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Dudysová D, Janků K, Piorecký M, Hantáková V, Orendáčová M, Piorecká V, Štrobl J, Kliková M, Ngo HVV, Kopřivová J. Closed-loop auditory stimulation of slow-wave sleep in chronic insomnia: a pilot study. J Sleep Res 2024:e14179. [PMID: 38467353 DOI: 10.1111/jsr.14179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/12/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024]
Abstract
Insomnia is a prevalent and disabling condition whose treatment is not always effective. This pilot study explores the feasibility and effects of closed-loop auditory stimulation (CLAS) as a potential non-invasive intervention to improve sleep, its subjective quality, and memory consolidation in patients with insomnia. A total of 27 patients with chronic insomnia underwent a crossover, sham-controlled study with 2 nights of either CLAS or sham stimulation. Polysomnography was used to record sleep parameters, while questionnaires and a word-pair memory task were administered to assess subjective sleep quality and memory consolidation. The initial analyses included 17 patients who completed the study, met the inclusion criteria, and received CLAS. From those, 10 (58%) received only a small number of stimuli. In the remaining seven (41%) patients with sufficient CLAS, we evaluated the acute and whole-night effect on sleep. CLAS led to a significant immediate increase in slow oscillation (0.5-1 Hz) amplitude and activity, and reduced delta (1-4 Hz) and sigma/sleep spindle (12-15 Hz) activity during slow-wave sleep across the whole night. All these fundamental sleep rhythms are implicated in sleep-dependent memory consolidation. Yet, CLAS did not change sleep-dependent memory consolidation or sleep macrostructure characteristics, number of arousals, or subjective perception of sleep quality. Results showed CLAS to be feasible in patients with insomnia. However, a high variance in the efficacy of our automated stimulation approach suggests that further research is needed to optimise stimulation protocols to better unlock potential CLAS benefits for sleep structure and subjective sleep quality in such clinical settings.
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Affiliation(s)
- Daniela Dudysová
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic
| | - Marek Piorecký
- National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Veronika Hantáková
- National Institute of Mental Health, Klecany, Czech Republic
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Mária Orendáčová
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Physiology, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Václava Piorecká
- National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Štrobl
- National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Monika Kliková
- National Institute of Mental Health, Klecany, Czech Republic
| | - Hong-Viet V Ngo
- Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Essex, Colchester, UK
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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