Kayumov L, Soare K, Serbine O, Kotlyar B, Simkhovich Z, Goldstein Y, Gavrilov D, Gavrilov D, Levin Y, Shapiro CM

Introduction: The close relationship between insomnia and anxiety is well established. Anxious patients have difficulties maintaining sleep, they spend less time in deep sleep and their sleep is more fragment that that of normals. Traditional approaches have emphasized pharmacological treatment of insomnia.

Benzodiazepines have become the most widly prescribed of all pharmaceuticals. Concern has been expressed however about their potential to cause dependency associated with self-dosing management. A non-pharmacological method ˝ ýbrain music therapyţ has been recently developed for treatment of some psychosomatic symptoms. This method allows establishing the most effective rhythmic and tonal parameters creating meditative conditions in patients by influencing the bioelectrical brain activity in the process of music therapy depending on the individual EEG.

Subsequently EEG patterns are converted into unique music recorder on a personalized compact disc with listening instructions catered on each individual. Brain music therapy because of its more favorable side-effect profile may represent a possible alternative for therapeutic management of insomnia and anxiety. The purpose of the recent study was to assess the effectiveness of brain music therapy for treatment of insomnia in anxious patients using objective actigraphic measures and psychometric testing.

Methods: Eighteen volunteers who had complained of symptoms of insomnia of at least two years duration and who had scored above 50 on the Zung Self Rating Anxiety Scale were recruited for participation in the study. Patients were divided into two groups on a double-blind randomized basis. Experimental group I comprised ten insomniacs (7 females and 3 males, aged 41.6▒5.8) who where provided with their authentic ýbrain musicţ(computerized or composed during neurofeedback session). Placebo group II of eight patients (5 females and 3 males, aged 42.8▒7.8) who received compact disks with brain music of a different subject. The duration of the treatment, which entailed listening to the music on a daily basis, was four weeks. Athens Insomnia Scale and actigraphy were used for assessment of subjective and objective quality of sleep. Forty eight-hour actigraphic recordings were performed before and after 4 weeks of brain music therapy. Average sleep on set latency (SOL), total sleep time (TST), and amount of intervening wakefulness were determined. Affective status of the patients was controlled by using the CES Depression Scale. Participants from both groups had slightly elevated scores (19.6▒3.8 and 20▒5.4 respectively; P>.05). Statistical analysis was performed using the independent samplesÝ t-test in the SPSS statistical software package with significance set at p<0.05. Bonferoni correction was used for multiple variable analyses.

Results: Both authentic and placebo brain music reduced anxiety scores with more pronounced effects observed in the experimental group (58.1▒2.8 vs. 314.6 and 60▒ 5.6 vs. 46.5▒6.1 respectively, p<. 01). There was a dramatic improvement in sleep quality as judged by the Athens Insomnia Scale (p<.001). However there was no significant difference between the effect of authentic and placebo brain music. Interestingly some actigraphic parameters characterizing insomnia in anxious patients were found to be significantly improved only in the experimental group of patients who were using authentic brain music therapy. Amount of intervening wakefulness was significantly less following brain music therapy (p=. 02). The patients had a significant increase in TST (p=.004). SOL remained unchanged before and after brain music treatment (p>.05).

Conclusions:In the study a 4-week regiment of brain music therapy was shown to be of value in reducing symptoms of anxiety and insomnia as evidence by psychometric testing. Objective actigraphic measures of insomnia have been improved in the group of anxious insomniacs treated with endogenously generated brain music. Brain music therapy is a useful alternative to pharmaceutical therapy for treating these conditions.