Neurofeedback for insomnia: a pilot study of Z-score SMR and individualized protocols

Disclaimer: The content below was generated with the assistance of AI and then reviewed and edited by BrainMaster Technologies, Inc. It is provided for educational and informational purposes only and does not constitute medical advice.

Overview #

This pilot study investigates whether Z-Score neurofeedback, using either SMR-based protocols or individualized sQEEG-guided protocols, may support improvements in insomnia symptoms. The work revisits classic SMR insomnia research using modern digital neurofeedback systems and standardized Z-Score training methods.

Background #

Insomnia affects an estimated 20–30% of U.S. adults and contributes to significant personal and economic burden. Traditional treatments—including cognitive behavioral therapy and pharmacotherapy—can be limited by access, side effects, or required expertise. Earlier SMR findings (1960s–1980s) suggested neurofeedback could benefit sleep regulation, but equipment limitations restricted widespread clinical use.

Study Purpose #

The primary aim was to compare treatment effects between:

• Z-Score SMR protocol (training at Cz/C4 with SMR reward and theta/high-beta inhibition).

• Z-Score individualized protocol (targeting the highest abnormal sQEEG sites using HAS4 methodology).

Methods #

• Design: Single-blind pilot trial.

• Participants: 12 eligible adults with DSM-IV Primary Insomnia; 8 completed treatment.

• Intervention: Fifteen 20-minute neurofeedback sessions.

• Measures: ISI, PSQI, daily sleep diaries, MMPI-2-RF, Quality of Life Index, and sQEEG assessments.

Key Findings #

• Significant improvement across all primary subjective sleep measures (ISI, PSQI).

• Post-treatment sleep efficiency exceeded diagnostic cutoffs.

• QOLI scores improved, indicating better daytime functioning.

• sQEEG showed reductions in delta (sleepiness) and beta (arousal) activity.

• Six-month follow-up: 5 of 6 respondents maintained non-insomnia status.

• SMR protocol was at least as effective as individualized training and required less complexity.

Safety & Tolerability #

• No adverse events were reported.

• Dropouts were unrelated to treatment.

• Neurofeedback was well-tolerated and non-invasive.