Dados do Trabalho

Título

Transcutaneous auricular vagus nerve stimulation for insomnia: a systematic review and meta-analysis

Introdução

Although insomnia is a prevalent sleep disorder that significantly impacts health and quality of life, current treatment options are still limited. While transcutaneous auricular vagus nerve stimulation (t-VNS) is a promising alternative, the current literature lacks a clear evaluation of its effectiveness.

Objetivo

Our systematic review and meta-analysis aimed to assess the efficacy of t-VNS for patients with insomnia.

Métodos

We systematically searched Pubmed, Embase, and Cochrane databases from inception to July 2024 for randomized controlled trials (RCTs) comparing t-VNS to sham transcutaneous non-vagus nerve stimulation with a follow-up of at least 2 weeks. Statistical analysis was performed using R Studio software (2023.12.1 Build 402). We computed the mean differences for continuous outcomes, with 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics.

Resultados

We included three RCTs comprising 167 patients with insomnia, of whom 84 (50.3%) underwent t-VNS. All studies had a follow-up of 4 weeks, and only one analyzed 8 weeks of intervention. While t-VNS significantly improved the Pittsburgh Sleep Quality Index (MD -4.61; 95% CI -6.89, -2.33; p < 0.001; I² = 19%), statistical significance was not reached for anxiety (SMD -0.42; 95% CI -1.22, 0.38; p = 0.30) and depression (MD 2.41; 95% -0.01, 4.83; p = 0.051) scales. Only one study evaluated polysomnographic alterations and found a statistically significant decrease in insomnia severity index, better sleep efficiency, increased N3 deep sleep period and shortened sleep latency in t-VNS group.

Conclusões

Our findings offer preliminary evidence that t-VNS could serve as an alternative treatment for reducing sleep impairment in patients with insomnia. However, our limited number of studies and small sample size underscores the need for future RCTs to evaluate this hypothesis with greater statistical power, providing a more robust understanding of t-VNS efficacy.

Palavras -chave

insomnia, transcutaneous auricular vagus nerve stimulation, randomized controlled trials.