Tag Archives: insomnia treatment

A View from the Trenches: Why Psychiatry needs CES – Part 4

CES vs. Drugs

I would like to highlight various advantages of CES relative to other existing treatments, especially medications that may not be well appreciated. Take for example, the difficulty faced by primary care physicians and mental health professionals in treating female patients of child bearing age. All available medications have teratogenic risk and are not recommended during pregnancy and breast feeding. Patients desiring to become pregnant have justified concerns about taking psychotropic medication

Current treatment algorithms encourage polypharmacy when initial treatments with a single drug are not effective. While there is some increased response, polypharmacy only increases the side effects burden and can result in untoward drug/drug interactions. These types of problems do not occur with CES.


Many psychotropic medications for the treatments of depression, anxiety and insomnia have discontinuation syndromes. Given the high rate of discontinuation of these medications by patients due to side effects and lack of efficacy, many patients unfortunately suffer when the take a medication prescribed to alleviate their suffering. This does not occur with CES. There are circumstances, for example prior to surgery, when certain psychotropic medications are required to be discontinued. CES does not have to be discontinued prior to surgery.

One my greatest concerns in treating patients with depression, anxiety and insomnia involves suicide. We know increased risk of suicide in depressed patients but it is often global insomnia is a significant risk factor for suicide as well as anxiety/agitation. Although safer than the older tricyclic and tetracylcic antidepressants, the current medications carry a significant risk of death in overdose, especially when combined with other analgesic medications. Too often, the medications we prescribed to prevent suicide become a means through which the patient attempts suicide. In fact, there are black box warnings that these medications may increase suicidal impulses, especially in adolescents. CES does not pose this risk.

As in many developed countries, we are an aging population. The treatment of depression, anxiety and insomnia in the geriatric patients with medications present unique challenges due to the increased risk of adverse side effects. These side effects include the risk of falls and motor vehicle accidents.

Again, the number of medications taken in our geriatric patients continues to increase. Thus risk of adding psychotropic medications to their other medications poses additional drug/drug interactions and side effect burden. CES avoids this disadvantage and provides a safe alternative to patients, their families and care givers. Furthermore, missing a CES treatment does not carry the risks of missing doses of psychotropic medications in this population.

I have worked with primary care physicians in our federally qualified health clinics on the Big Island. They, like others across the country, are stymied and frustrated by the challenge of treating chronic pain. In particular, they face patients with bona fide pain but who also have depression, anxiety, insomnia and substance abuse. With regards to treatment interventions, they are damned if the do and damned if the don’t treatment with various classes of analgesic medications, including narcotic medications.

They are particularly afraid of the increasing fatalities occurring with the use of narcotic analgesic medications in combination with benzodiazepines and antidepressant medications. They welcome alternatives to medications for those patients whose emotional distress intensifies their suffering and pain sensation. CES could provide a safe alternative for them that do not currently exist.

In summary, CES represents as safe intervention for conditions for which existing treatments, especially pharmacologic and invasive interventions pose significant risk for adverse side effects. It is especially beneficial in defined populations. These include those who refuse medications and psychotherapy, dual diagnosed patients, geriatric patients, females of child bearing age and during pregnancy.

By Jason Worchel, M.D. is a noted psychiatrist and Director of the Hilo Mental Health Center in Hilo, HI. This post is from a paper written by Dr. Worchel in his testimony before the F.D.A. concerning the effectiveness and safety of CES from the perspective of a practicing psychiatrist.

Why medicating is a temporary fix for poor sleep and how CES can help me sleep better

Have you already tried many of the standard pharmaceutical methods known to western medicine to re-establish normal sleeping patterns without success?


Have you found yourself asking:

  • How come my medications no longer help me sleep, or help me go to sleep?
  • What can I use to help me get to sleep without the danger of serious side effects?
  • What can I use besides drugs to help me sleep better? (The Big Question)

If so you are not alone: Pharmaceutical drugs do not treat the causes of poor sleep, only the symptoms. Often making the initial causes worsen over time.

The reasons this occurs are simple, and can be debilitating

Falling out of a healthy sleep pattern happens slowly. The brain works from habit, striving to maintain that which would be considered “the neuro-chemical norm” for us as individuals. Maintaining a healthy balance for our overall well being is the brains number one assignment. It takes time for the brain to form new habits. Adding pharmaceuticals to the mix begins creating a new habit for the brain. The brain will cease to make the natural chemistry that is being replaced by that of the drugs. Read Report

Over time the brain becomes accustom to not making or even calling out for the making of the “replaced” neuro-chemicals. Leaving an individual depleted of that which would be normal for the brain to manufacture, and reliant on the drugs being ingested. Having this “new habit” fully in place things begin to deteriorate further as one develops a higher tolerance for the medications. Requiring a higher dose with continued use, eventually the dosage needed for the desired effect will exceed what is considered safe for ingestion. At which point continual use no longer has positive effect.

HENCE: My medications no longer help me sleep, or even help me go to sleep
Remember “The Big Question”?
What Can I Use Besides Drugs To Help Me Sleep Better?

The Answer: Cranial Electro Therapy Stimulation (CES) Treats the Causes of Poor Sleep Rather than the Symptoms!!

  • CES uses the natural processes of the brain to reset an individual’s sleep clock (link to ces and insomnia page under cesultra tab)
  • There are no known serious side effects from the use of CES.
  • CES re-adjusts the natural neuro-chemical output of the brain without the addition of outside harmful chemicals.
  • CES relieves the stress caused by sleep disorders, anxiety, and depression.

CES has been available for clinical use since the 1950’s and was invented in Russia. Originally CES was referred to as “electrosleep”.

CES uses a gentle electrical impulse applied to the ear lobes which is anatomically transferred to the brain. The tendency is for the frequency to cause the brain to release the neuro-chemistry needed for healthy sleep. The U.S. Food and Drug Administration allows the medical claims of “insomnia, anxiety, and depression” for CES use. Anxiety and depression are two common triggers of insomnia or sleep problems in general. Depression and anxiety will begin to cause sleep problems in people who haven’t previously experienced difficulties with sleep. A vicious cycle will often begin to take place in individuals whereby: the more anxious a person becomes the more they suffer from sleep disorders; the more one suffers from sleep disorder the more anxious one becomes, and on and on. The same is true of those who suffer from depression.

By using the natural processes of the brain to reset levels of normal neuro-chemicals in the brain CES causes a “new and healthy habit” for the brain to fall back into. In general end users report a substantial decline in sleep problems within 2 weeks of daily use. Read CES Experience.

Take Control: Reset Your Sleep Clock With The CES Ultra

Portable Affordable, and Easy To Use

  • Hand held unit designed to be used at home.
  • Use while reading, watching television or, just relaxing at your computer
  • A fraction of the cost of Doctors visits and prescription drugs ($349.00 U.S.D)
  • The human system was not designed to deal with the daily stresses of our modern existence. 10,000 years ago our toughest decisions were along the lines of: Do I want to eat nuts or berries for lunch, and should I take a nap now or later. The daily demands that we put on our selves have changed far faster than what the normal course of evolution has been able to keep up with. It is no wonder that we find ourselves felling stressed out and overloaded as often as we do. The CES Ultra is a safe, natural and convenient way to dial down your stress by redeveloping a healthy sleep cycle…


How to Optimize Your Sleep

Dr. Mercola’s top guidelines for promoting good sleep.

  1. Avoid watching TV or using your computer at night—or at least about an hour or so before going to bed—as these technologies can have a significantly detrimental impact on your sleep. TV and computer screens emit blue light; nearly identical to the light you’re exposed to outdoors during the day. This tricks your brain into thinking it’s still daytime, thereby shutting down melatonin secretion.

Under normal circumstances, your brain starts secreting melatonin between 9 or 10 pm, which makes you sleepy. When this natural secretion cycle is disrupted, due to excessive light exposure after sunset, insomnia can ensue.

  1. Sleep in complete darkness, or as close to it as possible. Even the slightest bit of light in the room can disrupt your internal clock and your pineal gland’s production of melatonin and serotonin. So close your bedroom door, and get rid of night-lights. Refrain from turning on any light at all during the night, even when getting up to go to the bathroom. Cover up your clock radio.

Make sure to cover your windows—I recommend using blackout shades or drapes.

  1. Keep the temperature in your bedroom no higher than 70 degrees F. Many people keep their homes and particularly their upstairs bedrooms too warm. Studies show that the optimal room temperature for sleep is between 60 to 68 degrees. Keeping your room cooler or hotter can lead to restless sleep. This is because when you sleep, your body’s internal temperature drops to its lowest level, generally about four hours after you fall asleep. Scientists believe a cooler bedroom may therefore be most conducive to sleep, since it mimics your body’s natural temperature drop.
  2. Take a hot bath 90 to 120 minutes before bedtime. This increases your core body temperature, and when you get out of the bath it abruptly drops, signaling your body that you are ready for sleep.
  3. Check your bedroom for electro-magnetic fields (EMFs). These can disrupt your pineal gland and the production of melatonin and serotonin, and may have other negative effects as well. To do this, you need a gauss meter. You can find various models online, starting around $50 to $200. Some experts even recommend pulling your circuit breaker before bed to shut down all power in your house.
  4. Move alarm clocks and other electrical devices away from your bed. If these devices must be used, keep them as far away from your bed as possible, preferably at least three feet. This serves at least two functions. First, it can be stressful to see the time when you can’t fall asleep, or wake up in the middle of the night. Secondly, the glow from a clock radio can be enough to suppress melatonin production and interfere with your sleep. Cell phones, cordless phones and their charging stations should ideally be kept three rooms away from your bedroom to prevent harmful EMFs.

Sleeping Well Is Part of a Healthy Lifestyle Plan

Find how Sleep Better With CES Ultra

There’s convincing evidence showing that if you do not sleep enough, you’re really jeopardizing your health. Everybody loses sleep here and there, and your body can adjust for temporary shortcomings. But if you develop a chronic pattern of sleeping less than five or six hours a night, then you’re increasing your risk of a number of health conditions, including weakening your immune system and increasing your risk of degenerative brain disorders. If you’re feeling anxious or restless, try using the Emotional Freedom Techniques (EFT), which can help you address any emotional issues that might keep you tossing and turning at night.

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%.