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Open-Loop Neurofeedback Audiovisual Stimulation: A Pilot Study of Its Potential for Sleep Induction in Older Adults

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Abstract

This pilot study tested the efficacy of a 30-min audio–visual stimulation (AVS) program for the treatment of chronic insomnia in older adults. Chronic insomnia has been conceptualized as entailing increased cortical high frequency EEG activity at sleep onset and during NREM sleep. We hypothesized that an AVS program gradually descending from 8 to 1 Hz would potentially reduce the excessive cortical activation that is thought to contribute to difficulties with initiating and maintaining sleep. Accordingly, we conducted an intervention study of AVS using a pre-post design. Eight older adults (88 ± 8.7 years) complaining of chronic insomnia self-administered a 30-min AVS program nightly at bedtime for one month. Sleep was assessed at baseline and throughout the 4-week intervention. After using AVS for 4 weeks, significant improvement was reported in insomnia symptoms (ISI, p = 0.002) and sleep quality (PSQI, p = 0.004); with moderate to large effect sizes (Partial Eta2: 0.20–0.55)(Cohen’s d: 0.7–2.3). The training effect (self-reported sleep improvement) was observed at the end of week one and persisted through the 1-month intervention. The results from this pilot study suggest that further exploration of AVS as a treatment for insomnia is warranted.

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Acknowledgments

This project was conducted with the support of (1) John A. Hartford Foundation Claire M. Fagin Fellowship - National Hartford Center of Gerontological Nursing Excellence, (2) National Institute of Nursing Research T-32 Post-doctoral fellowship (NINR 5-T32-NR009356) from the NewCourtland Center for Transitions and Health, School of Nursing University of Pennsylvania, (3) the pilot study fund from the Biobehavioral Research Center, School of Nursing University of Pennsylvania, (4) the Sinegal Faculty Development Fund, College of Nursing, Seattle University, (5) Center for Research on the Management of Sleep Disturbances (P30 NR011400), University of Washington, and (6) Elizabeth Giblin Endowed Research Fund, School of Nursing University of Washington. Special thanks to Akiko Miller, Yip-Han Lee, Taylor Goulding, and Regina Belche for their dedicated work on this project.

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Correspondence to Hsin-Yi (Jean) Tang.

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Tang, HY., Vitiello, M.V., Perlis, M. et al. Open-Loop Neurofeedback Audiovisual Stimulation: A Pilot Study of Its Potential for Sleep Induction in Older Adults. Appl Psychophysiol Biofeedback 40, 183–188 (2015). https://doi.org/10.1007/s10484-015-9285-x

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