Clinical effect analysis of pulsed electromagnetic fields on primary insomnia

doi:10.3969/j.issn.1672-6731.2023.08.009

Abstract

Abstract:

Objective: To investigate the therapeutic effect of pulsed electromagnetic fields (PEMFs) on primary insomnia. Methods: A total of 120 patients with primary insomnia admitted to the The First Hospital of Hebei Medical University from January to December 2021 were randomly divided into conventional treatment and sham stimulation group (control group) and conventional treatment and PEMFs stimulation group (PEMFs group), with 60 patients in each group. Before and after 2 weeks of treatment, Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality, and Insomnia Severity Index (ISI) was used to evaluate the severity of insomnia. Results: The total effective rate of PEMFs group was higher than that of control group[81.67% (49/60) vs. 41.67% (25/60); χ²=20.306, P=0.000]. After treatment, the total PSQI score (F=228.729, P=0.000), sleep quality (F=87.291, P=0.000), time to fall asleep (F=181.842, P=0.000), sleep time (F=143.355, P=0.000) and ISI score (F=361.348, P=0.000) of the 2 groups were significantly lower than those before treatment. PSQI total score (F=13.297, P=0.000), sleep quality (F=7.573, P=0.007), time to fall asleep (F=9.776, P=0.002), sleep time (F=8.566, P=0.004), and ISI score (F=5.350, P=0.000) in PEMFs group after treatment were significantly lower than those of the control group. Conclusions: PEMFs are safe and effective in the treatment of patient with primary insomnia, which can significantly improve the sleep quality, and can be used as a non-drug treatment for patients with primary insomnia.

Key words: Sleep initiation and maintenance disorders, Electromagnetic field, Electric stimulation therapy

摘要：

目的: 探讨脉冲电磁场（PEMFs）治疗原发性失眠的疗效。方法: 纳入2021年1-12月河北医科大学第一医院收治的120例原发性失眠患者，随机予以常规治疗合并假刺激（对照组）和常规治疗联合脉冲电磁场刺激（PEMFs组），治疗前和治疗后2周采用匹兹堡睡眠质量指数（PSQI）评价睡眠质量、失眠严重程度指数（ISI）评价失眠严重程度。结果: PEMFs组总有效率高于对照组[81.67%（49/60）对41.67%（25/60）；χ²=20.306，P=0.000]。两组患者治疗后PSQI总评分（F=228.729，P=0.000）及睡眠质量（F=87.291，P=0.000）、入睡时间（F=181.842，P=0.000）、睡眠时间（F=143.355，P=0.000）分评分，ISI评分（F=361.348，P=0.000）均低于治疗前；治疗后PEMFs组PSQI总评分（F=13.297，P=0.000）及睡眠质量（F=7.573，P=0.007）、入睡时间（F=9.776，P=0.002）、睡眠时间（F=8.566，P=0.004）分评分，ISI评分（F=5.350，P=0.022）均低于对照组。结论: 脉冲电磁场治疗原发性失眠安全、有效，可显著改善睡眠质量，可以作为原发性失眠的非药物治疗方法。

关键词: 入睡和睡眠障碍, 电磁场, 电刺激疗法

Ya-yun TIAN, Gang LI, Ming-wei WANG, Qi-jun YU, Kai CAO, Qin-ying MA. Clinical effect analysis of pulsed electromagnetic fields on primary insomnia[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(8): 709-715.

田亚云, 李刚, 王铭维, 余启军, 曹凯, 马芹颖. 脉冲电磁场治疗原发性失眠临床疗效分析[J]. 中国现代神经疾病杂志, 2023, 23(8): 709-715.

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References 29

1	Soldatos CR , Allaert FA , Ohta T , Dikeos DG . How do individuals sleep around the world: results from a single-day survey in ten countries?. Sleep Med, 2005, 6: 5- 13. doi: 10.1016/j.sleep.2004.10.006
2	Zhao ZX , Ye JY . Sleep medicine. 2nd ed Beijing: People's Medical Publishing House, 2022: 64.
	赵忠新, 叶京英. 睡眠医学. 2版北京: 人民卫生出版社, 2022: 64.
3	Riemann D , Benz F , Dressle RJ , Espie CA , Johann AF , Blanken TF , Leerssen J , Wassing R , Henry AL , Kyle SD , Spiegelhalder K , Van Someren EJW . Insomnia disorder: state of the science and challenges for the future. J Sleep Res, 2022, 31: e13604. doi: 10.1111/jsr.13604
4	Hu H , Yang W , Zeng Q , Chen W , Zhu Y , Liu W , Wang S , Wang B , Shao Z , Zhang Y . Promising application of pulsed electromagnetic fields (PEMFs) in musculoskeletal disorders. Biomed Pharmacother, 2020, 131: 110767. doi: 10.1016/j.biopha.2020.110767
5	Wei QC , Li Y , He CQ , Yang L . Progress of low frequency pulsed electromagnetic fields against neurological disease. Xun Zheng Yi Xue, 2017, 17: 373- 376. doi: 10.7507/1672-2531.201608041
	魏清川, 李懿, 何成奇, 杨霖. 低频脉冲电磁场治疗神经系统疾病的研究进展. 循证医学, 2017, 17: 373- 376. doi: 10.7507/1672-2531.201608041
6	Psychiatry Branch, Chinese Medical Association . The third edition of Chinese classification and diagnostic criteria for mental disorders (classification of mental disorders). Zhonghua Jing Shen Ke Za Zhi, 2001, 34: 184- 188. doi: 10.3760/j:issn:1006-7884.2001.03.028
	中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版(精神障碍分类). 中华精神科杂志, 2001, 34: 184- 188. doi: 10.3760/j:issn:1006-7884.2001.03.028
7	Buysse DJ , Reynolds CF 3rd , Monk TH , Berman SR , Kupfer DJ . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 1989, 28: 193- 213. doi: 10.1016/0165-1781(89)90047-4
8	Hamilton M . The assessment of anxiety states by rating. Br J Med Psychol, 1959, 32: 50- 55. doi: 10.1111/j.2044-8341.1959.tb00467.x
9	Xu O , Qi P , Zhu QS . Effect of cognitive behavioral therapy with virtual reality in the treatment of insomnia in adolescents. Zhongguo Quan Ke Yi Xue, 2022, 25: 1378- 1382. URL
	徐鸥, 齐培, 祝绮莎. 认知行为疗法联合虚拟现实技术治疗青少年失眠症患者的效果研究. 中国全科医学, 2022, 25: 1378- 1382. URL
10	Okajima I , Miyamoto T , Ubara A , Omichi C , Matsuda A , Sumi Y , Matsuo M , Ito K , Kadotani H . Evaluation of severity levels of the Athens insomnia scale based on the criterion of insomnia severity index. Int J Environ Res Public Healt, 2020, 17: 8789. doi: 10.3390/ijerph17238789
11	Cirelli C , Tononi G . Cortical development, electroencephalogram rhythms, and the sleep/wake cycle. Biol Psychiatry, 2015, 77: 1071- 1078. doi: 10.1016/j.biopsych.2014.12.017
12	Landolt HP , Rétey JV , Tönz K , Gottselig JM , Khatami R , Buckelmüller I , Achermann P . Caffeine attenuates waking and sleep electroencephalographic markers of sleep homeostasis in humans. Neuropsychopharmacology, 2004, 29: 1933- 1939. doi: 10.1038/sj.npp.1300526
13	Jiang B , He D , Guo Z , Mu Q , Zhang L . Efficacy and placebo response of repetitive transcranial magnetic stimulation for primary insomnia. Sleep Med, 2019, 63: 9- 13. doi: 10.1016/j.sleep.2019.05.008
14	Schmid MR , Murbach M , Lustenberger C , Maire M , Kuster N , Achermann P , Loughran SP . Sleep EEG alterations: effects of pulsed magnetic fields versus pulse-modulated radio frequency electromagnetic fields. J Sleep Res, 2012, 21: 620- 629. doi: 10.1111/j.1365-2869.2012.01025.x
15	Lustenberger C , Murbach M , Dürr R , Schmid MR , Kuster N , Achermann P , Huber R . Stimulation of the brain with radiofrequency electromagnetic field pulses affects sleep-dependent performance improvement. Brain Stimul, 2013, 6: 805- 811. doi: 10.1016/j.brs.2013.01.017
16	Hug K , Röösli M . Therapeutic effects of whole-body devices applying pulsed electromagnetic fields (PEMF): a systematic literature review. Bioelectromagnetics, 2012, 33: 95- 105. doi: 10.1002/bem.20703
17	Dorokhov VB , Tkachenko ON , Sakharov DS , Arsenyev GN , Taranov AO . Effects of weak low-frequency electromagnetic field on sleep structure during daytime sleep. Zh Nevrol Psikhiatr Im SS Korsakova, 2021, 121: 65- 70.
18	Mann K , Röschke J . Effects of pulsed high-frequency electromagnetic fields on human sleep. Neuropsychobiology, 1996, 33: 41- 47. doi: 10.1159/000119247
19	Regel SJ , Tinguely G , Schuderer J , Adam M , Kuster N , Landolt HP , Achermann P . Pulsed radio-frequency electromagnetic fields: dose-dependent effects on sleep, the sleep EEG and cognitive performance. J Sleep Res, 2007, 16: 253- 258. doi: 10.1111/j.1365-2869.2007.00603.x
20	Huber R , Schuderer J , Graf T , Jütz K , Borbély AA , Kuster N , Achermann P . Radio frequency electromagnetic field exposure in humans: estimation of SAR distribution in the brain, effects on sleep and heart rate. Bioelectromagnetics, 2003, 24: 262- 276. doi: 10.1002/bem.10103
21	Fritzer G , Göder R , Friege L , Wachter J , Hansen V , Hinze-Selch D , Aldenhoff JB . Effects of short-and long-term pulsed radiofrequency electromagnetic fields on night sleep and cognitive functions in healthy subjects. Bioelectromagnetics, 2007, 28: 316- 325. doi: 10.1002/bem.20301
22	Gulec M , Ozkol H , Selvi Y , Tuluce Y , Aydin A , Besiroglu L , Ozdemir PG . Oxidative stress in patients with primary insomnia. Prog Neuropsychopharmacol Biol Psychiatry, 2012, 37: 247- 251. doi: 10.1016/j.pnpbp.2012.02.011
23	Urnukhsaikhan E , Mishig-Ochir T , Kim SC , Park JK , Seo YK . Neuroprotective effect of low frequency-pulsed electromagnetic fields in ischemic stroke. Appl Biochem Biotechnol, 2017, 181: 1360- 1371. doi: 10.1007/s12010-016-2289-z
24	Castello P , Jimenez P , Martino CF . The role of pulsed electromagnetic fields on the radical pair mechanism. Bioelectromagnetics, 2021, 42: 491- 500. doi: 10.1002/bem.22358
25	De Pedro JA , Pérez-Caballer AJ , Dominguez J , Collía F , Blanco J , Salvado M . Pulsed electromagnetic fields induce peripheral nerve regeneration and endplate enzymatic changes. Bioelectromagnetics, 2005, 26: 20- 27. doi: 10.1002/bem.20049
26	Li Y , Zhao L , Xing X , Lou SJ , He C , Lu CL . Effects of different frequency electromagnetic fields on the differentiation of midbrain neural stem cells. Hang Tian Yi Xue Yu Yi Xue Gong Cheng, 2002, 15: 374- 376. doi: 10.3969/j.issn.1002-0837.2002.05.016
	李怡, 赵仑, 邢萱, 娄淑杰, 何成, 路长林. 5 Hz和20 Hz磁场对中脑神经干细胞分化的影响. 航天医学与医学工程, 2002, 15: 374- 376. doi: 10.3969/j.issn.1002-0837.2002.05.016
27	Sisken BF , Kanje M , Lundborg G , Kurtz W . Pulsed electromagnetic fields stimulate nerve regeneration in vitro and in vivo. Restor Neurol Neurosci, 1990, 1: 303- 309.
28	Lewczuk B , Redlarski G , Zak A , Ziółkowska N , Przybylska-Gornowicz B , Krawczuk M . Influence of electric, magnetic, and electromagnetic fields on the circadian system: current stage of knowledge. Biomed Res Int, 2014, 169459.
29	Waldorff EI , Zhang N , Ryaby JT . Pulsed electromagnetic field applications: a corporate perspective. J Orthop Translat, 2017, 9: 60- 68. doi: 10.1016/j.jot.2017.02.006

观察指标	对照组（n = 60）	PEMFs组（n = 60）	统计量值	P值
性别[例（%）]			0.556	0.456
男性	26（43.33）	22（36.67）
女性	34（56.67）	38（63.33）
年龄 [M（P₂₅，P₇₅），岁]	59.00 （41.00，68.00）	58.50 （36.00，66.00）	- 0.507	0.612
受教育程度（$\bar x \pm s$，年）	12.90 ± 3.41	12.98 ± 3.49	0.132	0.895
病程 [M（P₂₅，P₇₅），年]	4.50 （2.00，9.50）	3.00 （2.00，7.00）	- 0.702	0.483
高血压[例（%）]	11（18.33）	13（21.67）	0.208	0.648
糖尿病[例（%）]	5（8.33）	7（11.67）	0.370	0.543
冠心病[例（%）]	4（6.67）	5（8.33）	—	1.000
高脂血症[例（%）]	10（16.67）	7（11.67）	0.617	0.432
吸烟[例（%）]	4（6.67）	4（6.67）	0.000	1.000
饮酒[例（%）]	6（10.00）	9（15.00）	0.686	0.408

观察指标	对照组（n = 60）	PEMFs组（n = 60）	统计量值	P值
性别[例（%）]			0.556	0.456
男性	26（43.33）	22（36.67）
女性	34（56.67）	38（63.33）
年龄 [M（P₂₅，P₇₅），岁]	59.00 （41.00，68.00）	58.50 （36.00，66.00）	- 0.507	0.612
受教育程度（$\bar x \pm s$，年）	12.90 ± 3.41	12.98 ± 3.49	0.132	0.895
病程 [M（P₂₅，P₇₅），年]	4.50 （2.00，9.50）	3.00 （2.00，7.00）	- 0.702	0.483
高血压[例（%）]	11（18.33）	13（21.67）	0.208	0.648
糖尿病[例（%）]	5（8.33）	7（11.67）	0.370	0.543
冠心病[例（%）]	4（6.67）	5（8.33）	—	1.000
高脂血症[例（%）]	10（16.67）	7（11.67）	0.617	0.432
吸烟[例（%）]	4（6.67）	4（6.67）	0.000	1.000
饮酒[例（%）]	6（10.00）	9（15.00）	0.686	0.408

变异来源	SS	df	MS	F值	P值	变异来源	SS	df	MS	F值	P值
总评分						睡眠效率
处理因素	116.204	1	116.204	13.297	0.000	处理因素	1.350	1	1.350	1.139	0.288
测量时间	1062.604	1	1062.604	228.729	0.000	测量时间	46.817	1	46.817	75.504	0.000
处理因素×测量时间	124.704	1	124.704	26.843	0.000	处理因素×测量时间	6.017	1	6.017	9.703	0.002
组间误差	1031.192	118	8.739			组间误差	139.833	118	1.185
组内误差	548.192	118	4.646			组内误差	73.167	118	0.620
睡眠质量						睡眠障碍
处理因素	3.750	1	3.750	7.573	0.007	处理因素	0.004	1	0.004	0.170	0.897
测量时间	24.067	1	24.067	87.291	0.000	测量时间	1.204	1	1.204	14.511	0.000
处理因素×测量时间	2.400	1	2.400	8.705	0.004	处理因素×测量时间	0.504	1	0.504	6.076	0.015
组间误差	58.433	118	0.495			组间误差	29.058	118	0.246
组内误差	32.533	118	0.276			组内误差	9.792	118	0.083
入睡时间						催眠药物
处理因素	5.400	1	5.400	9.776	0.002	处理因素	2.400	1	2.400	2.832	0.095
测量时间	52.267	1	52.267	181.842	0.000	测量时间	0.150	1	0.150	2.260	0.135
处理因素×测量时间	2.817	1	2.817	9.800	0.002	处理因素×测量时间	0.017	1	0.017	0.251	0.617
组间误差	65.183	118	0.552			组间误差	100.000	118	0.847
组内误差	33.917	118	0.287			组内误差	7.833	118	0.066
睡眠时间						日间功能障碍
处理因素	7.350	1	7.350	8.566	0.004	处理因素	1.837	1	1.837	2.675	0.105
测量时间	66.150	1	66.150	143.355	0.000	测量时间	14.504	1	14.504	43.894	0.000
处理因素×测量时间	5.400	1	5.400	11.702	0.001	处理因素×测量时间	7.004	1	7.004	21.197	0.000
组间误差	101.250	118	0.858			组间误差	81.058	118	0.687
组内误差	54.450	118	0.461			组内误差	38.992	118	0.330

变异来源	SS	df	MS	F值	P值	变异来源	SS	df	MS	F值	P值
总评分						睡眠效率
处理因素	116.204	1	116.204	13.297	0.000	处理因素	1.350	1	1.350	1.139	0.288
测量时间	1062.604	1	1062.604	228.729	0.000	测量时间	46.817	1	46.817	75.504	0.000
处理因素×测量时间	124.704	1	124.704	26.843	0.000	处理因素×测量时间	6.017	1	6.017	9.703	0.002
组间误差	1031.192	118	8.739			组间误差	139.833	118	1.185
组内误差	548.192	118	4.646			组内误差	73.167	118	0.620
睡眠质量						睡眠障碍
处理因素	3.750	1	3.750	7.573	0.007	处理因素	0.004	1	0.004	0.170	0.897
测量时间	24.067	1	24.067	87.291	0.000	测量时间	1.204	1	1.204	14.511	0.000
处理因素×测量时间	2.400	1	2.400	8.705	0.004	处理因素×测量时间	0.504	1	0.504	6.076	0.015
组间误差	58.433	118	0.495			组间误差	29.058	118	0.246
组内误差	32.533	118	0.276			组内误差	9.792	118	0.083
入睡时间						催眠药物
处理因素	5.400	1	5.400	9.776	0.002	处理因素	2.400	1	2.400	2.832	0.095
测量时间	52.267	1	52.267	181.842	0.000	测量时间	0.150	1	0.150	2.260	0.135
处理因素×测量时间	2.817	1	2.817	9.800	0.002	处理因素×测量时间	0.017	1	0.017	0.251	0.617
组间误差	65.183	118	0.552			组间误差	100.000	118	0.847
组内误差	33.917	118	0.287			组内误差	7.833	118	0.066
睡眠时间						日间功能障碍
处理因素	7.350	1	7.350	8.566	0.004	处理因素	1.837	1	1.837	2.675	0.105
测量时间	66.150	1	66.150	143.355	0.000	测量时间	14.504	1	14.504	43.894	0.000
处理因素×测量时间	5.400	1	5.400	11.702	0.001	处理因素×测量时间	7.004	1	7.004	21.197	0.000
组间误差	101.250	118	0.858			组间误差	81.058	118	0.687
组内误差	54.450	118	0.461			组内误差	38.992	118	0.330

变异来源	SS	df	MS	F值	P值
处理因素	63.037	1	63.037	5.350	0.022
测量时间	1029.204	1	1029.204	361.348	0.000
处理因素×测量时间	254.204	1	254.204	89.250	0.000
组间误差	1390.258	118	11.782
组内误差	336.092	118	2.848

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