiveness against placebo, no treatment, and other cognitive behavioral therapy techniques.

Main Methods:

  • Systematic review of randomized and quasi-randomized clinical trials.
  • Inclusion of studies comparing biofeedback with control conditions or other therapies.
  • Evaluation of outcomes including sleep onset latency, total sleep time, sleep fragmentation, sleep efficiency, and subjective sleep quality.

Main Results:

  • Some studies suggest biofeedback may decrease sleep onset latency and awakenings compared to placebo or no treatment, but results are divergent.
  • No significant improvements were found for total sleep time, sleep efficiency, or subjective sleep quality.
  • No significant differences in effectiveness were observed between biofeedback and other cognitive behavioral therapy techniques for most outcomes.
  • Evidence for long-term benefits of biofeedback is lacking.

Conclusions:

  • Conflicting evidence exists regarding the effectiveness of biofeedback for chronic insomnia treatment.
  • Clinical heterogeneity among studies may explain divergent results.
  • Further high-quality randomized clinical trials are necessary to clarify biofeedback's role in managing chronic insomnia.