Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report

Post-stroke sleep disorders (PSSDs), particularly insomnia, are common yet insufficiently recognized complications that can negatively affect recovery in stroke patients. Existing treatment options are often hindered by side effects, complex protocols, or cumbersome equipment. This short report intr...

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Main Authors: Jisoo Park, Minyong Jung, Jiyeon Ha, Jonghwa Jeonglok Park, Sun Im
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1601821/full
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author Jisoo Park
Minyong Jung
Jiyeon Ha
Jonghwa Jeonglok Park
Jonghwa Jeonglok Park
Sun Im
author_facet Jisoo Park
Minyong Jung
Jiyeon Ha
Jonghwa Jeonglok Park
Jonghwa Jeonglok Park
Sun Im
author_sort Jisoo Park
collection DOAJ
description Post-stroke sleep disorders (PSSDs), particularly insomnia, are common yet insufficiently recognized complications that can negatively affect recovery in stroke patients. Existing treatment options are often hindered by side effects, complex protocols, or cumbersome equipment. This short report introduces a smartphone-based biofeedback intervention designed to address insomnia by targeting autonomic nervous system (ANS) dysfunction. The intervention was tested on three subacute stroke in-patients unresponsive to pharmacological therapies. All patients demonstrated significant improvements in subjective sleep quality, assessed primarily with the Korean version of the Richards-Campbell Sleep Questionnaire (RCSQ) and secondarily with the Insomnia Severity Index (ISI-K) and Pittsburgh Sleep Quality Index (PSQI-K). RCSQ results indicated improvements in subjective sleep quality across all patients. ISI scores showed all three patients achieved remission thresholds for insomnia, with improvements exceeding the Minimal Clinically Important Difference (MCID). PSQI-K scores also improved in all cases, with two patients reaching threshold levels for insomnia. The intervention’s efficacy was validated through an on–off–on design, as improvements were observed during intervention periods, diminished during washout phases, and resurfaced with reintroduction. Results highlight the potential of a fully non-invasive solution for managing insomnia in stroke patients, offering a practical and effective alternative to traditional treatments.
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spelling doaj-art-457e2ad5a5ea4a6fbe46dafcf203aa632025-08-20T03:24:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.16018211601821Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short reportJisoo Park0Minyong Jung1Jiyeon Ha2Jonghwa Jeonglok Park3Jonghwa Jeonglok Park4Sun Im5Department of Rehabilitation Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaBELL Therapeutics Inc, Seoul, Republic of KoreaBELL Therapeutics Inc, Seoul, Republic of KoreaBELL Therapeutics Inc, Seoul, Republic of KoreaIntelligence and Interaction Research Center, Korea Institute of Science and Technology, Seoul, Republic of KoreaDepartment of Rehabilitation Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaPost-stroke sleep disorders (PSSDs), particularly insomnia, are common yet insufficiently recognized complications that can negatively affect recovery in stroke patients. Existing treatment options are often hindered by side effects, complex protocols, or cumbersome equipment. This short report introduces a smartphone-based biofeedback intervention designed to address insomnia by targeting autonomic nervous system (ANS) dysfunction. The intervention was tested on three subacute stroke in-patients unresponsive to pharmacological therapies. All patients demonstrated significant improvements in subjective sleep quality, assessed primarily with the Korean version of the Richards-Campbell Sleep Questionnaire (RCSQ) and secondarily with the Insomnia Severity Index (ISI-K) and Pittsburgh Sleep Quality Index (PSQI-K). RCSQ results indicated improvements in subjective sleep quality across all patients. ISI scores showed all three patients achieved remission thresholds for insomnia, with improvements exceeding the Minimal Clinically Important Difference (MCID). PSQI-K scores also improved in all cases, with two patients reaching threshold levels for insomnia. The intervention’s efficacy was validated through an on–off–on design, as improvements were observed during intervention periods, diminished during washout phases, and resurfaced with reintroduction. Results highlight the potential of a fully non-invasive solution for managing insomnia in stroke patients, offering a practical and effective alternative to traditional treatments.https://www.frontiersin.org/articles/10.3389/fneur.2025.1601821/fullbiofeedbackstrokestroke rehabilitationsleep initiation and maintenance disordersinsomniadigital health
spellingShingle Jisoo Park
Minyong Jung
Jiyeon Ha
Jonghwa Jeonglok Park
Jonghwa Jeonglok Park
Sun Im
Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
Frontiers in Neurology
biofeedback
stroke
stroke rehabilitation
sleep initiation and maintenance disorders
insomnia
digital health
title Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
title_full Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
title_fullStr Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
title_full_unstemmed Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
title_short Smartphone-based non-invasive biofeedback therapy for post-stroke sleep disorders: short report
title_sort smartphone based non invasive biofeedback therapy for post stroke sleep disorders short report
topic biofeedback
stroke
stroke rehabilitation
sleep initiation and maintenance disorders
insomnia
digital health
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1601821/full
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