Intensive Neurofeedback Protocol: An Alpha Training to Improve Sleep Quality and Stress Modulation in Health Care Professionals During the Covid-19 Pandemic. A Pilot Study

Objective health care workers (HCWs) represent a vulnerable group in the COVID-19 pandemic, given the exposure to greater risk and higher levels of work-related stress. Neurofeedback (NF) has shown to be effective in the treatment of stress-related symptoms. We aimed to assess the effectiveness of an alpha-increase NF protocol for the treatment of acute stress symptoms in HCWs exposed to the COVID-19 pandemic. Method eighteen medical doctors on duty during the COVID-19 health emergency underwent an intensive NF alpha-increase protocol. The mean alpha wave values were recorded at the beginning (T0) and at the last day of stimulation (T1). Rapid Stress Assessment: Italian version; Copenhagen Burnout Inventory (CBI); Pittsburgh Sleep Quality Index (PSQI), and Brief-COPE were administered as psychometric assessment. Results a significant increase in alpha wave values and a significant reduction of the PSQI scores from T0 to T1 were found. Conclusions NF alpha-increase protocol showed promising results in terms of stress modulation, sleep quality improvement, and safety in a pilot sample of HCWs.

[1]  Hussain Marzooq,et al.  The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19 , 2020, Sleep and Breathing.

[2]  T. Jiang,et al.  The differential psychological distress of populations affected by the COVID-19 pandemic , 2020, Brain, Behavior, and Immunity.

[3]  Lijun Kang,et al.  Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak , 2020, Frontiers in Psychiatry.

[4]  Kun Wang,et al.  Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China , 2020, Psychotherapy and Psychosomatics.

[5]  T. Shanafelt,et al.  Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. , 2020, JAMA.

[6]  Han-i Wang,et al.  Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study , 2020, Psychiatry Research.

[7]  Y. Xiang,et al.  Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China , 2020, Psychological Medicine.

[8]  Yan Wang,et al.  Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter , 2020, Psychiatry Research.

[9]  Yu Yu,et al.  Prevalence of sleep disturbances in Chinese healthcare professionals: a systematic review and meta-analysis. , 2020, Sleep medicine.

[10]  C. Yen,et al.  The effects of alpha asymmetry and high-beta down-training neurofeedback for patients with the major depressive disorder and anxiety symptoms. , 2019, Journal of affective disorders.

[11]  L. S. Panisch,et al.  The Effectiveness of Using Neurofeedback in the Treatment of Post-Traumatic Stress Disorder: A Systematic Review , 2018, Trauma, violence & abuse.

[12]  D. Palomba,et al.  Frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety. , 2017, Behaviour research and therapy.

[13]  M. Mansourian,et al.  Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications , 2016, Basic and clinical neuroscience.

[14]  H. Schächinger,et al.  Relevance of Stress and Female Sex Hormones for Emotion and Cognition , 2011, Cellular and Molecular Neurobiology.

[15]  S. Ho,et al.  Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors , 2010, General Hospital Psychiatry.

[16]  E. Susser,et al.  The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk , 2009, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[17]  C. Chu,et al.  Long-term psychiatric morbidities among SARS survivors , 2009, General Hospital Psychiatry.

[18]  C.-Y. Lin,et al.  The psychological effect of severe acute respiratory syndrome on emergency department staff , 2006, Emergency Medicine Journal.

[19]  B. Löwe,et al.  A brief measure for assessing generalized anxiety disorder: the GAD-7. , 2006, Archives of internal medicine.

[20]  Ebbe Villadsen,et al.  The Copenhagen Burnout Inventory: A new tool for the assessment of burnout , 2005 .

[21]  H. Hull,et al.  SARS Control and Psychological Effects of Quarantine, Toronto, Canada , 2005, Emerging infectious diseases.

[22]  K. Wu,et al.  Posttraumatic stress, anxiety, and depression in survivors of severe acute respiratory syndrome (SARS) , 2005, Journal of traumatic stress.

[23]  J. Démos Getting Started with Neurofeedback , 2005 .

[24]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[25]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[26]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[27]  Book Forum,et al.  Introduction to Quantitative Eeg and Neurofeedback , 2022 .

[28]  James R. Evans,et al.  Neurofeedback and neuromodulation techniques and applications , 2011 .

[29]  R. Maunder,et al.  Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. , 2008, Psychiatric services.

[30]  C. Carver You want to measure coping but your protocol’ too long: Consider the brief cope , 1997, International journal of behavioral medicine.