Biofeedback for sleep disorders

Having a bad night’s sleep now and then – that’s a problem with which many people are probably familiar. However, if sleep problems persist and develop into chronic sleep disorders, they can lead to serious consequences such as emotional instability, or difficulties with concentration and performance. Sleep disorders are also frequently associated with mental or physical illnesses.

Treatment of sleep disorders using biofeedback

In general, the rationale for using relaxation techniques to treat sleep disorders is the realisation that people with sleep problems often exhibit elevated levels of arousal (physiological, cognitive and emotional). Biofeedback This method is used here to promote the relaxation response¹.

When treating sleep disorders with biofeedback, the training usually involves learning a kind of „sleep diary“ or „sleep ritual“. Techniques such as respiratory biofeedback, hand-warming exercises or EMG biofeedback can be used here to help patients learn how to achieve a pleasant state of relaxation before falling asleep.

In particular, passive respiratory biofeedback, in which participants perceive their breathing as a monotonous, endogenous rhythm, leads to drowsiness and a hypnoid state. By learning and practising such exercises or rituals, sleep can be actively induced. It brings the body and brain, so to speak, into a state of rest. However, other forms of relaxation biofeedback are also suitable for inducing sleep.

Effectiveness and tips

Due to issues such as tolerance to the medication, dependence on it and the possibility that sleep disturbances may recur once the medication is discontinued, pharmacotherapy is not regarded by some as the treatment of choice for chronic sleep disorders¹. Behavioural treatments (such as biofeedback, for example), on the other hand, are regarded as equally effective, and it was also found that the effects were still evident after 6 months – which was not the case with pharmacotherapy³.

Several existing controlled studies provide evidence that biofeedback is at least as effective as other treatment methods for (non-organic) sleep disorders¹.

Practical tips

Some participants report that, to help them fall asleep, they visualise the biofeedback screen in their mind’s eye. On the one hand, this helps them to remember the methods that allow them to relax effectively; on the other hand, it is particularly helpful for people who otherwise tend to overthink things before falling asleep. By concentrating on this mental image, negative thoughts – which would otherwise prevent them from falling asleep – arise much less frequently.