I am in a small basement room in a London clinic with five electrodes attached to my head.
Three run to a small black box about the size of a hard drive, the other two are clipped to my ears and join a grey device.
The neuro-psycho-physiologist Lesley Parkinson looks on with interest.
‘Well done brain, yes!’ she says. ‘Look, absolutely lovely bursts of alpha waves.’
I’m having an electroencephalogram (EEG), which measures brain electrical activity before, during and after using an Alpha-Stim device.
I’m here because of a diagnosis of generalised anxiety disorder three years ago, a history of insomnia and the hope this unorthodox approach might prove one of the final bricks in the wall of my recovery.
Alpha-Stim has been around for a while, but it’s starting to make waves in some areas of mental health care, thanks to a small but growing body of evidence from clinical studies and patient testimonials — and a need to find alternatives to medication and waiting times involved in therapy.
My battle with insomnia, which I had experienced on and off for seven years, had dropped off a cliff. I was spending whole nights awake, at turns frustrated, hysterical and back to sanguine. I had amassed generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), a specific phobia of going to bed (clinophobia) and situational depression as a result of all these conditions
Marketed as a treatment for anxiety, insomnia, depression and pain, Alpha-Stim is a form of cranial electrotherapy stimulation — the device I’m attached to generates a microcurrent of electricity (less than half a milliampere, compared with, say, the 540 milliamperes drawn from a 60-watt lightbulb) — which increases the proportion of a certain type of brainwave called alpha waves.
These are associated with states of calmness, relaxation and meditation in an awake brain and have a measurable frequency (between 7.5 Hz and 13 Hz on an EEG).
Other brainwaves also read by an EEG include beta waves (associated with a busy, active, anxious mind), delta waves (linked to sleep) and gamma waves (associated with concentration).
I notice little during the treatment, except a fuzzy rhythmic buzzing every couple of seconds at my earlobes.
To my surprise, my EEG shows there’s a significant change in the frequency and size of my alpha waves — I wasn’t expecting such an immediate effect.
This is not my first time using the device. For five weeks I’ve been ‘plugging myself in’ for an hour every evening in front of the television, and for the first time in years I’m able to fall asleep without medication.
For me, three years after being admitted to the Priory Hospital in Roehampton, South-West London, this is no small miracle.
My battle with insomnia, which I had experienced on and off for seven years, had dropped off a cliff.
I was spending whole nights awake, at turns frustrated, hysterical and back to sanguine. I had amassed generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), a specific phobia of going to bed (clinophobia) and situational depression as a result of all these conditions.
For five weeks I’ve been ‘plugging myself in’ for an hour every evening in front of the television, and for the first time in years I’m able to fall asleep without medication. For me, three years after being admitted to the Priory Hospital in Roehampton, South-West London, this is no small miracle
In the worst moments, I’d avoid going into my bedroom during the day because it had taken on such negative connotations. The panic attacks I’d started experiencing I had alone, screaming into a pillow in our attic bedroom so as not to wake my husband or our young daughter. Although I could function during the day, for example keeping up with work and friends on the surface, my husband took the brunt of my short fuse behind closed doors. I didn’t deal well with him changing plans or sneezing at night.
Anxiety — not something I had previously identified with — increased week on week. I was malfunctioning on a grand scale.
After a month as an in-patient and several more as a day-patient, I was discharged from hospital with prescriptions and an altered outlook.
During the months and years since, I’ve spent time and energy turning this mess around with a combination of time away from work and a social life, psychoeducation, cognitive behavioural therapy, medication and various other coping mechanisms, such as yoga, deep breathing and keeping a diary. I reorganised myself at a fundamental level.
Last year, I felt comfortable enough to begin the slow process of dropping my sleep medication.
It took ten months to reduce the amitriptyline from 40mg to 5mg, but stopping that final, measly half-pill was proving difficult.
Old feelings of anxiety, linked to sleep, re-emerged along with a night-time agitation I hadn’t felt for years.
I’m having an electroencephalogram (EEG), which measures brain electrical activity before, during and after using an Alpha-Stim device. I’m here because of a diagnosis of generalised anxiety disorder three years ago, a history of insomnia and the hope this unorthodox approach might prove one of the final bricks in the wall of my recovery. An Alpha-Stim Aid is seen above
I heard about Alpha-Stim while researching a book I’m writing about anxiety, and wondered if it could help me. In truth, it sounded far-fetched — bathing your brain in electricity on the sofa to quell anxiety — so I checked it was safe with my psychiatrist.
Last year, the National Institute for Health and Care Excellence (NICE) concluded that Alpha-Stim showed promise for managing anxiety disorders and it’s currently being trialled by the NHS in Northamptonshire.
An earlier study, published in 2019 by Nottingham University in the Journal of Affective Disorders, found that around half of 161 volunteers with generalised anxiety disorder were in remission after 24 weeks, having used the device for an hour every day over a 12-week period — although the study participants were not compared to a control group.
Side-effects were fleeting and rare: mild headache, short spells of dizziness or nausea (if levels were too high) or skin irritation from the electrodes.
Alpha-Stim is safe, my psychiatrist agreed, and could be worth a try, as any reduction in my anxiety might give me more confidence in my ability to sleep at night.
The first evening I’m wired up to the device, I feel relaxed enough to hold off taking my sleep medication.
The device is easy to use, you simply moisten the disposable electrode felt pads with a conduction solution containing mineral salts to help the current flow better, attach the clips to each ear and turn the device on. Nothing much seems to happen apart from the rhythmic tingle at my earlobes — but that night I drift into sleep without trouble. I wake up tentatively happy and more confident.
Users are advised to aim for 20, 40 or 60 minutes every day for around four to eight weeks, then scale back use to roughly three times a week — or when required. Alpha-Stim can be used before or alongside medication and therapy.
The kit costs from £480, or you can rent it from £25 a week plus VAT for a minimum of four weeks, which is expensive (I borrowed mine from a supplier, themicrocurrentsite.co.uk).
Dr James Kustow, a psychiatrist and medical director of The Grove Practice, a mental health training provider and therapy service, has used the device with about 200 patients.
He says that, while there’s enough good data for people to feel ‘reasonably confident’ in its efficacy and safety, there are unanswered questions and the NHS would need to see more research before it could consider rolling it out.
One concern is that no one has yet proven how its anti-anxiety effect works. As well as boosting alpha waves, some research suggests the device activates groups of nerve cells located in the base of the brain which produce the chemicals serotonin and acetylcholine, which relate to positive mood, according to James Giordano, a professor of neurology at Georgetown University, in the U.S., who works with Alpha-Stim.
Dr Kustow and others believe it probably works by directly stimulating the vagus nerve, part of the autonomic nervous system which controls unconscious actions such as breathing and digestion.
The vagus nerve stretches from the brain to our major organs, and stimulating it is thought to put us into a ‘rest-and-digest’ (rather than fight-or-flight) state, says Dr Kustow.
Since using the device for the first time 12 weeks ago, I’ve not felt the need to take the amitriptyline once, and my anxiety surrounding bedtime has dropped to almost zero.
The only downsides have been a slightly itchy, irritated patch of skin behind my ears and — once — a short spell of nausea and dizziness when I turned the current up too high to see what would happen.
This, according to Dr Kustow, is because the device can stimulate the vestibulocochlear nerve which passes near the ear and is involved in balance.
Turning down the device stopped the sensation in seconds — but clinicians argue this underlines why Alpha-Stim should be introduced to patients by trained professionals, rather than it being purchased online as it currently is in the UK.
After one week, I was sleeping more deeply and waking less often. A few times I have even awoken having slept soundly the entire night — something I haven’t done for many years. After ten weeks I stopped using it; I kept forgetting, which shows how relaxed I have become.
It’s hard to know exactly how much is actually down to the placebo effect but, frankly, I don’t care. Getting a good night’s sleep without relying on medication has been a long time coming.
Dr Kustow is running a training course for mental health professionals this month.
Apps that claim to send you to sleep
Patients with insomnia can now be prescribed a sleep app, Sleepio, developed by an Oxford University professor, on the NHS. I asked sleep expert Dr Maja Schaedel for her verdict on Sleepio and four other sleep apps — which I tested.
Free with a GP’s referral, or register at sleepio.com/waitinglist
Claim: ‘A science-based approach.’ This app gives you a six-week course of cognitive behavioural therapy for insomnia (CBT-i), a clinically proven strategy to tackle the disorder.
The app works on breaking negative thoughts about sleep, reorganising your sleep schedule, and ensuring your lifestyle and bedroom are sleep-friendly. It includes a weekly 90-minute ‘community chat’ with a sleep psychologist.
In studies against a placebo, Sleepio users fell asleep 54 per cent faster and spent 62 per cent less time awake after eight weeks.
Expert verdict: ‘I recommend Sleepio to many patients,’ says Dr Schaedel, a clinical psychologist and co-founder of The Good Sleep Clinic.
‘CBT-i works well because it helps unpick unhelpful patterns of behaviour that perpetuate sleeplessness.’
User verdict: Easy to use. I like the community aspect (discussion and messaging with other insomniacs).
Best for: Treating long- term issues.
£28.99 a year, App Store or Google Play
Claim: ‘The number-one app for sleep, meditation and relaxation, with more than 1.5 million five-star reviews.’ This is best known for sleep stories read by celebrities.
Expert verdict: ‘Calm helps you to relax, rather than cure sleep issues, reducing physiological arousal and slowing heart and breathing rates,’ says Dr Schaedel.
User verdict: Listening to Cillian Murphy reading about crossing Ireland by train made me drift off within 20 minutes. And the app is easy to navigate.
Best for: Getting your mind sleep-ready.
£29.99 a year, App Store or Google Play
Claim: ‘Fall asleep faster. Stay asleep longer. Wake up feeling refreshed.’ This is based on acceptance and commitment therapy (ACT), an approach endorsed by the NHS. It encourages accepting negative thoughts about sleep.
Expert verdict: ‘ACT is a respected approach and useful for those suffering chronic anxiety alongside insomnia,’ says Dr Schaedel.
User verdict: Informative, but requires commitment.
Best for: Helping insomnia and anxiety issues.
Full access £48.99 a year or £7.99 a month, App Store or Google Play
Claim: ‘The world’s most advanced sleep and power nap system.’ This is a library of calming audio (music, narratives and sound-effects) to play in bed. Research shows that music, heart rate variability, breathing, hypnosis and muscle relaxation improve sleep quality.
Expert verdict: ‘Less useful for chronic insomniacs as the app has a focus on naps — one of the first things I recommend patients stop doing,’ says Dr Schaedel.
User verdict: Relaxing, but it didn’t work for me.
Best for: Napping, perhaps while travelling.
£49.99 a year or £9.99 a month, App Store or Google Play
Claim: ‘It can help you relax your mind in minutes and get the best sleep.’ This app offers everything from guided meditation and ‘night-time SOS’ — for when you wake in the night — to breathing exercises.
Expert verdict: ‘Headspace teaches methods of reducing physiological arousal through muscle relaxation, breathing exercises and visualisation,’ says Dr Schaedel. ‘It’s good for reducing anxiety surrounding sleep.’
User verdict: This has so much. A 20-minute visualisation exercise has me asleep before it finishes.
Best for: Relaxing meditations and audio courses.