Current status and progress of transcranial electrical stimulation for insomnia_West China Medical Journal

Authors：

HUANG Zhiqiang ,  WANG Xiaoming

Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding?author：

WANG Xiaoming, Email: wangnsmc@163.com

Keywords：

Insomnia; transcranial electrical stimulation; closed-loop neural neuromodulation

DOI：

10.7507/1002-0179.202506160

Video：

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Transcranial electrical stimulation (tES) is a non-invasive neuromodulation technique characterized by high safety and minimal side effects, and has been widely applied in the treatment of insomnia and its accompanying symptoms. tES can be divided into transcranial direct current stimulation and transcranial alternating current stimulation. This article explores the mechanism of action of tES for insomnia, reviews the current research status and progress of tES for insomnia in recent years, and proposes potential future research directions.

Citation： HUANG Zhiqiang, WANG Xiaoming. Current status and progress of transcranial electrical stimulation for insomnia. West China Medical Journal, 2026, 41(4): 671-674. doi: 10.7507/1002-0179.202506160 Copy

1.	Riemann D, Espie CA, Altena E, et al. The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res, 2023, 32(6): e14035.
2.	Becker PM. Overview of sleep management during COVID-19. Sleep Med, 2022, 91: 211-218.
3.	Abubaker M, Al Qasem W, Kva?ňák E. Working memory and cross-frequency coupling of neuronal oscillations. Front Psychol, 2021, 12: 756661.
4.	Jones AP, Choe J, Bryant NB, et al. Dose-dependent effects of closed-loop tACS delivered during slow-wave oscillations on memory consolidation. Front Neurosci, 2018, 12: 867.
5.	Kuhn M, Wolf E, Maier JG, et al. Sleep recalibrates homeostatic and associative synaptic plasticity in the human cortex. Nat Commun, 2016, 7: 12455.
6.	Aktürk T, de Graaf TA, Güntekin B, et al. Enhancing memory capacity by experimentally slowing theta frequency oscillations using combined EEG-tACS. Sci Rep, 2022, 12(1): 14199.
7.	Gabis L, Shklar B, Baruch YK, et al. Pain reduction using transcranial electrostimulation: a double blind “active placebo” controlled trial. J Rehabil Med, 2009, 41(4): 256-261.
8.	Zhou Q, Yu C, Yu H, et al. The effects of repeated transcranial direct current stimulation on sleep quality and depression symptoms in patients with major depression and insomnia. Sleep Med, 2020, 70: 17-26.
9.	Minichino A, Bersani FS, Spagnoli F, et al. Prefronto-cerebellar transcranial direct current stimulation improves sleep quality in euthymic bipolar patients: a brief report. Behav Neurol, 2014, 2014: 876521.
10.	Sheng J, Xie C, Fan DQ, et al. High definition-transcranial direct current stimulation changes older adults’ subjective sleep and corresponding resting-state functional connectivity. Int J Psychophysiol, 2018, 129: 1-8.
11.	Lu H, Ni X, Man Chan SS, et al. Pre-treatment subjective sleep quality as a predictive biomarker of tDCS effects in preclinical Alzheimer’s disease patients: secondary analysis of a randomised clinical trial. PLoS One, 2025, 20(1): e0317700.
12.	Simonetta C, Bissacco J, Conti M, et al. Motor cortex transcranial direct current stimulation improves non-motor symptoms in early-onset Parkinson’s disease: a pilot study. J Neural Transm (Vienna), 2024, 131(2): 189-193.
13.	Samartin-Veiga N, Pidal-Miranda M, González-Villar AJ, et al. Transcranial direct current stimulation of 3 cortical targets is no more effective than placebo as treatment for fibromyalgia: a double-blind sham-controlled clinical trial. Pain, 2022, 163(7): e850-e861.
14.	Bakhshayesh Eghbali B, Ramezani S, Sedaghat Herfeh S, et al. Transcranial direct current stimulation improves sleep quality in patients with insomnia after traumatic brain injury. Brain Inj, 2023, 37(1): 63-73.
15.	Alfonsi V, D’Atri A, Scarpelli S, et al. The effects of bifrontal anodal transcranial direct current stimulation (tDCS) on sleepiness and vigilance in partially sleep-deprived subjects: a multidimensional study. J Sleep Res, 2023, 32(4): e13869.
16.	Marshall L, Helgadóttir H, M?lle M, et al. Boosting slow oscillations during sleep potentiates memory. Nature, 2006, 444(7119): 610-613.
17.	Saebipour MR, Joghataei MT, Yoonessi A, et al. Slow oscillating transcranial direct current stimulation during sleep has a sleep-stabilizing effect in chronic insomnia: a pilot study. J Sleep Res, 2015, 24(5): 518-525.
18.	Hathaway E, Morgan K, Carson M, et al. Transcranial electrical stimulation targeting limbic cortex increases the duration of human deep sleep. Sleep Med, 2021, 81: 350-357.
19.	Johnson JM, Durrant SJ. The effect of cathodal transcranial direct current stimulation during rapid eye-movement sleep on neutral and emotional memory. R Soc Open Sci, 2018, 5(7): 172353.
20.	D’Atri A, De Simoni E, Gorgoni M, et al. Electrical stimulation of the frontal cortex enhances slow-frequency EEG activity and sleepiness. Neuroscience, 2016, 324: 119-30.
21.	Prehn-Kristensen A, Munz M, G?der R, et al. Transcranial oscillatory direct current stimulation during sleep improves declarative memory consolidation in children with attention-deficit/hyperactivity disorder to a level comparable to healthy controls. Brain Stimul, 2014, 7(6): 793-799.
22.	Ladenbauer J, Ladenbauer J, Külzow N, et al. Promoting sleep oscillations and their functional coupling by transcranial stimulation enhances memory consolidation in mild cognitive impairment. J Neurosci, 2017, 37(30): 7111-7124.
23.	Eggert T, Dorn H, Sauter C, et al. No effects of slow oscillatory transcranial direct current stimulation (tDCS) on sleep-dependent memory consolidation in healthy elderly subjects. Brain Stimul, 2013, 6(6): 938-945.
24.	Pa?mann S, Külzow N, Ladenbauer J, et al. Boosting slow oscillatory activity using tDCS during early nocturnal slow wave sleep does not improve memory consolidation in healthy older adults. Brain Stimul, 2016, 9(5): 730-739.
25.	Dehnavi F, Koo-Poeggel PC, Ghorbani M, et al. Spontaneous slow oscillation-slow spindle features predict induced overnight memory retention. Sleep, 2021, 44(10): zsab127.
26.	Ladenbauer J, Khakimova L, Malinowski R, et al. Towards optimization of oscillatory stimulation during sleep. Neuromodulation, 2023, 26(8): 1592-1601.
27.	Agnihotri SK, Cai J, Wang Z. Exploring the synchronization of cortical networks via entrainment to intrinsic frequencies. Heliyon, 2024, 10(24): e41034.
28.	Shan Y, Wang H, Yang Y, et al. Evidence of a large current of transcranial alternating current stimulation directly to deep brain regions. Mol Psychiatry, 2023, 28(12): 5402-5410.
29.	Zhu X, Ren Y, Tan S, et al. Efficacy of transcranial alternating current stimulation in treating chronic insomnia and the impact of age on its effectiveness: a multisite randomized, double-blind, parallel-group, placebo-controlled study. J Psychiatr Res, 2024, 170: 253-261.
30.	Wang HX, Wang L, Zhang WR, et al. Effect of transcranial alternating current stimulation for the treatment of chronic insomnia: a randomized, double-blind, parallel-group, placebo-controlled clinical trial. Psychother Psychosom, 2020, 89(1): 38-47.
31.	Motamedi GK, Jeliazkov PG, Oyegbile-Chidi TO, et al. Transcranial alternating current stimulation (tACS) as a treatment for insomnia. Can J Neurol Sci, 2023, 50(3): 446-449.
32.	Shi Y, Tian X, Li T, et al. The influence of transcranial alternating current stimulation on EEG spectral power during subsequent sleep: a randomized crossover study. Sleep Med, 2025, 126: 185-193.
33.	Tabarak S, Zhu X, Li P, et al. Temporal dynamics of negative emotional memory reprocessing during sleep. Transl Psychiatry, 2024, 14(1): 434.
34.	Scangos KW, Ross DA. What we’ve got here is failure to communicate: improving interventional psychiatry with closed-loop stimulation. Biol Psychiatry, 2018, 84(8): e55-e57.
35.	Haslacher D, Narang A, Sokoliuk R, et al. In vivo phase-dependent enhancement and suppression of human brain oscillations by transcranial alternating current stimulation (tACS). Neuroimage, 2023, 275: 120187.
36.	Robinson CSH, Bryant NB, Maxwell JW, et al. The benefits of closed-loop transcranial alternating current stimulation on subjective sleep quality. Brain Sci, 2018, 8(12): 204.
37.	Robert BM, Jones AP, Mullins TS, et al. Closed-loop transcranial alternating current stimulation of slow wave oscillations during sleep reduces declarative learning the next day. Brain Stimul, 2022, 15(6): 1565-1566.
38.	Jones AP, Bryant NB, Robert BM, et al. Closed-loop tACS delivered during slow-wave sleep reduces retroactive interference on a paired-associates learning task. Brain Sci, 2023, 13(3): 468.
39.	Lerner I, Ketz NA, Jones AP, et al. Transcranial current stimulation during sleep facilitates insight into temporal rules, but does not consolidate memories of individual sequential experiences. Sci Rep, 2019, 9(1): 1516.
40.	Lustenberger C, Boyle MR, Alagapan S, et al. Feedback-controlled transcranial alternating current stimulation reveals a functional role of sleep spindles in motor memory consolidation. Curr Biol, 2016, 26(16): 2127-2136.

1. Riemann D, Espie CA, Altena E, et al. The European insomnia guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res, 2023, 32(6): e14035.
2. Becker PM. Overview of sleep management during COVID-19. Sleep Med, 2022, 91: 211-218.
3. Abubaker M, Al Qasem W, Kva?ňák E. Working memory and cross-frequency coupling of neuronal oscillations. Front Psychol, 2021, 12: 756661.
4. Jones AP, Choe J, Bryant NB, et al. Dose-dependent effects of closed-loop tACS delivered during slow-wave oscillations on memory consolidation. Front Neurosci, 2018, 12: 867.
5. Kuhn M, Wolf E, Maier JG, et al. Sleep recalibrates homeostatic and associative synaptic plasticity in the human cortex. Nat Commun, 2016, 7: 12455.
6. Aktürk T, de Graaf TA, Güntekin B, et al. Enhancing memory capacity by experimentally slowing theta frequency oscillations using combined EEG-tACS. Sci Rep, 2022, 12(1): 14199.
7. Gabis L, Shklar B, Baruch YK, et al. Pain reduction using transcranial electrostimulation: a double blind “active placebo” controlled trial. J Rehabil Med, 2009, 41(4): 256-261.
8. Zhou Q, Yu C, Yu H, et al. The effects of repeated transcranial direct current stimulation on sleep quality and depression symptoms in patients with major depression and insomnia. Sleep Med, 2020, 70: 17-26.
9. Minichino A, Bersani FS, Spagnoli F, et al. Prefronto-cerebellar transcranial direct current stimulation improves sleep quality in euthymic bipolar patients: a brief report. Behav Neurol, 2014, 2014: 876521.
10. Sheng J, Xie C, Fan DQ, et al. High definition-transcranial direct current stimulation changes older adults’ subjective sleep and corresponding resting-state functional connectivity. Int J Psychophysiol, 2018, 129: 1-8.
11. Lu H, Ni X, Man Chan SS, et al. Pre-treatment subjective sleep quality as a predictive biomarker of tDCS effects in preclinical Alzheimer’s disease patients: secondary analysis of a randomised clinical trial. PLoS One, 2025, 20(1): e0317700.
12. Simonetta C, Bissacco J, Conti M, et al. Motor cortex transcranial direct current stimulation improves non-motor symptoms in early-onset Parkinson’s disease: a pilot study. J Neural Transm (Vienna), 2024, 131(2): 189-193.
13. Samartin-Veiga N, Pidal-Miranda M, González-Villar AJ, et al. Transcranial direct current stimulation of 3 cortical targets is no more effective than placebo as treatment for fibromyalgia: a double-blind sham-controlled clinical trial. Pain, 2022, 163(7): e850-e861.
14. Bakhshayesh Eghbali B, Ramezani S, Sedaghat Herfeh S, et al. Transcranial direct current stimulation improves sleep quality in patients with insomnia after traumatic brain injury. Brain Inj, 2023, 37(1): 63-73.
15. Alfonsi V, D’Atri A, Scarpelli S, et al. The effects of bifrontal anodal transcranial direct current stimulation (tDCS) on sleepiness and vigilance in partially sleep-deprived subjects: a multidimensional study. J Sleep Res, 2023, 32(4): e13869.
16. Marshall L, Helgadóttir H, M?lle M, et al. Boosting slow oscillations during sleep potentiates memory. Nature, 2006, 444(7119): 610-613.
17. Saebipour MR, Joghataei MT, Yoonessi A, et al. Slow oscillating transcranial direct current stimulation during sleep has a sleep-stabilizing effect in chronic insomnia: a pilot study. J Sleep Res, 2015, 24(5): 518-525.
18. Hathaway E, Morgan K, Carson M, et al. Transcranial electrical stimulation targeting limbic cortex increases the duration of human deep sleep. Sleep Med, 2021, 81: 350-357.
19. Johnson JM, Durrant SJ. The effect of cathodal transcranial direct current stimulation during rapid eye-movement sleep on neutral and emotional memory. R Soc Open Sci, 2018, 5(7): 172353.
20. D’Atri A, De Simoni E, Gorgoni M, et al. Electrical stimulation of the frontal cortex enhances slow-frequency EEG activity and sleepiness. Neuroscience, 2016, 324: 119-30.
21. Prehn-Kristensen A, Munz M, G?der R, et al. Transcranial oscillatory direct current stimulation during sleep improves declarative memory consolidation in children with attention-deficit/hyperactivity disorder to a level comparable to healthy controls. Brain Stimul, 2014, 7(6): 793-799.
22. Ladenbauer J, Ladenbauer J, Külzow N, et al. Promoting sleep oscillations and their functional coupling by transcranial stimulation enhances memory consolidation in mild cognitive impairment. J Neurosci, 2017, 37(30): 7111-7124.
23. Eggert T, Dorn H, Sauter C, et al. No effects of slow oscillatory transcranial direct current stimulation (tDCS) on sleep-dependent memory consolidation in healthy elderly subjects. Brain Stimul, 2013, 6(6): 938-945.
24. Pa?mann S, Külzow N, Ladenbauer J, et al. Boosting slow oscillatory activity using tDCS during early nocturnal slow wave sleep does not improve memory consolidation in healthy older adults. Brain Stimul, 2016, 9(5): 730-739.
25. Dehnavi F, Koo-Poeggel PC, Ghorbani M, et al. Spontaneous slow oscillation-slow spindle features predict induced overnight memory retention. Sleep, 2021, 44(10): zsab127.
26. Ladenbauer J, Khakimova L, Malinowski R, et al. Towards optimization of oscillatory stimulation during sleep. Neuromodulation, 2023, 26(8): 1592-1601.
27. Agnihotri SK, Cai J, Wang Z. Exploring the synchronization of cortical networks via entrainment to intrinsic frequencies. Heliyon, 2024, 10(24): e41034.
28. Shan Y, Wang H, Yang Y, et al. Evidence of a large current of transcranial alternating current stimulation directly to deep brain regions. Mol Psychiatry, 2023, 28(12): 5402-5410.
29. Zhu X, Ren Y, Tan S, et al. Efficacy of transcranial alternating current stimulation in treating chronic insomnia and the impact of age on its effectiveness: a multisite randomized, double-blind, parallel-group, placebo-controlled study. J Psychiatr Res, 2024, 170: 253-261.
30. Wang HX, Wang L, Zhang WR, et al. Effect of transcranial alternating current stimulation for the treatment of chronic insomnia: a randomized, double-blind, parallel-group, placebo-controlled clinical trial. Psychother Psychosom, 2020, 89(1): 38-47.
31. Motamedi GK, Jeliazkov PG, Oyegbile-Chidi TO, et al. Transcranial alternating current stimulation (tACS) as a treatment for insomnia. Can J Neurol Sci, 2023, 50(3): 446-449.
32. Shi Y, Tian X, Li T, et al. The influence of transcranial alternating current stimulation on EEG spectral power during subsequent sleep: a randomized crossover study. Sleep Med, 2025, 126: 185-193.
33. Tabarak S, Zhu X, Li P, et al. Temporal dynamics of negative emotional memory reprocessing during sleep. Transl Psychiatry, 2024, 14(1): 434.
34. Scangos KW, Ross DA. What we’ve got here is failure to communicate: improving interventional psychiatry with closed-loop stimulation. Biol Psychiatry, 2018, 84(8): e55-e57.
35. Haslacher D, Narang A, Sokoliuk R, et al. In vivo phase-dependent enhancement and suppression of human brain oscillations by transcranial alternating current stimulation (tACS). Neuroimage, 2023, 275: 120187.
36. Robinson CSH, Bryant NB, Maxwell JW, et al. The benefits of closed-loop transcranial alternating current stimulation on subjective sleep quality. Brain Sci, 2018, 8(12): 204.
37. Robert BM, Jones AP, Mullins TS, et al. Closed-loop transcranial alternating current stimulation of slow wave oscillations during sleep reduces declarative learning the next day. Brain Stimul, 2022, 15(6): 1565-1566.
38. Jones AP, Bryant NB, Robert BM, et al. Closed-loop tACS delivered during slow-wave sleep reduces retroactive interference on a paired-associates learning task. Brain Sci, 2023, 13(3): 468.
39. Lerner I, Ketz NA, Jones AP, et al. Transcranial current stimulation during sleep facilitates insight into temporal rules, but does not consolidate memories of individual sequential experiences. Sci Rep, 2019, 9(1): 1516.
40. Lustenberger C, Boyle MR, Alagapan S, et al. Feedback-controlled transcranial alternating current stimulation reveals a functional role of sleep spindles in motor memory consolidation. Curr Biol, 2016, 26(16): 2127-2136.

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