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Neurofeedback brain assessment and training for improving sleep

Step 1:

What is troubling my sleep?

We will do a full assessment of brain functions to discover what patterns are out of balance in a way that disturb your quality or onset of sleep. 
Few examples can be:

I'm waking up in the morning exhausted and not feeling refreshed 

An example of what we find when assessing brain functions (QEEG) are brains that are so limited metabolically that they cannot sustain beta (fast wave activity), so they are unable to rise into REM sleep, and psychological restoration doesn’t happen. These people may sleep very deeply, awaken slowly and never feel rested.


I'm frequently waking up during the night. Sometimes can't get back to sleep

Strong slow-alpha patterns found as part of brain functions assessment relate to Alpha-Delta sleep, where the brain is unable to achieve a Delta sleep state during which physical restoration happens.

This may also correlate with chronic pain or fatigue


I find it hard to fall asleep. Can't quiet my mind

Sometimes what we will find is very fast brain activity (Beta) at the back of the head, especially as the right back hemisphere. Together with low levels of the Sensory-Motor Rhythm (SMR) this can be related to sleep-onset insomnia, active sleep, restless leg syndrome or bruxism

Step 2:

Training HEG and EEG brain activity to re-balance those patterns

Training oxygen patterns and electrical brain activity of specific networks show significant results in improving sleep onset, quality and cycles. 

An example for a trained pattern in neurofeedback for sleep is the SensoryMotor Rhythm.

Studies reviewed in 2011 demonstrated positive effects of SMR-Neurofeedback training in young healthy individuals (Hoedlmoser et al., 2008) and young patients with subclinical insomnia (Schabus et al., 2014). In particular, results indicated a beneficial effect of only 10 sessions of 12–15 Hz SMR Neurofeedback training on sleep quality and memory performance (Hoedlmoser et al., 2008) or even overnight memory consolidation (Schabus et al., 2014).


The latter finding is especially relevant from a clinical perspective as insomniacs frequently complain about problems related to attention and memory. 

Sterman et al.(1970) was able to show in his pioneering work that when cats are trained to increase EEG power in the (12–14 Hz) SMR frequency band during wakefulness, they also presented with more sleep spindles and enhanced sleep quality (i.e. less fragmentation) during subsequent sleep. This is intriguing not only because it suggests that neurofeedback training effects may translate to other vigilance states (i.e. from wakefulness to sleep), but it importantly also suggests a possible treatment for insomnia, a burden that is estimated to affect between 10 and 35% of the general population worldwide (Morin et al., 2006).


One mechanism that has been proposed to explain Sterman’s findings is that the SMR frequency band significantly overlaps with the 12–15 Hz frequency range in which sleep spindles occur during non-REM sleep. Eventually, an increase in spindle activity may account for the improvements in sleep quality (i.e. shorter sleep onset latency and less sleep fragmentation) observed. However, despite the burden insomnia depicts for our society, only few studies followed-up on Sterman’s findings (Hauri, 1981; Hauri et al., 1982; Cortoos et al., 2010) with all of them attesting neurofeedback beneficial effects on sleep.


Further reading

Arns, M., Feddema, I., & Kenemans, J. L. (2014). Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency. Frontiers in human neuroscience, 8, 1019.

Sterman, M. B., Howe, R. C., & Macdonald, L. R. (1970). Facilitation of spindle-burst sleep by conditioning of electroencephalographic activity while awake. Science, 167(3921), 1146-1148.

Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep medicine, 7(2), 123-130.

Hauri, P. (1981). Treating psychophysiologic insomnia with biofeedback. Archives of General Psychiatry, 38(7), 752-758.

Hauri, P. J., Percy, L., Hellekson, C., Hartmann, E., & Russ, D. (1982). The treatment of psychophysiologic insomnia with biofeedback: A replication study. Biofeedback and Self-regulation, 7(2), 223-235.

Cortoos, A., De Valck, E., Arns, M., Breteler, M. H., & Cluydts, R. (2010). An exploratory study on the effects of tele-neurofeedback and tele-biofeedback on objective and subjective sleep in patients with primary insomnia. Applied psychophysiology and biofeedback, 35(2), 125-134.

Hoedlmoser, K., Pecherstorfer, T., Gruber, G., Anderer, P., Doppelmayr, M., Klimesch, W., & Schabus, M. (2008). Instrumental conditioning of human sensorimotor rhythm (12-15 Hz) and its impact on sleep as well as declarative learning. Sleep, 31(10), 1401-1408.

Schabus, M., Heib, D. P., Lechinger, J., Griessenberger, H., Klimesch, W., Pawlizki, A., ... & Hoedlmoser, K. (2014). Enhancing sleep quality and memory in insomnia using instrumental sensorimotor rhythm conditioning. Biological psychology, 95, 126-134.

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