RESEARCH

Brainwave Entrainment using Visual- Auditory Stimulation as Therapy for Sleep Disorders

Karuppathal E*1, Kalpana R2 and Srinivasan A.V3

1Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, India. 2Department of Biomedical engineering, Rajalakshmi Engineering College, Chennai, India. 3AVS Clinic, Chennai, India.

*Corresponding author e-mail: [email protected]

ABSTRACT Sleep disorder is one of the problems faced as a side effect to many disease like depression, epilepsy, cardiac problems., It is generally treated either by means of sleeping pills or through psychotherapy which when taken for long time leads to health problems. In this work, attempted is to develop a device which provides a combination of audio visual entrainment therapy to induce sleep. This device provides drug-free treatment through a user friendly environment that enables relaxation of and muscles. Two audio signals at two different were given to left and right ears. This results in binaural signal in delta band. Visual input (Red LED) is also given to two eyes through eye-mask to block the entry of external . These two which when applied simultaneously suppresses alpha band and increases delta band of brain signal and thus induces sleep. When this procedure tried on controls and test subjects, subjects with sleep disorder took 10 to 15 extra to enter into sleep state. Thus this device provides no discomfort to the user and also very cost effective.

KEYWORDS: Binaural beat, EEG, Entrainment, Insomnia, Sleep

Citation: Karuppathal E, Kalpana R and Srinivasan A.V (2018) Brainwave Entrainment using Visual-Auditory Stimulation as Therapy for Sleep Disorders. Research Reports 2:e1-e7.doi:10.9777/rr.2018.10323.

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I. INTRODUCTION distributed on pathological condition from EEG results. Apart from diagnosis, photic stimulation is Sleep is one important factor that keeps a person used in therapeutic application. Hiroaki et al., active and healthy. Insomnia is a condition that (1996) have increased the alpha activity through makes disorderness in the sleep. It plays a photic stimulation for a subject suffering with significant role in normal, pathological and depression and insomnia. psychiatric subjects (Mathew R et al., 2012). Many pathological conditions like cardiac problems, Audio is one another stimulating factor that thyroid, blood pressure and stress, anxiety also activates brain function. Specifically Binaural beat, contributes to the disorders of sleep. Most of the arising from two different frequencies when times inducing sleep either through hypnotics or presented separately to left and right ears (James through sedative medicines are commonly D et al., 1998). Hillel et al., (2009) investigated the adopted for treating sleeplessness (Mathew R et brain activity on different auditory frequencies and al., 2012). This however have side effects includes was able to obtain better response for lower Diarrhea, Dizziness and Headache and day time frequencies than higher. drowsiness (Daniel F et al., 2013). Audio-Visual Entrainment (AVE) is yet another Brainwave Entrainment is an alternative procedure method of stimulating the brain activity. This that modulates neural activities by synchronizing entrainment at low frequencies promotes deep brainwave frequency with that of stimuli (Shusheng relaxation. From the above discussion it is clear et al., 2016). Human conscious state is dictated by that audio and visual stimulation at specific the kind of brainwave generated by the brain. frequency is useful in relaxing stress and also for High mental activity is associated to the frequency inducing sleep. On this background attempted of 13-30 Hz (beta), alert state to 9-13 Hz (alpha), here is to develop delta frequency in the brain drowsy state to 5-8 Hz (theta) and deep sleep through AVE in normal and control subjects. (Hisn- state to 0.5-4 Hz (delta) (Hsin- Yi Tang et al., 2015). Yi et. al., 2015) have concluded that when AVE is Audio or visual is one way of influencing applied over chronic Insomnia subjects, quality of neural activity. By selecting the right stimulating sleep found to increase. They have also observed frequency, Delta can be generated and this kind of test, in addition to improve sleep, it hence inducing sleep. reduces the body pain and anxiety.

Various photic effects on brain are a point of II. METHODOLOGY discussion for the past six to seven decades. John & Barlow, (1959) have demonstrated the relation A. System Overview between rhythmic brain and photic flash AVE experiment is performed on CONTROL rates. They have also demonstrated the responses subjects and subjects with sleep disorderness. of the difference between the two hemispheres of Audio and Visual stimulus are given simultaneously the brain for the subject with cerebral in silent environment and brainwave is recorded hemorrhage. Whereas a great degree of similarity across P4 and O2 using BIOPAC 4.0 with 125 Hz as between hemispheres were observed on visual sampling frequency. In addition to this, Controls stimulation. are also subjected to audio and visual stimulation separately. Response from the brain is recorded in Donker et al., (1988) have studied inter the same procedure as mentioned above for AVE. hemispheric response to visual stimulation on The Figure 1 shows the recording setup of AVE normal and pathological subjects and conducted therapy for inducing sleep for the insomnia that inter hemispheric communication is patients.

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Figure 1. Experimental setup of brainwave entrainment using audio and visual stimulus.

B. Audio Unit sleep disorder, in the age group between 20 and One of the stimulating factors for brain is audio. 70 with mean age being 38 and Standard Two different audio signals at 60 Hz and 64 Hz are deviation (SD) 20. All the enrolled subjects were given to Left and Right ears. Due to the explained about the nature of study and written superposition of neuronal activity arising from consent was obtained from them participants. The these two frequencies Binaural beats are formed in experiment was carried out in a proof room the brain (Hillel et. al., 2009). The audio signals are that has the facility to record the brain signal checked for its frequency components using without any disturbance. All the subjects were Audacity software. (Courtesy: An open source asked to relax for 60 seconds and then first audio frequency signal generator. brainwave signal is recorded. After obtaining first www.wavetones.com/functiongenerator.php). brainwave signal, AV stimulus is begin.

C. Visual Unit A. Test on CONTROL Subjects Apart from light being used for diagnostic The experimental procedure consists of 3 parts: a purposes, photic stimulation is also used to treat pre-AVE test and two tests during AVE phase, sleep disorderness and migraine (Michael L et. al., where the subjects enters into drowsy state and 2001; Anderson D. J. et. al., 1989). Visual unit is when the subject enters into deep sleep state. constructed using Black colored eye mask over Signals were recorded after 10 and 15 minutes of which Red LEDs (one for each eye) are place and commencement of AV stimulus. After the end of covered in such a way that no external light this therapy (15 minutes) all the CONTROL subjects influences either the LED or eyes. Due to the direct started sleeping. relationship between wavelength of red light and B. Test on Subjects with Sleep Disorderness melatonin (Deanna Alicia et. al., 2007), the visual stimulation also aids in inducing sleep. Three Participants with sleep disorderness were tested for AVE response (Participant 1, aged 70, Combination of Audio and Visual units and male; Participant 2, aged 64, female; Participant 3, applying these two stimulations simultaneously aged 42, female). They were medically apt to forms the AVE unit. undergo AVE test as suggested by the neuro physician. After relaxed state AV stimulus is III. STIMULI AND PROCEDURE applied, signals were recorded after 10 minutes, 20 The investigation was carried out in a group of 5 minutes and 25 minutes. The period here normal subjects (CONTROL) and 3 subjects with

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RESEARCH extended by 10 minutes because the subjects The brain signal measured is the distribution of relatively took longer time to fall asleep. electrical voltage with respect to time. However, the focus of this study is to induce sleep i.e., delta IV. RESULTS wave (0.5-4 Hz) and to suppress active state i.e., alpha wave (8-12 Hz) by AV stimulation. This is Brainwave arising due to AV stimulus is recorded achieved by measuring brain signals before and on (A1-P3-O1, A2-P4-O2) both the hemispheres after AV stimulation and analysing it for power for all the subjects undergoing test procedure. distribution on different frequencies. Therefore Response of brain to audio and visual input is after finding power spectral density of the signal, widely observed in parietal and occipital lobes average power over a band of frequency is (Adrian E et. al., 1934). In normal condition, the computed and plotted in Figure 2. This kind of response of two hemispheres will be similar. analysis is done for both CONTROL and Whereas, on pathological condition, response pathological subjects on both the hemispheres. arising from two hemispheres could be different.

(a) (d)

(b) (e)

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(c) Figure 2. Band power measured during AVE a) on right hemisphere for CONTROLs, b) on right hemisphere for participant 1, c) on left hemisphere for participant 1, d) on right hemisphere for participant 2, e) on right hemisphere for participant3.

V. DISCUSSION found to increase, This confirms that both visual and Audio inputs helps sleep induction. Sleep disorder normally arises in patients suffering from neuro related problems, emotional stress, After ascertaining the effectiveness of AV stimulus, work nature or as a side effect of any other test was extended to subjects with sleep disorder. pathological conditions. This leads to poor These people took relatively longer time to enter efficiency in work and fatigue if not treated into sleep state when compare with CONTROLs. correctly. The main aim of this study is to induce From this experimental analysis the following are sleep in subjects with sleep disorder without any the observations. drugs. An AVE unit is developed in such a manner i. During relaxed state, though low frequency that it gives relaxation and comfort to the user. is present, content of high frequency (8-12 This is tried over 5 CONTROL subjects and 3 TEST Hz) is dominant. subjects. ii. Time taken for CONTROL subjects to enter At first control subjects are tested with Audio and into sleep state is less when compared to Visual inputs when given respectively with other subjects with sleep disorder. condition like environment and time remaining the iii. After AVE is commenced, it can be observed same. All the participants felt that audio that (Figure 2 a to e), power in low stimulation is more effective than visual. This is frequency content increases and power in because of the production of binaural beat that high frequency content decreases. This is a activates in such a phase to produce delta proof for entry into sleep. waves. But visual signal input (Red light), though iv. As time progresses, there is further increase do not aid in the sleep inducing mechanism in low frequency and further decrease in (production of melatonin) they do not suppress it high frequency where the subject went to (Deanna Alicia et. al., 2007). However, when the deep sleep. This state occurred in both the same Subjects are tried with simultaneous Audio & cases (CONTROL and pathological), only Visual (AV) stimulus, response in delta band was

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difference being time duration i.e, CONTROL Author’s Contributions subjects take smaller duration when compared to test subjects to enter into Kindly add sleep. v. When signals from two hemispheres are REFERENCES compared, CONTROL subject exhibits similar [1] Adrian E. Matthews B. (1934). The berger : response with magnitude of power being Potential changes from the occipital lobes of man. Brain. the same. But the pathological subjects vol. 57, pp. 355-385. shows similar variation in frequency content, [2] Daniel F, Kripke. Surprising View of Insomnia and Sleeping Pills. (2013). Sleep, Vol 36, Issue 8. pp 1127–1128. however its power value is different. All the Mathew R Ebben, Mariya Narizhnaya. (2012). Cognitive three pathological subjects exhibited high and behavioral treatment options for Insomnia. Mount power on right side and low power on left Sinai Journal of medicine. vol. 79. pp.512-523. side of hemisphere. [3] Deanna Alicia oleske. Janis T Eells. Diane S Henshel. (2007). Melatonin as a principal component of red light From this it can be observed that AVE increases therapy Medical Hypotheses. vol. 69, 372-376. power in delta band and decreases power in alpha [4] D. J. Anderson. (1989). The Treatment of Migraine with band indicating lowering the active state. In Variable Frequency Photo-Simulation. Headache. vol. 29. addition to this, the test group of subjects are pp. 154-155. [5] D.N.J. Donker. L. Njio. W. Storm Van Leeuwen. G. interviewed for their comments on this therapy. All Wieneke. (1998). Interhemispheric Relationships of the participants uniformly welcomed this sort of responses to sine wave modulates light in normasl non-invasive therapy without any oral intervention. subjects and patients. Elsevier, They also felt more convenient in the audio than and clinical Neurophysiology. vol. 44. pp.479-489. video input. Few are of opinion that the drug they [6] Hiroaki Kumano. Harumi Horie, Tomoko Shidara. Tomifusa Kuboki. Hiroyuki suematsu. Mitsuo Yasuhi. consume for sleep gives sort of inconvenience like (1996). Treatment of a Depressive Disorder Patient with headache and made them less active, specifically if EEG Driven Photic stimuluation. and self- sedative drugs are consumed in combination with regulation. vol. 21. No. 4. pain killers or drugs related to their physiological [7] Hillel pratt. Arnold Starr. Henry J. Mchalewski. Andrew Dimitrjievic Naomi Bleich. Nomi Mittelman. (2009). condition, sometimes its interaction leads to Cortical evoked potentials to an auditory illusion: Binaural disturbed sleep. Above all the participants felt an beats. Clinical Neurophysiology. 120. pp. 1514-1524. improvement in quality of sleep in the night after [8] Hsin-Yi Tang. Michael V. Vitiello. Michael Perlis. Jun this AVE therapy. However still more study is to be James Mao. Barbara Riegel. (2014). A Pilot Study of done to quantify the quality of sleep. This however Audio-Visual Stimulation As a self-Care Treatment or Insomnia in Adults with Insomnia and Chronic pain. being a primitive study would definitely prove to Applied Psychophysiol Biofeedback. 39(39). 219-225. be an alternative for drug based therapy. doi:10.1007/s10484-014-9263-8. [9] Hsin- Yi Tang. Barbara Riegel. Susan M. McCurry. Michael Acknowledgement V. Vitiello. (2015). Open-Loop Audio-Visual Stimulation (AVS): A Useful Tool for Management o Insomnia. Kindly add Applied Psychophysiol Biofeedback. doi:10.1007/s10484- 015-9285. [10] John s. Barlow. (1959). Rhymtic activity induced by photic Conflict of interest statement stimulation in relation to intrinsic alpha activity of the The author has declared that no competing or brain in man. Neurological diseases and blindness. 12:317- conflict of interests exist. The funders had no role 26 in study design, writing of the manuscript and [11] James D. Lane. Stefan J. Kasian. Justine E. Owenst. Gail R. Marsh. (1998). Binaural auditory Beats Affect Vigilance decision to publish. Performance and Mood. Elsevier, physiology & Behavior. vol. 63. No. 2. pp. 249-252.

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[12] Michael L. perlis. Helli Merica. M. T. Smith. Donna E. Giles. (2001). Beta EEG activity and insomnia. Sleep Medicine Reviews. vol. 5, No. 5, pp. 365-376. [13] Mathew R Ebben, Mariya Narizhnaya. (2012). Cognitive and behavioral treatment options for Insomnia. Mount Sinai Journal of medicine. vol. 79. pp.512-523. [14] Shusheng Zand. Dangxiao wang. Naqash Afzal. Yuru Zhang. Ruilin Wu. (2016). Rhythmic Haptic Stimuli Improve short-term Attention. IEEE Trans on Haptics, vol.9. pp.437

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