Monthly Archives: May 2013

CES helps to sleep – Insomnia Case 3

Magora, Florella, Beller, A., Aladjemoff, L., Magora, A., and Tannenbaum, J. Observations on electrically induced sleep in man. British Journal of Anesthesiology. 37:480 491, 1965.

Device: 100 Hz, 10 – 100 Hz, 1 – 10 mS, 0.4 – 5 mA, square pulses, cathodes over orbits or forehead, anodes over mastoids

The authors were studying CES to determine what it took to put a patient to sleep. They varied hertz, amplitude, pulse width and the like, performing 65 experiments. The subjects were healthy volunteers, 5 females and 10 males with ages ranging from 30 – 45 years, 2 pts with Parkinson’s disease (a 62 year old female and a 82 year old male), and 1 male, 65, with dystonia musculorum. All subjects were advised to refrain from taking any drugs 12 hours prior to the experiments. In a group of 7 healthy subjects, the 2 pts with Parkinson’s, and the 1 with dystonia musculorum, sleep did occur in most of the experiments as measured by objective criteria (respiration, EEG, EMG). An unexpected finding was that the involuntary movements in the pts with Parkinson’s and dystonia musculorum were changed in character during the passage of current, and eventually completely eliminated, as evidenced by clinical and EMG observations. Sleep was not induced in a second group of 13 healthy individuals, although in 7 a definite change was obvious consisting of lack of blinking, preference for eyes closed, passiveness, and disruption of the idea pattern obvious in conversation. On questioning, after the current was discontinued, these subjects had no evaluation of the lapsed time and stressed that while the current was on they felt detached from their surroundings and had an agreeable feeling throughout the experiment. No ill effects were observed after repeated experiments in the same and different individuals.

More research –

CES helps to sleep – Insomnia Case 4

Device: Diastim: 350 Hz, 0.7 mS, 1 – 1.2 mA, rectangular monophasic pulses, cathodes over orbits, anodes over mastoids

21 psychiatric inpatients suffering major depressive disorders according to DSM III-R criteria were divided into 2 groups for this double-blind study. The active CES group (N = 10) had 3 males and 7 females (age 44.9  10.3) with an average length of depressive illness of 56 months (1 – 156). The placebo group (N = 11) had 3 males and 8 females (age 36.4  13.8) with an average length of depressive illness of 64 months (5 – 222). All patients completed informed consent. The treatment withdrawn upon admission consisted of benzodiazepines (9 of 10 active and 8 of 11 placebo), barbituates (1 of 10 active), antidepressant drugs (5 of 10 active and 8 of 11 placebo), and neuroleptics (1 of 10 active and 1 of 11 placebo). The study began on the first drug-free day. Depressive pathology was evaluated daily by the Montgomery and Asberg Depression Rating Scale (MADRS). Sleep was evaluated using a sleep diary and questionnaire. Analogic self-rating scales evaluated anxiety, fatigue, arousal, and life events. Student’s paired t-test was used to analyze the data. During the 5 day washout period, the natural development of symptoms consists of a rise in anxiety and an exacerbation of sleep disorders. In 2 cases, benzodiazepine withdrawal induced epileptic seizures in pts devoid of epileptic history. These seizures did not occur during CES sessions. The depressive criteria in the CES group paralleled that in the placebo group. Anxiety and sleep criteria showed divergent changes between groups. Anxiety on MADRS was exacerbated in the placebo group but reduced in the CES group (P<.01). The same was true of the ninth criteria of MADRS, pessimism about the future and feelings of guilt and failure. There was no other significant changes on MADRS in either group. Sleep duration improved in the CES treatment group, but was significantly worsened in the placebo group (P<.05). Feelings of fatigue and alertness revealed a positive change in the CES group (P<.05), but not in the placebo group. The authors concluded that the effects of a drug washout period are markedly attenuated by cerebral electrostimulation, which is of possible interest in the management of psychotropic drug withdrawal. No side effects were reported. Philip, P., Demotes-Mainard, J., Bourgeois, M. and Vincent, J.D. Efficiency of transcranial electrostimulation on anxiety and insomnia symptoms during a washout period in depressed patients; a double-blind study. Biological psychiatry. 29:451-456, 1991.

CES helps to sleep – Insomnia Case 5

Device, 100 Hz, 1mS, 0.5 – 1.2 mA, orbit to mastoid electrodes.

22 neurotic and personality disorder pts (including 2 inpatients) with anxiety, depression, and insomnia (20 females, 2 males 26 – 63 years old, mean = 43.1 years) were divided into active (N = 11), or sham groups (N = 11), each given 5, 30 minute treatments in a double-blind design. A 1 – 7 clinical rating scale was used by a psychiatrist before the first and after the final treatment for 3 areas of symptomatology: anxiety, sleep disturbance, and depression. The Zung depression scale was also employed at the same times. Pts receiving active treatment had a marked clinical improvement over pts receiving placebo treatment. Of the 11 CES pts, 8 showed a marked improvement, 2 showed a partial improvement, and 1 showed no improvement. Of the placebo group, 1 showed marked improvement, 2 showed partial improvement, and 8 showed no improvement. Average “total clinical ratings” on anxiety, sleep disturbance, and depression fell from 11.3 before CES treatment to 3.2 following treatment. The placebo group only fell from 12.2 to 9.5. In anxiety, the CES group fell from 4.3 to 1.4 while the placebo group only fell from 4.4 to 3.2. 8 of the pts who had sham treatments were then given real CES. Pts receiving active treatment following inactive treatment responded better than pts receiving inactive treatment, but did not respond as well as those who received active treatment first. For example, the anxiety score fell from 4.0 to 2.5. At the end of the CES treatment, pts felt no confusion, memory loss, or disorientation. They usually reported a calm, relaxed sensation during the treatment, and a feeling of sedation with a desire to sleep following the treatment. The author stated that he can not help being a little skeptical at his own results. He added that no treatment in common experience is as effective with this type of pt as these results indicate. No side effects were reported.

Rosenthal, Saul H. Electrosleep: A double blind clinical study. Biological Psychiatry. 4(2):179185, 1972.

CES helps to sleep – Insomnia Case 6

Device: Electrodorn I, electrodes on forehead and neck

10 pts with objectively established insomnia were randomly selected from 40 volunteers solicited by newspaper ads. The subjects spent 3 initial nights in a sleep lab to establish baseline measurements, and then returned for 2 nights at the end of the study and again for follow-up. They were given 24, 15 minute CES treatments (N = 5) or simulated treatments (N = 5) in a double-blind manner and measured before and after treatment, and after a 14 day post treatment period. The MMPI was used to establish equivalency of groups. EEG latencies of sleep onset in minutes for the CES group pretreatment means was 60.8 to 10.6 post treatment, and for the sham group 60.5 to 58.8. The CES group had a significant decline in latency of sleep onset (P=.00077), percentage of bed time awake (CES pretreatment 19.334 to 4.192 post, and sham 17.296 pre to 18.500 post, P=.367), and percentage of total sleep time in stage 1 sleep. A significant increase in the total sleep time in stage 4 and total delta sleep was also found in the CES group. All differences found were maintained at the 2 week and 2 year follow up. No significant improvement was found in the placebo group. The author stated that we can now conclude that CES is effective in the treatment of chronic, sleep onset insomnia. No side effects were reported.

Weiss, Marc F. The treatment of insomnia through use of electrosleep: an EEG study. Journal of Nervous and Mental Disease. 157(2):108 120, 1973.