144 Participants Needed

Transcranial Magnetic Stimulation for Insomnia

WK
Overseen ByWilliam Killgore, Ph.D.
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a treatment called Transcranial Magnetic Stimulation (TMS) to determine its effectiveness in improving sleep for people with insomnia. Participants will receive TMS targeted at different brain areas over a two-to-three week period to assess its long-term impact on sleep, up to three months. The study includes four groups: three will receive active TMS targeting different brain areas, and one will receive a sham (inactive) treatment. Suitable candidates for this trial are those diagnosed with insomnia who experience moderate to severe sleep issues. As an unphased trial, this study allows participants to contribute to innovative research that could lead to new sleep treatments.

Will I have to stop taking my current medications?

The trial requires that participants do not use certain prescription medications that can influence seizure threshold or neuroimaging findings. If you are taking such medications, you may need to stop them to participate.

What prior data suggests that Transcranial Magnetic Stimulation is safe for treating insomnia?

Studies have shown that Transcranial Magnetic Stimulation (TMS) is generally safe. TMS uses magnetic fields to stimulate the brain and has mostly been used to treat depression. Researchers are also exploring its use for other conditions, such as insomnia.

Research indicates that TMS is well-tolerated, with most people experiencing only mild side effects like headaches or scalp discomfort, which usually resolve on their own. Theta burst stimulation (TBS), a specific type of TMS used in this study, is also considered safe. However, due to its novelty, doctors recommend using it with caution.

Overall, TMS is a non-invasive and straightforward procedure. Following all safety guidelines during treatment is important to ensure the best possible experience for participants.12345

Why are researchers excited about this trial?

Researchers are excited about transcranial magnetic stimulation (TMS) for insomnia because it offers a non-invasive approach that directly targets specific brain areas involved in sleep regulation. Unlike traditional insomnia treatments such as cognitive-behavioral therapy or medications like benzodiazepines and non-benzodiazepine hypnotics, TMS uses magnetic fields to stimulate neurons without the need for drugs. This technique targets areas like the Posterior Cingulate Cortex, Inferior Parietal Lobule, and Dorsomedial Prefrontal Cortex, potentially reducing side effects commonly associated with medication. Additionally, the precise targeting of brain regions could lead to quicker and more effective results, offering new hope for those struggling with sleep disorders.

What evidence suggests that this trial's treatments could be effective for insomnia?

This trial will compare different active stimulation targets of transcranial magnetic stimulation (TMS) for treating insomnia, including the Posterior Cingulate Cortex, Inferior Parietal Lobule, and Dorsomedial Prefrontal Cortex, along with a sham stimulation group. Studies have shown that TMS can help people with insomnia sleep better. One study found that individuals who received TMS treatment were less likely to experience a return of insomnia within three months compared to those who did not receive the treatment. Additionally, a review of several studies demonstrated that TMS could effectively help with insomnia, especially when depression is also present. While some research highlights limitations, the overall findings suggest that TMS could be a promising treatment for improving sleep in people with insomnia.678910

Are You a Good Fit for This Trial?

This trial is for individuals suffering from insomnia. Participants must pass an initial screening, including a psychological interview and at-home sleep monitoring. They should be willing to undergo physical exams, wear sleep monitors nightly, and attend 10 lab visits over two-to-three weeks for treatment sessions.

Inclusion Criteria

* Must score in the moderate or higher range on the Insomnia Severity Index (ISI ≥ 15)
* Must meet the criteria for DSM-5 insomnia disorder as determined by a clinical interview with a board-certified sleep medicine physician.
* Sex ratio will be set to \~50% males; \~50% females
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 virtual visit, 1 in-person visit

Pre-Intervention Monitoring

Participants undergo a week-long at-home monitoring phase with sleep and brain wave monitors

1 week
At-home monitoring

Treatment

Participants receive 10 sessions of cTBS or sham stimulation over 2-3 weeks, with cognitive testing and brain scanning

2-3 weeks
10 in-person visits

Post-Intervention Monitoring

Participants continue at-home monitoring for 7 nights and complete a final close-out visit

1 week
1 in-person visit, at-home monitoring

Follow-up

Participants complete online assessments and a psychological interview at 1-month and 3-months post-study

3 months
Online assessments

What Are the Treatments Tested in This Trial?

Interventions

  • Transcranial Magnetic Stimulation (TMS)
Trial Overview The study tests if transcranial magnetic stimulation (TMS) can improve sleep in insomniacs by administering it repeatedly over two weeks. It compares the effects of TMS on different brain areas versus sham (inactive) stimulation to see which leads to better long-term sleep improvements.
How Is the Trial Designed?
4Treatment groups
Active Control
Placebo Group
Group I: Active Stimulation - Posterior Cingulate CortexActive Control1 Intervention
Group II: Active Stimulation - Inferior Parietal LobuleActive Control1 Intervention
Group III: Active Stimulation - Dorsomedial Prefrontal CortexActive Control1 Intervention
Group IV: Sham StimulationPlacebo Group1 Intervention

Transcranial Magnetic Stimulation (TMS) is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Transcranial Magnetic Stimulation (TMS) for:
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Approved in European Union as Transcranial Magnetic Stimulation (TMS) for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Arizona

Lead Sponsor

Trials
545
Recruited
161,000+

U.S. Army Medical Research Acquisition Activity

Collaborator

Trials
26
Recruited
10,500+

Published Research Related to This Trial

Theta burst stimulation (TBS) is a promising technique for altering brain excitability, with a review of studies showing that adverse events were mostly mild and occurred in only 5% of subjects, indicating a generally safe profile.
Despite its safety, TBS carries a theoretical higher risk of seizures compared to other stimulation methods, necessitating cautious application and further research into its dosing parameters to better understand seizure risks.
Safety of theta burst transcranial magnetic stimulation: a systematic review of the literature.Oberman, L., Edwards, D., Eldaief, M., et al.[2022]
Repetitive transcranial magnetic stimulation (rTMS) has gained popularity for its ability to modulate brain activity, but safety considerations are crucial, especially with the recent updates to safety guidelines published in 2021.
The guidelines emphasize the importance of screening for risks, monitoring for adverse events, and specific safety measures when using rTMS, particularly in patients with conditions like stroke and traumatic brain injury.
Safety Review for Clinical Application of Repetitive Transcranial Magnetic Stimulation.Kim, WS., Paik, NJ.[2023]
In a safety and efficacy study involving a 26-year-old man with severe traumatic brain injury (TBI), a 6-week rTMS protocol showed no adverse events, indicating it is a safe treatment option for individuals in a minimally conscious state.
The rTMS treatment was associated with a trend toward significant neurobehavioral improvements and enhanced neural conduction, suggesting its potential to facilitate recovery in patients with severe TBI.
Repetitive transcranial magnetic stimulation-associated neurobehavioral gains during coma recovery.Louise-Bender Pape, T., Rosenow, J., Lewis, G., et al.[2016]

Citations

Effectiveness of TES and rTMS for the Treatment of InsomniaThis review aims to examine the effectiveness of randomized sham-controlled trials of TES and rTMS in improving insomnia and examine potential moderators ...
The effects of transcranial magnetic stimulation on patients ...Previous studies have indicated that patient's treated with rTMS had the lowest relapse rate within 3 months compared to insomnia patients who received ...
A Meta-Analysis of the Effectiveness of Transcranial ...Most RCTs studying TMS/tDCS in insomnia reported high comorbidity with depression. Keywords: Transcranial magnetic stimulation; Insomnia; ...
Impact of deep transcranial magnetic stimulation on insomnia ...Our results suggest that dTMS holds promise to improve insomnia outcomes in patients with TRD. However, the study's limitations, including its ...
Effect of Insomnia on Repetitive Transcranial Magnetic ...Our results suggest that while baseline insomnia is not associated with response to TMS treatment, treating insomnia may affect the trajectory of TMS therapy.
Transcranial magnetic stimulationTranscranial magnetic stimulation (TMS) is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression.
Safety of Theta Burst Transcranial Magnetic StimulationBased on this review, TBS appears to be a safe and efficacious technique. However, given its novelty, it should be applied with caution.
TMS (Transcranial Magnetic Stimulation): What It IsTranscranial magnetic stimulation uses a magnet to influence brain electrical activity. It's effective in treating depression and other mental health ...
Transcranial Magnetic Stimulation (TMS) in the Treatment ...TMS is a non-invasive treatment that uses pulsed magnetic fields to induce an electric current in a localized region of the cerebral cortex.
Safety and recommendations for TMS use in healthy ...This is the third article on safety of use of repetitive Transcranial Magnetic Stimulation (rTMS) in clinical practice and research following by eleven years ...
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