베타 감소 뉴로피드백 훈련이 수면의 질에 미치는 영향†
The Effect of Beta Neurofeedback Training on the Quality of Sleep
권윤나 (덕성여자대학교 심리학과)
최승원 (덕성여자대학교)
- 다운로드 수
- 조회수
초록
베타 감소 뉴로피드백 훈련이 수면의 질이 좋지 못한 일반인을 대상으로 수면에 어떠한 영향을 미치는지 효과를 확인하였다. 연구대상자들은 사전에 온라인을 통해서 Pittsburgh 수면의 질 척도, 불면증 심각도 척도, 수면 전 각성척도, Epworth 낮 졸리움 척도를 실시하였다. 사전에 실시한 척도 중 Pittsburgh 수면의 질 척도 점수 5점 이상의 대상자만을 선발하였다. 최종 선발된 15명의 연구대상자들은 Beta 감소 뉴로피드백 훈련 집단, SMR 강화 뉴로피드백 훈련 집단, 이완훈련 집단으로 각각 5명씩 무선배정 되었다. 대상자들은 6주 간의 수면일지를 작성하도록 하였고, 작성 2주 후 뉴로피드백 훈련이 실시되었다. 뉴로피드백 훈련은 총 4세션으로, 세션당 4회/10분으로 훈련이 실시되었다. 뉴로피드백 훈련이 종료된 후 사후 검사를 실시하였고, 2주 후 추적검사가 실시되었다. 연구 결과, Beta 감소 뉴로피드백 훈련 집단은 다른 두 집단과 달리 Pittsburgh 수면의 질 척도, 불면증 심각도 척도, 수면 전 각성 척도에서 유의미하게 감소되었다. 수면일지를 통해서 알아본 주관적 수면상태에서는 Beta 감소 뉴로피드백 훈련 집단의 수면효율이 다른 두 집단과 달리 유의미하게 증가하였다. 이러한 경향은 추적검사 때 까지 유지되었다. 끝으로 본 연구의 의의, 제한점과 미래 연구에 대한 제안점이 논의되었다.
- keywords
- 뉴로피드백, 불면증, 수면, 과다각성, Beta 감소, neurofeedback, insomnia, sleep, hyperarousal, beta decrease.
Abstract
Insomnia is a sleeping problem that is experienced by many people at least once in their lifetimes. Neurofeedback training is known to be effective for treating insomnia. However, neurofeecback training for insomnia generally SMR protocol. Recently, hyperarousal theory is supported by relevance to occurrence and maintenance in insomnia. It is known that patients with insomnia have increased psychophysiological indicators such as a high Beta frequency. Despite this evidence, a beta decrease neurofeedback protocol has not yet been developed. Therefore, the objective of this study is the development of a new neurofeedback training protocol for insomnia. Several questionnaires were used for selection of participants and administration of the pre-test: the Pittsburgh Sleep Quality Index(PSQI), the Insomnia Severity Index(ISI), the Pre-Sleep Arousal Scale(PSAS), and the Epworth Sleepiness Scale(ESS). 15 participants were randomly assigned to receive beta decrease neurofeedback(n=5) or SMR increase neurofeedback(n=5) or relaxation training(n=5). Four days during the course of 2 weeks of Neurofeedback and relaxation training was performed, and the neurofeedback sessions took place 4 times a day(10min/times), for a total of 4 sessions. At the end of training, the results were assessed for the post-test, and also during a 2 week follow-up period. As a result, the PSQI, ISI, PSAS scores of beta neurofeedback group significantly decreased. To conclude, study limitations are discussed as well as suggestion for future studies.
- keywords
- 뉴로피드백, 불면증, 수면, 과다각성, Beta 감소, neurofeedback, insomnia, sleep, hyperarousal, beta decrease.
참고문헌
건강보험심사평가원 (2007). 건강보험통계연보, 국민건강보험공단.
김린 (2001). 불면증의 진단과 치료. 대한신경과학회 춘계학술대회, 36-45.
김선영 (2014). 마음챙김 명상을 결합한 인지행동치료가만성 불면증 환자의 수면에 미치는 효과: 인지행동치료와의 비교. 덕성여자대학교 일반대학원 석사학위 청구논문.
김석주 (2009). 불면증의 약물치료. Journal of Korean Medical Association, 52(7), 719-726.
김지혜 (2011). 음악을 사용한 점진적 근육이완법이 사회복귀시설 정신분열병 환자의 불안과 스트레스에미치는 영향. 명지대학교 사회교육대학원 석사학위청구논문.
박병운 (2004). 뇌파밴드별 상호연관성에 따른 뇌기능의최적화연구. 한국정신과학회 학술대회논문집, 21, 103-108.
신수진, 황은희 (2008). 불면증을 호소하는 성인의 주관적 수면 평가와 객관적 수면 평가. 대한임상건강증진학회지, 8(3), 141-149.
양혜련, 이재식 (2010). 뉴로피드백 훈련이 회상기억과재인기억에 미치는 효과. 감성과학, 13(4), 647-658.
이성훈, 이홍식, 유계준, 김소희 (1988). 성인 수면 질환의 빈도 연구. 대한의학회지, 31(6), 657-664.
임정화, 성우용 (2014). 뇌파를 이용한 생기능자기조절(뉴로피드백) 훈련에 대한 임상연구 동향–2000년부터 2013년까지 국내 학술지 논문을 중심으로. 대한한방신경정신과학회지, 25(3), 271-286.
장창현, 김석현, 오동훈 (2013). 불면증의 인지행동치료. Hanyang Medical Reviews, 33, 210-215.
조영은 (2010). 스트레스와 인지적 과정이 불면증에 미치는 영향. 고려대학교대학원 석사학위 청구논문.
조용원 (2004). 수면척도와 수면위생. 대한수면학회지, 1(1), 12-23.
채규영 (2007). 수면의 생리. Korean Journal of Pediatrics, 50(8), 711-717.
최승원, 조혜현, 허지원, 김기성, 정선용, 설재현 (2012). neurofeedback 입문. 서울: 시그마프레스.
Altevogt, B. M., & Colten, H. R. (2006). Sleep disorders and sleep deprivation: An unmet public health problem. Washington DC: National Academies Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180-189.
Arns, M., Feddema, I., & Kenemans, J. L. (2014). Differential effects of theta/beta and SMR neurofeedback in ADHD on slep onset latency. Frontiers In Human Neuroscience, 8.
Bastien, C. H., St-Jean, G., Turcotte, I., Morin, C. M., Lavallée, M., & Carrier, J. (2009). Sleep spindles in chronic psychophysiological insomnia. Journal of psychosomatic research, 66(1), 59-65.
Batty, M. J., Bonnington, S., Tang, B. K., Hawken, M. B., & Gruzelier, J. H. (2006). Relaxation strategies and enhancement of hypnotic susceptibility: EEG neurofeedback, progressive muscle relaxation and self-hypnosis. Brain research bulletin, 71(1), 83-90.
Bell, J. S. (1979). The use of EEG theata biofeedback in the treatment of a patient with sleep-onset insomnia. Biofeedbackand Self-regulation, 4(3), 229-236.
Besset, A., Villemin, E., Tafti, M., & Billiard, M. (1998). Homeostatic process and sleep spindles in patients with sleep-maintenance insomnia (SMI):Effect of partial (21 h) sleep deprivation(PSD). Electroencephalography and clinical neurophysiology, 107(2), 122-132.
Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep medicine reviews, 1(2), 97-108.
Bonnet, M. H., & Arand, D. L. (1998). The consequences of a week of insomnia II: Patients with insomnia. Sleep, 21(4), 359-370.
Bonnet, M. H., & Arand, D. L. (2010). Hyperarousal and insomnia: state of the science. Sleep medicine reviews, 14(1), 9-15.
Budzynski, T. H. (1973). Biofeedback procedures in the clinic. Seminars in psychiatry, 5(4), 537-547.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The pittsburgh sleep quality index: anew instrument for psychiatric practice and research. Psychiatry Research, 29, 193-213.
Cash, S. S., Halgren, E., Dehghani, N., Rossetti, A. O., Thesen, T., Wang, C., & Madsen, J. R. (2009). The human K-complex represents an isolated cortical down-state. Science, 324(5930), 1084-1087.
Centers for Disease Control and Prevention. (2015). Sleep and Sleep Disorders. Retrieved from https://www.cdc.gov/sleep/index.html
Choi, S. J., & Kim, K. S. (2010). The effects of sleep restriction-emphasized cognitive behavioral therapy for insomnia on sleep with chronic insomniacs: A preliminary study. J Korean Sleep Res Soc, 7(7), 49-56.
Cortoos, A., De Valck, E., Arns, M., Breteler, M. H., & Cluydts, R. (2010). An exploratory study on the effects of tele-neurofeedback and tele-biofeedback on objective and subjective sleep inpatients with primary insomnia disorder. Applied Psychophysiology and Biofeedback, 35(2), 125-134.
De Gennaro, L., Ferrara, M., & Bertini, M. (2001). The boundary between wakefulness and sleep:Quantitative electroencephalographic changes during the sleep onset period. Neuroscience, 107, 1-11.
De Gennaro, L., & Ferrara, M. (2003). Sleep spindles:An overview. Sleep Medicine Reviews, 7(5), 423-440.
Friel, P. N. (2007). EEG biofeedback in the treatment of attention deficit/hyperactivity disorder. Alternative Medicine Review, 12(2), 146.
Hammer, B. U., Colbert, A. P., Brown, K. A., & Ilioi, E. C. (2011). Neurofeedback for insomnia: A pilot study of Z-Score SMR and individualized protocols. Applied Psychophysiology and Biofeedback, 36, 251-264.
Hauri, P. (1981). Treating psychophysiologic insomnia disorder with biofeedback. Archives of General Psychiatry, 38(7), 752-758.
Hauri, P. J., Percy, L., Hellekson, C., Hartmann, E., & Russ, D. (1982). The treatment of psychophysiologic insomnia disorder with biofeedback: A replication study. Biofeedback and Self Regulation, 7(2), 223-235.
Hillard, B., El-Baz, A. S., Sears, L., Tasman, A., & Sokhadze, E. M. (2013). Neurofeedback Training Aimed to Improve Focused Attention and Alertness in Children With ADHD A Study of Relative Power of EEG Rhythms Using Custom-Made Software Application. Clinical EEG and Neuroscience, 44(3), 193-202.
Hoedlmoser, K., Pecherstorfer, T., Gruber, G., Anderer, P., Doppelmayr, M., Klimesch, W., & Schabus, M. (2008). Instrumental conditioning of human sensorimotor rhythm (12-15 Hz) and its impact on sleep as well as declarative learning. Sleep, 31(10), 1401.
Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540-545.
Kim, G. D. (2000). A study on quality of sleep and sleep disturbing factors among community dwelling elderly. Korean J Society of Welfare for the Aged, 7(1), 173-192.
Kotchoubey, B., Strehl, U., Uhlmann, C., Holzapfel, S., König, M., Fröscher, W., & Birbaumer, N. (2001). Modification of slow cortical potentials in patients with refractory epilepsy: a controlled outcome study. Epilepsia, 42(3), 406-416.
Lamarche, C. H., & Ogilvie, R. D.(1997). Electrophysiological changes during the sleep onset period of psychophysiological insomniacs, psychiatric insomniacs and normal sleepers. Journal of Sleep Research and Sleep Medicine, 20(9), 724-733.
Lansbergen, M. M., van Dongen-Boomsma, M., Buitelaar, J. K., & Slaats-Willemse, D. (2011). ADHD and EEG-neurofeedback: A double-blind randomized placebo-controlled feasibility study. Journal of Neural Transmission, 118(2), 275-284.
Lee, J. S. (2003). Comparison of daytime sleepiness between normal subjects and patients with sleep disorders and analysis of its clinical implications. Department of Medical Science Graduate school Seoul National University. 1-16.
Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. CHEST Journal, 147(4), 1179-1192.
Morin, C. M. (1993). Insomnia: Psychological Assessment and Management. New York: Guilford Publications.
Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the presleep state: The development of the pre-sleep arousal scale. Behavior Research Therapy, 23, 263-271.
Niv, S. (2013). Clinical efficacy andpotential mechanisms of neurofeedback. Personality and Individual Differences, 54, 676-686.
Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004). Functional neuroimaging evidence for hyperarousal in insomnia. The American Journal of Psychiatry, 161, 2126-2129.
Merica, H., Blois, R., & Gaillard, J. M. (1998). Spectral characteristics of sleep EEG in chronic insomnia. The European Journal of Neuroscience, 10, 1826-1834.
Perlis, M. L., Smith, M. T., Andrews, P. J., Orff, H., & Giles, D. E. (2001). Beta/Gamma EEG activity in patientswith primary and secondary insomnia and good sleeper controls. Sleep, 24(1), 110-117.
Riedel, B. W., & Lichstein, K. L.(2000). Insomnia and daytime functioning. Sleep Medicine Reviews, 4(3), 277-298.
Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., & Nissen, C. (2010). The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews, 14(1), 19-31.
Rosa, R. R., & Bonnet, M. H. (2000). Reported chronic insomnia is independent of poor sleep as measured by electroencephalography. Psychosomatic Medicine, 62(4), 474-482.
Schabus, M., Griessenberger, H., Heib, D., Lechinger, J., & Hoedlmoser, K. (2013). Non-pharmacological treatment of primary insomnia using sensorimotor-rhythm neurofeedback. Sleep Medicine, 14, e260-e261.
Schabus, M., Heib, D. P., Lechinger, J., Griessenberger, H., Klimesch, W., Pawlizki, A., & Hoedlmoser, K. (2014). Enhancing sleep quality and memory in insomnia using instrumental sensorimotor rhythm conditioning. Biological Psychology, 95, 126-134.
Sherlin, L. H., Arns, M., Lubar, J., Heinrich, H., Kerson, C., Strehl, U., & Sterman, B. (2011). Neurofeedback and Basic Learning Theory:Implications for Research and Practice, Journal of Neurotherapy 15(4), 292-304,
Sterman, M. B., LoPresti, R. W., & Fairchild, M. D. (1969). Electroencephalographic and behavioral studies of monomethylhydrazine toxicity in the cat. Technical Report AMRL–TR-69-3(AD691474). Wright-Patterson Air Force Base, Ohio, Aerospace Medical Research Laboratory.
Sterman, M. B., Howe, R. C., & Macdonald, L. R. (1970). Facilitation of spindle-burst sleep by conditioning of electroencephalographic activity while awake. Science, 167(921), 1146-1148.
Sterman, M. B., MacDonald, L. R., & Stone, R. K. (1974). Biofeedback training of the sensorimotor electroencephalogram rhythm in man: Effects on epilepsy. Epilepsia, 15(3), 395-416.
Suh, H. S., & Park, H. B. (2007). Clinical applications of neurofeedback treatment for insomnia. Sleep Medicine and Psychophysiology, 14(2), 79-85.
Vgontzas, A. N., Bixler, E. O., Lin, H. M., Prolo, P., Mastorakos, G., Vela-Bueno, A., ... Chrousos, G. P. (2001). Chronic insomnia is associated with nyctohemeral activation of the hypothalamicpituitary-adrenal axis: Clinical implications. The Journal of Clinical Endocrinology and Metabolism, 86, 3787-3794.
Wołyńczyk-Gmaj, D., & Szelenberger, W. (2011). Waking EEG in primary insomnia. Acta Neurobiol Exp, 71, 387-392.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수