Pre-sleep alpha brain entrainment for chronic pain and sleep disturbance

Home-based neuromodulation is a potentially scalable option to help address the globally important challenge of chronic pain. Alpha entrainment is a neuromodulatory technique which has emerged as potentially helpful for pain. In this project it has been applied via a smartphone application called hBET which provides repetitive audio or visual stimulation at 10 Hz. The general aim is to study the feasibility and effect of home-based use of hBET delivered pre-sleep for people with chronic pain and sleep disturbance, in a way which helpfully informs future research.
To fulfil this aim three studies are presented. In the first, an uncontrolled feasibility study, participants with chronic pain and disturbed sleep found the use of hBET at home acceptable and beneficial to symptoms. The high adherence rate and improvements in participant-reported measures of pain, sleep, mood and fatigue demonstrates the technique is feasible and clinically promising. The second study, a qualitative investigation into participants’ experience of engaging with hBET, contributes detailed learning on how the intended users interact with this technology which informs future development and provides new insights into how pain and sleep interact. The third study progresses the investigation by adding a sham control and real time home-based EEG monitoring, using a crossover randomised design. This trial confirms that hBET entrains alpha and results in an improvement in pain at night and sleep quality, compared to the sham control. It also demonstrates, for the first time in the literature, the feasibility of pre-sleep sensory alpha entrainment in conjunction with home EEG monitoring for individuals with chronic pain.
Taken together, this body of work establishes the potential of sensory alpha entrainment as a management tool for chronic pain and sleep disturbance and informs the technical development of the intervention and future trial design.