Insomnia
Conditions
Keywords
Standard Cognitive Behavioural Therapy, tACS, Treatment-Resistant Insomnia
Brief summary
The main purpose of this study is to investigate the efficacy of CBTI + transcranial alternating current (TAC) technology in the treatment of refractory insomnia and the mechanism of 'cognitive-behavioural-brain network' interactions.
Detailed description
Difficult to treat insomnia is a sleep disorder that significantly reduces the quality of sleep for patients, seriously affecting their daily work and study. At present, the main treatment method for refractory insomnia in clinical practice is drug therapy. The problems with drug therapy mainly include easy recurrence after discontinuation and the need for long-term or even lifelong medication. However, tolerance or other adverse reactions limit its long-term use. In recent years, studies have shown that cognitive-behavioral therapy and transcranial alternating current stimulation are effective in treating chronic insomnia, prolonging sleep time and improving sleep quality. However, there have been no reports on the efficacy and safety of CBTI combined with tACS in the treatment of refractory insomnia. Based on the important role of tACS in regulating cortical excitability and spontaneous EEG activity, as well as the precise efficacy of CBTI in improving insomnia, we plan to use CBTI combined with tACS to treat refractory insomnia disorders, in order to improve the effectiveness of treatment. This study adopts a randomized double-blind controlled trial to investigate the efficacy and safety of CBT+tACS in the treatment of refractory insomnia, aiming to provide a basis for clinical data of CBT+tACS in the treatment of refractory insomnia.
Interventions
OTHERCBTI + tACS
CBTI + tACS group method: CBTI for about 50 minutes each time, for a total of 6 weeks: ① first interview: enrolment assessment; ② second interview: treatment initiation; ③ third interview: sleep titration and sleep hygiene; ④ fourth interview: sleep titration; ⑤ fifth-seventh interview: sleep titration; ⑥ eighth interview: sleep titration (end of standardised CBTI treatment. tACS true stimulation) : Transcranial alternating current therapy (tACS) was operated during the same period of CBTI, with 3 electrodes, placed in the prefrontal lobe and bilateral mastoid; the stimulation intensity was 77.5 Hz, 15 mA, 40 min each time, once a day, 5 days a week, for 6 weeks.
OTHERCBTI + Sham tACS
CBTI+sham tACS group method: CBTI treatment method was the same as before. tACS pseudo-stimulation: the electrode placement position, stimulation frequency, and time settings were the same as the real stimulation, and the stimulation process only had the output of gradual rising and falling current at the beginning and the last 10s, respectively, so as to make the subjects produce the same subjective feelings as the real stimulation.
Sponsors
Xuanwu Hospital, Beijing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Meets the diagnostic criteria for insomnia in DSM-5; 2. Pittsburgh Sleep Quality Index (PSQI) total score\>5 points; 3. Age ≥ 18 years old, with a junior high school education or above; 4. Voluntarily participate in this study and sign an informed consent form.
Exclusion criteria
1. Individuals with severe physical or mental illnesses are at risk of suicide; 2. Clinically diagnosed or suspected sleep breathing disorders, restless leg syndrome, and sleep wake rhythm disorders, as well as workers on rotating shifts; 3. Pregnant and lactating women; 4. Currently undergoing any psychological therapy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Differences in change from baseline in Pittsburgh sleep quality index (PSQI) scores at the end of treatment in the two groups | Baseline to week 6 |
Secondary
| Measure | Time frame |
|---|---|
| Differences in changes in PSQI scores compared to baseline during follow-up at 3, 6, and 12 months between the two groups | Baseline to week 6, month 3, month 6, and month 12 |
| Differences in the changes in Beck Depression Inventory (BDI) scores from baseline at the end of treatment and follow-up at 3, 6, and 12 months between the two groups | Baseline to week 6, month 3, month 6, and month 12 |
| Differences in Beck Anxiety Inventory (BAI) scores between the two groups at the end of treatment, 3 months, 6 months, and 12 months of follow-up compared to baseline. | Baseline to week 6, month 3, month 6, and month 12 |
| Differences in changes in sleep hygiene awareness and practice scale (SHAPS) between the two groups compared to baseline at the end of treatment, 3 months, 6 months, and 12 months of follow-up [2]. | Baseline to week 6, month 3, month 6, and month 12 |
| Differences in changes in the Insomnia Severity Index (ISI) scores between the two groups at the end of treatment, 3 months, 6 months, and 12 months of follow-up compared to baseline. | Baseline to week 6, month 3, month 6, and month 12 |
Countries
China
Contacts
Primary ContactHongxing Wang, MD & PhD
Outcome results
None listed