Insomnia is one of the most common medical complaints. It frequently coexists with medical, psychiatric, sleep, or neurological disorders.
It may also be associated with acute stress, medication or substance, poor sleep habits, or changes in the sleep environment. It increases healthcare costs, causes or adds to medical and psychiatric comorbidities, cognitive impairments, accidents, absenteeism and reduced quality of life.
The diagnosis of insomnia requires three main components: persistent sleep difficulty, inadequate sleep opportunity, and associated daytime dysfunction. Insomnia symptoms that occur at least three times per week and persist for at least three months are considered chronic insomnia. In practice, however, most individuals with chronic insomnia report symptoms for many years.
TMS studies have shown presence of a diffuse cortical hyper-arousal in patients with chronic insomnia. High frequency TMS (>1 Hz) has been shown to be activating whereas low frequency TMS (<1Hz) has been shown to be inhibitory in clinical and neurophysiological studies.
TMS calms the activity in the area of the brain that causes insomnia to improve sleep quality. It gets to the root of the problem by resetting brain patterns and pathways using targeted magnetic pulses.
1) Efficacy of repetitive transcranial magnetic stimulation in the treatment of patients with chronic primary insomnia.
This study assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of patients with chronic primary insomnia. Hundred and twenty patients with chronic primary insomnia were randomly assigned to three study groups (n = 40 per group): rTMS, medication, or psychotherapy treatment (both latter as controls). The treatments proceeded for 2 weeks, after which treatment efficacies were assessed in each study group based on changes in polysomnography parameters. rTMS treatment significantly better (p < 0.05) improved stage III sleep and REM sleep cycle compared with both control groups. In addition, the relapse and recurrence rates were also the lowest in rTMS treatment group. In conclusion, rTMS treatment is more advantageous than both medication and psychotherapy treatments in improving the sleep architecture. Further, rTMS significantly decreases the body awakening level and provides a better long-term treatment effect
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