|
Clinical evidence now exists for the remediation
of a variety of sleep disorders with EEG biofeedback training,
including those sleep problems which may be ascribable to
neurological immaturity of childhood, or correlated with attentional
problems: bedwetting, sleep walking and talking, night terrors,
anxiety-related difficulties falling asleep, and insomnia.
Among adult sleep disorders, promising evidence exists for
remediation of insomnia and sleep apnea.
Many of the conditions helped with EEG biofeedback
are correlated with disorders of sleep. This includes epilepsy,
anxiety and depression, closed head injury, hyperactivity
and attention deficit disorder, chronic pain, and Tourette
Syndrome. Even when poor sleep is not the cause for referral
for biofeedback, it is often mentioned as a problem during
the intake interview. The first reported signs of change upon
initiating EEG training often relate to the quality of sleep.
We believe that the principal mechanism of efficacy of EEG
training is that it normalizes self-regulation of physiological
arousal, and the beneficial effects of the training on sleep
can be explained in the same manner. When self-regulation
is deficient, this should be apparent when arousal level is
least tightly regulated, i.e. during sleep in general, and
during transitions between sleep stages in particular. Nothing
so cogently demonstrates that EEG biofeedback confers a new
competence to the brain--as opposed to a consciously applied
tool to the patient--than its efficacy in remediating disorders
of sleep.
Bedwetting is among the most common symptoms
seen in our clinical population, which consists largely of
persons with attentional deficits (bedwetting is seen in 30%
of institutionalized children; i.e. there is a high correlation
with minor neurological deficits). In more than 90% of children
under twelve with this condition, remediation is expected
within the first twenty sessions of training. In older children
and in adults, the problem is more resistant to remediation.
It may take more training sessions than in younger children.
We have seen much lower incidence of sleep walking, sleep
talking, and night terrors. However, remediation is also observed
for these conditions. Excessive fears about falling asleep,
or about sleeping in one's own bed, usually remediate very
quickly with the onset of training.
There is an intimate connection of insomnia
with disorders of arousal such as anxiety and depression.
The success of EEG training in effecting improved self-regulation
of arousal should, therefore, be expected to result in improved
regulation of sleep in these cases, and that is what we observe.
Sleep apnea is generally thought to consist
of a central, neurological component, and a somatic, obstructive
component, the latter due to the fact that the condition closely
correlates with obesity. Obstructive sleep apnea has historically
been treated surgically, with rather poor outcomes, so that
surgery is now gradually being abandoned in favor of a breathing
aid device which provides continuous positive airway pressure
(CPAP). EEG training has been successful in fully remediating
apnea episodes in adult males, even in the absence of any
other behavioral changes such as weight loss. The condition
is seen as arising from cortical underarousal. Only a few
cases have been studied.
- Taken is from the EEG Spectrum Web Site and will be updated
soon.
|
