The effects of repeated transcranial direct current stimulation on sleep quality and depression symptoms in patients with major depression and insomnia

Qi Zhou; Chang Yu; Haihang Yu; Yuanyuan Zhang; Zhiwang Liu; Zhenyu Hu; Ti-Fei Yuan; Dongsheng Zhou

doi:10.1016/j.sleep.2020.02.003

The effects of repeated transcranial direct current stimulation on sleep quality and depression symptoms in patients with major depression and insomnia

Sleep Med. 2020 Jun:70:17-26. doi: 10.1016/j.sleep.2020.02.003. Epub 2020 Feb 20.

Authors

Qi Zhou¹, Chang Yu¹, Haihang Yu¹, Yuanyuan Zhang¹, Zhiwang Liu¹, Zhenyu Hu¹, Ti-Fei Yuan², Dongsheng Zhou³

Affiliations

¹ Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
² Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China. Electronic address: ytf0707@126.com.
³ Ningbo Kangning Hospital, Ningbo, Zhejiang, China. Electronic address: wyzhouds@sina.com.

PMID: 32179428
DOI: 10.1016/j.sleep.2020.02.003

Abstract

Importance: Although several strategies using transcranial direct current stimulation (tDCS) have been investigated to treat major depressive disorder (MDD), the efficacy of this treatment for patients with MDD who also have insomnia is unclear.

Objective: To observe the effects of tDCS on sleep quality and depressive symptoms in patients with MDD who have insomnia.

Methods: We conducted a randomized, double-blinded study involving adults with major depression and insomnia. We randomly assigned patients to either add tDCS or to sham tDCS to their regular treatment. After randomization, we treated a total of 90 patients at the Kangning Hospital, Ningbo, China. We allocated 47 patients to the tDCS group and 43 to the sham tDCS group. The tDCS treatment procedure included 20 sessions of 2-mA stimulation of the dorsolateral prefrontal cortex (DLPFC) for 30 min, which was followed by four weekly treatments. The anode and cathode electrodes were placed on the left and right DLPFC, respectively. We recorded the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Inventory (PSQI), and Polysomnography (PSG) at Day 1 and Day 28.

Results: Compared with the sham tDCS group, the active tDCS group showed improved total scores of SAS and SDS. PSQI total score and all PSQI sub-divisions, except for "sleep duration and sleep efficiency," significantly improved after treatment. We also observed that tDCS affected sleep architecture, by increasing total sleep time and improving sleep efficiency through PSG.

Conclusions: Our study demonstrated the effect of tDCS on sleep quality and depressive symptoms in patients with MDD and insomnia. These results suggested that tDCS stimulation not only improved symptoms of depression and anxiety but also had a positive effect on sleep quality in patients with MDD. For patients with depression and insomnia, tDCS stimulation could be a good supplement to drugs.

Keywords: Insomnia; Major depression; Polysomnography (PSG); Transcranial direct current stimulation (tDCS).

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Depression
Depressive Disorder, Major* / complications
Depressive Disorder, Major* / therapy
Double-Blind Method
Humans
Prefrontal Cortex
Sleep
Sleep Initiation and Maintenance Disorders* / therapy
Transcranial Direct Current Stimulation*
Treatment Outcome