Clinical study of transcranial direct current stimulation combined with eszopiclone in the treatment of chronic insomnia

doi:10.11958/20230429

Abstract

Abstract:

Objective To investigate the clinical application value of transcranial direct current stimulation (tDCS) combined with eszopiclone in treating chronic insomnia. Methods Sixty-eight patients with chronic insomnia were randomized into the control group (n=35, false tDCS combined with eszopiclone) and the study group (n=33, tDCS combined with eszopiclone). Both groups were treated for 4 weeks. Clinical efficacy after treatment, polysomnography (PSG) results, serum cortisol (CORT) and adrenocorticotropic hormone (ACTH) levels, Pittsburgh Sleep Quality Index (PSQI) scores, Patient Health Questionnaire-9 (PHQ-9) scores, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) scores and adverse reaction were compared between the two groups. Results After 4 weeks of treatment, the total effective rate was higher in the study group (93.94%, 31/33) than that in the control group (74.29%, 26/35, P<0.05). After 2 weeks and 4 weeks of treatment, compared with the control group, the total sleep time (TST) was longer, sleep latency (SL) was shorter, the proportion of stage N3 sleep and sleep efficiency (SE) were higher, microarousal index, the proportion of stage N1 sleep, serum CORT and ACTH levels were lower in the study group (P<0.05). After 4 weeks and 6 months of treatment, PSQI scores and PHQ-9 scores were lower in the study group than those of the control group (P<0.05). After 2 weeks, 4 weeks and 6 months of treatment, GAD-7 scores were lower in the study group than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion tDCS combined with eszopiclone can improve sleep quality in patients with chronic insomnia, reduce anxiety and depression and have long-term effect. The mechanism may be related to the down regulation of serum CORT and ACTH levels in patients.

Key words: chronic insomnia, transcranial direct current stimulation, eszopiclone, polysomnography, sleep quality

CLC Number:

R749.99

Figures/Tables 6

References 22

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组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	病程/月
对照组	35	21/14	30.49±7.01	22.86±2.31	9.89±2.13
研究组	33	17/16	31.09±6.55	23.52±2.14	9.67±2.89
χ²或t		0.496	0.367	1.217	0.357

组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	病程/月
对照组	35	21/14	30.49±7.01	22.86±2.31	9.89±2.13
研究组	33	17/16	31.09±6.55	23.52±2.14	9.67±2.89
χ²或t		0.496	0.367	1.217	0.357

组别	n	治愈	有效	无效	总有效率
对照组	35	12（34.29）	14（40.00）	9（25.71）	26（74.29）
研究组	33	21（63.64）	10（30.30）	2（6.06）	31（93.94）
Z或χ²		2.688^＊＊			4.839^＊

组别	n	治愈	有效	无效	总有效率
对照组	35	12（34.29）	14（40.00）	9（25.71）	26（74.29）
研究组	33	21（63.64）	10（30.30）	2（6.06）	31（93.94）
Z或χ²		2.688^＊＊			4.839^＊

组别	n		TST/min									SE/%								微觉醒指数/（次/h）
组别	n		治疗前			治疗2周			治疗4周			治疗前		治疗2周			治疗4周			治疗前		治疗2周			治疗4周
对照组	35		275.34±25.89			313.97±32.06^a			339.94±44.57^ab			60.88±6.30		69.12±5.56^a			76.29±5.54^ab			18.91±2.95		14.80±2.22^a			11.46±2.43^ab
研究组	33		282.39±27.58			334.97±23.04^a			378.64±31.89^ab			62.14±6.53		75.01±6.89^a			85.10±6.23^ab			19.67±2.56		13.39±2.18^a			9.39±2.02^ab
t			1.088			3.085^＊＊			4.135^＊＊			0.812		3.895^＊＊			6.165^＊＊			1.120		2.634^＊			3.799^＊＊
组别		SL/min								N1期睡眠比例/%								N2期睡眠比例/%
组别		治疗前			治疗2周			治疗4周		治疗前			治疗2周			治疗4周		治疗前			治疗2周			治疗4周
对照组		49.94±6.71			40.11±5.40^a			34.74±3.91^ab		12.56±2.93			8.23±1.66^a			5.34±0.38^ab		51.08±7.94			50.40±5.73			50.23±8.23
研究组		52.39±7.13			36.15±4.96^a			29.24±4.66^ab		12.79±2.74			7.32±1.52^a			4.07±0.38^ab		48.74±8.27			49.36±6.04			50.27±6.24
t		1.460			3.147^＊＊			5.284^＊＊		0.342			2.350^＊			13.794^＊＊		1.187			0.726			0.020
组别				N3期睡眠比例/%											R期睡眠比例/%
组别				治疗前			治疗2周				治疗4周				治疗前				治疗2周				治疗4周
对照组				8.86±2.22			12.85±2.92^a				16.21±1.96^ab				27.51±8.38				28.53±7.03				28.21±8.12
研究组				9.15±2.10			15.18±2.76^a				18.51±3.54^ab				29.31±8.72				28.14±6.95				27.14±6.41
t				0.560			3.389^＊＊				3.287^＊＊				0.870				0.230				0.599