Objective:

Evaluate the effectiveness of Personalized Repetitive Transcranial Magnetic Stimulation (PrTMS®) on sleep quality in adults with insomnia. We hypothesize that PrTMS will significantly improve subjective sleep quality.

Background:

Sleep disturbances are common and contribute to poor health outcomes across psychiatric, neurological, and systemic disorders. Altered cortical oscillatory dynamics, particularly within prefrontal networks regulating arousal and sleep–wake stability, may underlie insomnia. PrTMS utilizes spectral EEG guidance to iteratively optimize sleep-related network synchronization through low-power stimulation of multiple cortical areas. Adjustments of cortical treatment sites and stimulus frequency are guided by an algorithm identifying individualized stimulation frequencies within the brain’s default mode network alpha oscillatory band, targeting functional abnormalities of sleep–wake circuits.

Design/Methods:

A retrospective analysis was performed of adults treated with PrTMS. In line with guidelines, patients were included if they had a baseline insomnia Sleep Condition Indicator (SCI) score <16 and classified as severe (0–8), moderate (9–15), or subthreshold (≥16). Continuous improvement was calculated using Symmetrized Percent Change (SPC = 200 × [Final–Baseline]/[Final+Baseline])  to normalize improvement across a wide range of baseline values. Paired t-tests assessed change from baseline, and demographic variables were assessed for differences using linear regression.

Results:

Mean age was 44.4±15.2 years; 55.5% female. Average treatment duration was 55.6±18.2 days. 1,273 patients completed 7,625 SCI questionnaires. Mean SPC = +34.5±70.2% (t(1272)=17.53, p<0.001), indicating significant improvement in sleep quality. Of 658 with moderate insomnia, 89.7% experienced SCI improvement, with 46.7% achieving category transition (SCI ≥16). Of 615 with severe insomnia, 54.3% improved to at least moderate, and of those, 17.2% reached subthreshold. No effects of age or gender were observed.

Conclusions:

PrTMS was associated with significant improvements in subjective sleep quality, underscoring its potential role in therapeutic outcomes. Questionnaires like SCI can introduce self-report bias, highlighting the need for prospective, controlled PrTMS studies to substantiate findings.