Dados do Trabalho

Título

Effects of transcranial electrical stimulation in patients with insomnia: a systematic review and meta-analysis

Introdução

Insomnia is a common sleep disorder with significant impact on overall health and well-being. Given the limitations of current treatment options (i.e, behavioral interventions), transcranial electrical stimulation (TES) has emerged as a potential alternative approach, which includes transcranial direct (tDCS) and alternating current stimulation (tACS).

Objetivo

Our systematic review and meta-analysis evaluates the effectiveness of TES in patients with insomnia, given the lack of consensus on its efficacy.

Métodos

We systematically searched Pubmed, Embase and Cochrane databases from inception to July 2024, identifying randomized controlled trials (RCTs) that compared TES with sham stimulation, with a follow-up duration of at least 4 weeks. We performed statistical analyses using R Studio (version 2023.12.1 Build 402). Mean differences for continuous outcomes were calculated, with 95% confidence intervals (CIs).

Resultados

We included 3 RCTs involving a total of 272 patients with insomnia, among whom 138 (50.7%) received TES. All studies comprised a 4-week intervention period, two of them extending the evaluation to 8 weeks. While two studies used tACS, one RCT evaluated the effects of tDCs. TES significantly improved the overall Pittsburgh Sleep Quality Index (PSQI) score (MD -1.79; 95% CI -3.11, -0.47; p < 0.01) and sleep efficiency component (MD -0.78; 95% CI -1.29, -0.27; p < 0,01). There was a trend to improve sleep quality component score with a non-significant difference in the intervention (MD -0.41; 95% CI -0.85, 0.03 ; p = 0,07). In polysomnographic parameters, there was an improvement of total sleep time (TST) (MD 0.44 hour; 95% CI 0.19, 0.69; p < 0.01), while there was no significant improvement in sleep onset latency (MD -11.96 minutes; 95% CI -31.90, 7.98; p = 0.24).

Conclusões

Our findings provide preliminary evidence suggesting that TES could be an effective alternative for mitigating sleep disturbances in patients with insomnia. Nonetheless, the limited number of studies and small sample sizes underscore the necessity for future RCTs to explore this hypothesis with greater statistical power, enabling a more definitive assessment of TES efficacy.

Palavras -chave

insomnia, transcranial direct current stimulation, transcranial alternating current stimulation, transcranial electrical stimulation, randomized controlled trials.