Related Experiment Video
Updated: Oct 29, 2026
Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol
Published on: November 21, 2025
Efficacy of High-Frequency Transcranial Magnetic Stimulation Therapy for Depression With Insomnia Symptoms: A
Wenqing Yang1,2, Songbin Chen1, Xiaotong Li1
1Department of Rehabilitation Medicine, Guangzhou First People Hospital, Guangzhou, Guangdong, China.
Background:
This meta-analysis evaluated the efficacy of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) in patients with comorbid depression and insomnia.
Methods:
This analysis incorporated 7 studies, involving 709 subjects (control: 342; repetitive transcranial magnetic stimulation [rTMS]: 367). All included studies employed left DLPFC-targeted HF-rTMS. Treatment effectiveness for comorbid depression and insomnia was assessed. Subgroup analyses were conducted to explore possible sources of heterogeneity.
Results:
HF-rTMS significantly improved sleep quality (standardized mean difference [SMD] [95% confidence interval (CI)]: 0.97 [0.23 to 1.71], p = 0.01) and depressive symptoms (0.61 [0.38 to 0.84], p < 0.00001). There was a non-significant trend toward reduced sleep latency (0.50 [-0.17 to 1.18], p = 0.14). No significant difference in adverse reactions was observed (risk ratio [95% CI]: 1.09 [0.80 to 1.48], p = 0.57). Substantial heterogeneity was identified for the Pittsburgh Sleep Quality Index outcomes (I2 = 91%). Subgroup analyses indicated that this heterogeneity was attributed to variations in stimulation frequency and baseline antidepressant use.
Conclusion:
Very‑low to low certainty evidence suggests that left DLPFC‑targeted HF‑rTMS may improve sleep quality and depressive symptoms in patients with depression and insomnia symptoms, with a favorable safety profile. However, due to substantial heterogeneity and methodological limitations, these findings should be considered exploratory and warrant confirmation by future high‑quality trials.
