Traditional solutions for sleep disorders, including medications and cognitive behavioral therapies, often provide insufficient relief for military personnel, a problem researchers from the University of Arizona College of Medicine – Tucson will be hoping to solve with a $3 million grant from the Department of Defense Congressionally Directed Medical Research Program.
Sleep problems are among the top health concerns of military personnel, with an estimated 85% meeting criteria for a clinically relevant sleep disorder and as many as 25% identifying insomnia as a primary issue. The impact of sleeplessness on force readiness is profound, creating a critical need for developing innovative, effective, nondrug interventions.
For the past decade, William "Scott" Killgore, PhD, an Army veteran, has focused much of his work around factors affecting the mental health, well-being and performance of military personnel.
William "Scott" Killgore, PhD, and his team in the Social, Cognitive and Affective Neuroscience, or SCAN, Lab in the Department of Psychiatry hope to fill that need.
"Insomnia is generally believed to be caused, at least in part, by excessive arousal of the brain and body, which is often associated with worry and excessive pre-sleep negative and arousing thoughts," said Killgore, a professor of psychiatry and member of the BIO5 Institute.
Brain imaging has shown that internally focused thoughts tend to activate the default mode network, or DMN, a core system in the brain that processes internal thoughts and emotions and becomes active during rest or introspective activities. Killgore and his team recently completed a preliminary study to suppress the DMN before sleep using a handheld device that stimulates brain cells with magnetic fields.
Their device, which is held against the scalp for less than a minute, uses transcranial magnetic stimulation to target specific areas of the brain with continuous theta burst stimulation, which delivers rapid, repetitive bursts of magnetic pulses to inhibit brain activity. Transcranial magnetic stimulation is well-tolerated.
Many people with insomnia describe being unable to 'turn off' their thoughts when trying to fall asleep. This internal dialog, worry and rumination is facilitated by activation within the DMN, perpetuating a cycle of restlessness. Our study's initial findings suggest that by disrupting this brain network through a brief, 40-second stimulation, we can effectively help individuals achieve better sleep."
William "Scott" Killgore, PhD
Participants showed improvements in sleep after one session of continuous theta burst stimulation to a single region of the DMN.
The general use of continuous theta burst stimulation for sleep, depression and other mental health issues is not new, but Killgore's specific approach stimulates a network in the brain that has not been explored for this purpose.
Bolstered by these preliminary findings and the new grant, the research team is launching an expanded, three-year study to examine the long-term effects of 10 repeated administrations of continuous theta burst stimulation over a two-week period.
They will recruit 120 participants with chronic insomnia and assess sleep improvements over several months. Participants will receive brief brain-stimulation sessions, and their sleep will be monitored using state-of-the-art sleep trackers and portable at-home brain wave monitors.
"By investigating how different areas of the brain respond to continuous theta burst stimulation, we hope to fine-tune this approach for maximum effectiveness," Killgore said. "Our aim is to see whether we can improve sleep in the short term and if these improvements can be sustained following treatment."
The research team includes two active-duty military consultants with sleep disorders. Their insights and feedback have shaped the study's design, and they will provide guidance on how to translate the results into meaningful changes for the military community.
This study is part of a broader effort to address two crucial focus areas outlined by Congress' Traumatic Brain Injury and Psychological Health Research Program: reducing the risk of psychological health conditions and developing novel treatments and interventions.
"This innovative project has tremendous potential to open new avenues for treating one of the major health concerns facing service members, as well as those in the civilian community," said Jordan Karp, MD, psychiatry professor and department chair. "This would represent an important discovery for sleep science and would offer a tangible, drug-free treatment option for those grappling with chronic insomnia and other sleep disorders."
Traditional solutions for sleep disorders, including medications and cognitive behavioral therapies, often provide insufficient relief for military personnel, a problem researchers from the University of Arizona College of Medicine – Tucson will be hoping to solve with a $3 million grant from the Department of Defense Congressionally Directed Medical Research Program.
Sleep problems are among the top health concerns of military personnel, with an estimated 85% meeting criteria for a clinically relevant sleep disorder and as many as 25% identifying insomnia as a primary issue. The impact of sleeplessness on force readiness is profound, creating a critical need for developing innovative, effective, nondrug interventions.
William "Scott" Killgore, PhD, and his team in the Social, Cognitive and Affective Neuroscience, or SCAN, Lab in the Department of Psychiatry hope to fill that need.
"Insomnia is generally believed to be caused, at least in part, by excessive arousal of the brain and body, which is often associated with worry and excessive pre-sleep negative and arousing thoughts," said Killgore, a professor of psychiatry and member of the BIO5 Institute.
Brain imaging has shown that internally focused thoughts tend to activate the default mode network, or DMN, a core system in the brain that processes internal thoughts and emotions and becomes active during rest or introspective activities. Killgore and his team recently completed a preliminary study to suppress the DMN before sleep using a handheld device that stimulates brain cells with magnetic fields.
Their device, which is held against the scalp for less than a minute, uses transcranial magnetic stimulation to target specific areas of the brain with continuous theta burst stimulation, which delivers rapid, repetitive bursts of magnetic pulses to inhibit brain activity. Transcranial magnetic stimulation is well-tolerated.
"Many people with insomnia describe being unable to 'turn off' their thoughts when trying to fall asleep," Killgore said. "This internal dialog, worry and rumination is facilitated by activation within the DMN, perpetuating a cycle of restlessness. Our study's initial findings suggest that by disrupting this brain network through a brief, 40-second stimulation, we can effectively help individuals achieve better sleep."
Participants showed improvements in sleep after one session of continuous theta burst stimulation to a single region of the DMN.
The general use of continuous theta burst stimulation for sleep, depression and other mental health issues is not new, but Killgore's specific approach stimulates a network in the brain that has not been explored for this purpose.
Bolstered by these preliminary findings and the new grant, the research team is launching an expanded, three-year study to examine the long-term effects of 10 repeated administrations of continuous theta burst stimulation over a two-week period.
They will recruit 120 participants with chronic insomnia and assess sleep improvements over several months. Participants will receive brief brain-stimulation sessions, and their sleep will be monitored using state-of-the-art sleep trackers and portable at-home brain wave monitors.
"By investigating how different areas of the brain respond to continuous theta burst stimulation, we hope to fine-tune this approach for maximum effectiveness," Killgore said. "Our aim is to see whether we can improve sleep in the short term and if these improvements can be sustained following treatment."
The research team includes two active-duty military consultants with sleep disorders. Their insights and feedback have shaped the study's design, and they will provide guidance on how to translate the results into meaningful changes for the military community.
This study is part of a broader effort to address two crucial focus areas outlined by Congress' Traumatic Brain Injury and Psychological Health Research Program: reducing the risk of psychological health conditions and developing novel treatments and interventions.
"This innovative project has tremendous potential to open new avenues for treating one of the major health concerns facing service members, as well as those in the civilian community," said Jordan Karp, MD, psychiatry professor and department chair. "This would represent an important discovery for sleep science and would offer a tangible, drug-free treatment option for those grappling with chronic insomnia and other sleep disorders."
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