A Meta-Analyses of Cranial Electrotherapy Stimulation in the Treatment of Insomnia - Abstract
Increasing evidence supports the bidirectional relationship between physical and psychological well-being, morbidity, and mortality. Sleep disorders, especially insomnia, are a pervasive presenting symptom in patients with a range of psychiatric disorders. The sars-cov-2 pandemic has resulted in a historic 73% of the US population reporting disordered sleep, attributed to anxiety (48%), safety concerns (26%), and loneliness (23%). With insomnia as a moderating factor for suicide, the need for efficacious treatment for insomnia has never been more immediate. The mainstay insomnia treatments are often inadequate or contraindicated, resulting in increased demand for complementary or alternative treatments. In clinical trials since the 1970s, brain stimulation, in particular cranial electrical stimulation (CES), has shown efficacy in the treatment of insomnia. We have conducted, what we believe to be, the first 2 meta-analyses of CES as a treatment for insomnia. Methods: Fixed and random effects models, inclusive of homogeneity of Cohen’s d effect sizes are reported on 8 studies found in the Cochrane Central Register of Controlled Trials (CENTRAL), using Cooper’s Taxonomy of Literature Reviews. Results: A large (d = -0.83), average effect size for the 3 RCTs is shown, in addition to a small (d = -0.38), average effect size for 5 NRSI studies in favor of the active treatment group.
Conclusion: CES has a significant effect in the treatment of moderate to severe insomnia across a variety of patient populations.