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Audio Tone Therapy Shown to Relieve Insomnia

Asleep at the wheel

(Lechon Kirb,

27 Jan. 2023. Clinical trial findings show an electronic system that reads brain waves and feeds back personalized audio tones helps people with insomnia achieve better sleep. Results of the trial conducted by neuroscientists at Wake Forest University medical school in Winston-Salem, North Carolina appear in the 18 Jan. 2023 issue of the journal Global Advances in Integrative Medicine and Health.

Insomnia, as noted by the authors, is a continuing public health problem that shows up in absenteeism from work and school, reduced work productivity, greater risk of accidents, and higher health care costs. In addition, people with insomnia are also more likely to experience heart, metabolic, and neurological malfunctions contributing to higher risk of death. Treatments for insomnia such as cognitive behavioral therapy and some drugs are available, but the authors indicate these therapies can have limited efficacy and require extended periods of time, and in the case of drugs, undesirable adverse effects. In addition, insomnia may also be an indicator of reduced functioning of the autonomic nervous system that regulates involuntary physiological processes, such as heart rate, blood pressure, and respiration.

The team led by Charles Tegeler, chair of neurology at Wake Forest medical school, assessed an electronic therapy for insomnia called Cereset Research with Standard Operating Procedures. The Cereset techniques are an updated form of high-resolution, relational, resonance-based electroencephalic mirroring, or Hirrem, a non-invasive technique for addressing neurological disorders. With Hirrem, sensors are attached to the scalp, first to identify imbalances in brain waves contributing to the disorder, then later to respond to those imbalances with software-generated audio tones heard through headphones to recalibrate and rebalance those signals.

Tegeler and Wake Forest have studied Hirrem for a number of years. In Dec. 2017, Science & Enterprise reported on a study of Hirrem as a therapy for post-traumatic stress disorder or PTSD, finding the treatments reduced PTSD symptoms in current and former military personnel for six months. The company Cereset LLC — formerly Brain State Technologies — in Scottsdale, Arizona licenses the technology for research and evaluation.

Cerebral reset

Cereset Research with Standard Operating Procedures, or CR-SOP, is an updated form of Hirrem that the authors say is a simpler and more scalable process that allows for less operator-intensive monitoring and control. The Cereset technology — Cereset is  an acronym for cerebral reset — also uses smarter software protocols and faster computer systems to manage the treatments, enabling a more standard package with shorter therapy sessions. As with Hirrem, the system feeds back audio tones, delivered through earbuds to the patient.

In the clinical trial, Tegeler and colleagues pilot-tested CR-SOP as therapy for insomnia. “CR-SOP allows the brain to reset from stress patterns that contribute to insomnia,” says Tegeler in a Wake Forest statement. “During the intervention, the brain continuously updates with respect to its own activity patterns, resulting in auto-calibration or self-optimization.”

The trial enrolled 22 adults at the Wake Forest medical school diagnosed with clinical insomnia, defined as scoring 8 points or higher on a 28-point Insomnia Severity Index. Participants were randomly assigned to receive 10 sessions of CR-SOP or 10 sessions of random audio tones as a placebo, then assessed for sleep quality with Insomnia Severity Index over an average of 15 days. The study team also measured heart rate variability and baroflex sensitivity — an indicator of nervous system interaction with cardiac functions — during this period, as well as four to six weeks after the sessions.

Results show 20 of the 22 participants completed the trial, with no treatment-related adverse effects reported. CR-SOP recipients report lower insomnia severity index and higher sleep quality scores than random-tone recipients, soon after the sessions, and after the 4-6 week follow-ups, with differences large enough for statistical reliability. Likewise, the CR-SOP group reports improvements in heart rate variability and baroflex sensitivity than the random-tone recipients.

“This pilot study demonstrates these benefits with CR-SOP from sessions received over a short period,” notes Tegeler. “This is also an important step in showing the intervention’s potential scalability for treating more people.”

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