Monthly Archives: June 2013

CES can potentiate the effects of analgesics

Finally, noting that CES is apparently an effective treatment for pain, several studies have been done to assess its potential to potentiate the effects of analgesics. One anesthetist gave 90 urological patients and 30 abdominal surgery patients N2O (nitrous oxide) in concentrations of 75%, 62.5%, or 50% alone, or in combination with CES during surgery. After 20 minutes patients were given a painful stimulation with Kocker clamps on their inner thigh for one minute. It was found that CES increased the potency of all three levels of N2O by 37%.

In a more elaborate study, 50 patients underwent urological operations with anesthesia induced with doperidol, diazepan, and pancuronium. Half the patients also were given CES treatment during the surgery. Anesthesia was maintained as necessary throughout the surgery by an IV fentanyl drip. Those patients receiving CES required an average of 33% less fentanyl to maintain anesthesia than did those who were not receiving CES.

It was found in both of the above two studies, that analgesia was maintained for a longer period following surgery among those patients receiving CES, than among those who did not.

A Summary Look at CES Studies of Insomnia

Primary insomnia as a complaint lasting for a least one month, of difficulty initiating and/or maintaining sleep or of the presence of non restorative sleep, as defined by the Diagnostic and Statistical Manual of Mental Disorders.1 The International Classification of Sleep Disorders Revised (ICSD-R) uses the term “psychophysiologic insomnia” for a complaint of insomnia, and for the associated decreased functioning during wakefulness, and regards insomnia of 6 months duration as chronic.

Estimates of the number of people in the U.S. who suffer from insomnia range from 18 million to 24 million in adulthood, and up to 20% in later life, or 7 million in persons 65 years of age and older, with women being about two times as likely to develop insomnia as men.

The primary function of sleep is to ensure adequate cortical function when awake.5 According to one theory, two processes interact in normal sleep production. The sleep homeostat drives the sleep-wake schedule toward a balanced requirement (prolonged wakefulness incurs a “sleep debt”), and an internal circadian timer regulates the 24 hour biological clock’s sleep wake cycle.6 Together, the two processes regulate not only the amount of sleep but the type of sleep an individual will experience. The two processes also differ across the life span, with young children experiencing longer sleep periods, with more rapid eye movement (REM) sleep than do adults, and the homeostatic drive declines with age.

Good sleepers do not have a recipe for falling asleep and staying asleep. Instead the good sleeper is regarded as passive in the sleep process in which internal and external cues act as automated setting conditions for sleep. According to the inhibition model, there is both a physiological de-arousal, and a cognitive de-arousal, allowing sleep to occur.

Under conditions of cognitive arousal, sleep will usually not occur. Students are taught that according to Freud, the first step in becoming an insomniac is to worry that one will not sleep when one goes to bed. Recent research has borne out the fact that mental worries of any kind, but certainly a fear of not falling asleep and worrying about the resulting consequences of this for one’s life the next day, clearly deactivates the cognitive de-arousal required for sleeping.

When asked what kinds of thoughts they have when they attempt to sleep, insomniacs provide a long list, typically including planning, thinking things out, especially things with a negative emotional content, fear of not sleeping, plus concentrating on worrisome changes that are operative in their lives. Persons who have no sleep problems, when asked what they think about when they go to bed at night, are more likely to answer, “nothing especially.”

While medications are often used to treat insomnia, those that are of the benzodiazepine and related families have limited usefulness over the long range, since they suffer tachyphylaxis and produce tolerance. The use of cognitive behavior therapy is often suggested since it can often quickly identify the things that the insomniac is doing that is defeating the brain’s attempt to de-arouse.

Other things that can keep people awake are illnesses, especially pain, depression, medications of various types, sleep apnea, anxiety and other stress related disorders. These would all need to be addressed and evaluated in any therapy that is provided to the insomniac.

Of additional interest to practitioners of electromedicine is the fact that the head in the awake person has a negative ionic charge anteriorly and a positive ionic charge posteriorly. Those charges reverse, both when the person is asleep, and when under general anesthesia. The person whose head remains ionically negative in front will not sleep until it reverses.

Treating Insomnia with CES

While CES came to the U.S. as “electrosleep” and its intent was to put patients to sleep when the current was turned on, that simply did not occur irrespective of the manipulation of the stimulus parameters.

Along with Kratzenstein’s observation in 1743 that putting electricity on his body during the day helped him sleep at night,13 more modern clinicians and patients also observed that the use of CES, while not directly inducing sleep, helped them sleep better.

Studies began which attempted to assess the ability of CES to enhance sleep, even sometimes hours following treatment. In one study 10 patients were allowed to sleep in a sleep lab which monitored their EEG during the night. Half were given CES and half sham CES. After 30 minutes of stimulation daily for 10 days, it was found that those patients receiving actual CES went to sleep faster, awoke fewer times during the night, spent more time in Stage IV sleep, and reported feeling more rested the following morning. At two year follow up, the CES treated patients were still sleeping normally, while the sham treated patients were not.

Sleep stages are often divided into Stage I, in which there is a feeling of drowsiness, with alpha waves (8-13 cps) and theta waves (4-7 cps) predominating. Stage II is characterized as light sleep in which theta waves predominate. Rapid eye movement (REM) sleep is found in this Stage when beta waves (13-40 cps) invade the theta. Stage III is a deeper, non REM stage of sleep in which theta and delta waves (0-4 cps) predominate, and Stage IV is the deepest, most restful stage of sleep in which delta waves predominate.

Soon a growing number of researchers discovered that CES not only ensured sound, restful sleep for patients suffering from insomnia, but effectively treated stress in the process, as measured by various psychological measuring scales of depression and anxiety.

Feighner studied 21 long term insomniacs in which a global rating scale of sleep was employed. From the change in sleep pattern observed, a two-tailed t test of probability was obtained at the .0002 level. It should be noted that since this was a cross over design, the change given here was computed on the first group of treated patients prior to the cross over.

Flemenbaum studied 28 outpatients who had suffered from insomnia for from 3 to 4 years. They were provided with five, 30 minute CES treatments. The results were scored on a global rating scale, and a 50% improvement in their sleep was found that persisted six months later.

Frankel added a most unusual study to the CES insomnia literature in that half of the patients were treated with 100Hz, while simultaneously the other half were treated with 15Hz, then the two groups were crossed over. It was never explained why those two pulse rates were chosen, and in the data analysis, they were never broken down separately. The study statisticians combined data from both the 100 Hz and 15 Hz patients before the cross-over, then again following the cross-over so that any treatment effects from either Hz separately could not be ascertained.18 That study technique will be evaluated further in the section on recommended clinical treatment procedures with CES.

Gomez studied self withdrawal from methadone maintenance in 28 heroin addicts in a VA hospital. It was discovered that the treated patients, but not the controls, significantly reduced their prn sleep medication requests beginning the third night of the 10 day treatment.

Hearst gave 28 psychiatric outpatients five, 30 minute CES treatments or sham treatments, and had both physicians and the patients complete a global rating of sleep. The treated patients scored 42% higher than did the controls on sleep improvement.

Hozumi and his group studied a group of 27 inpatients with multi-infarct dementia, giving them either real or sham CES for 20 minutes a day for two weeks. They found that in addition to significantly improving their sleep, CES was significantly effective in improving sleep related behavior disorders such as nocturnal wandering and nocturnal delirium.

Kirsch compiled physicians’ ratings for 500 patients previously treated with CES. Among the 500, 135 complained of persistent sleep problems, and although they were treated for various lengths of time, 79% said they had experienced significant improvement of 25% or greater. The average improvement among the over all group was 62%.

Lichtbroun did two double-blind studies of fibromyalgia patients who customarily have very poor sleep. The first group of 30 self rated their sleep pre- and post-study in which they had received one hour of CES or sham CES per day for three weeks. Their self-rated improvement was 72%. Following the same treatment protocol, the second 60 patients rated their sleep as being 82% improved

Moore, gave 17 patients five days of CES, 30 minutes per day in a cross over design. The first group to get treatment prior to the crossover reported a 46% improvement on self rated sleep scales.
Patterson has two studies in the peer reviewed literature which address insomnia. One was a seven year retrospective review of 186 addicts who had been treated with neuroelectric therapy (NET), her version of CES, and the other was a small, 18 patients study of addicts. Sleep improvement was found in the first group to be 56% and in the second group, to be 55%.26,27
Philip withdrew patients from anti-depressant medication so they could be given electroshock therapy. The drugs were tapered with CES for one week. Philip was totally unaware of the ability of longer term CES to effectively treat depression, so while the patients got through their drug abstinence period successfully with 42% better sleep, they still faced the often dreaded electroconvulsive shock therapy.

Rosenthal completed three studies with 9, 18 and 22 patients, respectively, in which a clinical rating scale was used to assess changes in sleep behavior in his subjects. Patients were treated for 30 minutes a day for five days with CES or sham CES, and experienced 50%, 60% and 81% sleep improvement.

Straus gave CES or sham CES to 34 inpatients who suffered from insomnia. The study compared the effects of CES with that of phenobarbital in inducing sleep. The patients’ sleep improved over the one to two week treatment period approximately 33%. CES was rated as good as phenobarbital in inducing sleep, but had none of the adverse side effects.

Tyers completed two studies with fibromyalgia patients in which he gave them CES for one hour a day for three weeks. A10 point self rated sleep questionnaire was completed pre- and post-study and it was found that while in one study the 20 subjects’ sleep improved 79% on the average, the sleep of the 56 patients in the second study only improved 53%.