无创性神经调控技术治疗睡眠障碍的研究进展
Research Progress of Noninvasive Neuromodulation Technology in the Treatment of Sleep Disorders
DOI: 10.12677/jcpm.2026.52154, PDF,   
作者: 吴瑜婷*：暨南大学附属广东省第二人民医院医学影像科，广东 广州；江桂华#：暨南大学附属广东省第二人民医院医学影像科，广东 广州；广东省第二人民医院医学影像科，广东 广州；福建医科大学附属厦门弘爱医院医学影像科，福建 厦门
关键词: 睡眠障碍；无创神经调控技术；重复经颅磁刺激；经颅直流电刺激；Sleep Disorders； Non-Invasive Neuromodulation Techniques； Repetitive Transcranial Magnetic Stimulation； Transcranial Direct Current Stimulation
摘要: 睡眠障碍作为一类破坏正常睡眠模式的疾患，是临床实践中极为常见的问题之一。睡眠障碍干扰个体正常的躯体、心理、社交和情绪功能，严重时可能影响整体健康状况、个人安全乃至生活质量。无创神经调控技术是治疗睡眠障碍的非侵入性且安全有效的手段，主要通过磁刺激、电刺激等方式对大脑神经功能状态进行调控，主要类型包括重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)和经颅直流电刺激(transcranial direct current stimulation, tDCS)。本综述将从原理及特点、治疗方法、治疗效果等方面对tDCS及rTMS在睡眠障碍中的应用进行阐述，以期为今后睡眠障碍的临床治疗和研究提供借鉴。
Abstract: Sleep disorders, as a category of conditions that disrupt normal sleep patterns, are among the most prevalent issues in clinical practice. These disorders interfere with individuals’ normal physical, psychological, social, and emotional functions, and in severe cases, may adversely affect overall health status, personal safety, and even quality of life. Non-invasive neuromodulation techniques represent a non-invasive and safe therapeutic approach for sleep disorders, primarily involving the modulation of brain neural functional states through methods such as magnetic stimulation and electrical stimulation. The main types include repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). This review will elaborate on the application of tDCS and rTMS in sleep disorders from aspects such as principles and characteristics, treatment methods, and therapeutic outcomes, aiming to provide references for future clinical treatment and research on sleep disorders.
文章引用：吴瑜婷, 江桂华. 无创性神经调控技术治疗睡眠障碍的研究进展[J]. 临床个性化医学, 2026, 5(2): 534-546. https://doi.org/10.12677/jcpm.2026.52154

参考文献

[1] 黄鑫, 李苏宁, 尹军祥, 等. 我国睡眠障碍防控研究现状及建议[J]. 四川大学学报(医学版), 2023, 54(2): 226-230.
[2] Karna, B., Sankari, A. and Tatikonda, G. (2023) Sleep Disorder. StatPearls Publishing.
[3] Dopheide, J.A. (2020) Insomnia Overview: Epidemiology, Pathophysiology, Diagnosis and Monitoring, and Nonpharmacologic Therapy. The American Journal of Managed Care, 26, S76-S84.
[4] Sutton, E.L. (2021) Insomnia. Annals of Internal Medicine, 174, ITC33-ITC48. [Google Scholar] [CrossRef] [PubMed]
[5] Battisha, A., Kahlon, A. and Kalra, D.K. (2025) Sleep-disordered Breathing and Hypertension—a Systematic Review. Journal of Clinical Medicine, 14, Article 3115. [Google Scholar] [CrossRef] [PubMed]
[6] Foldvary-Schaefer, N.R. and Waters, T.E. (2017) Sleep-Disordered Breathing. Continuum, 23, 1093-1116. [Google Scholar] [CrossRef] [PubMed]
[7] Maski, K., Trotti, L.M., Kotagal, S., Robert Auger, R., Swick, T.J., Rowley, J.A., et al. (2021) Treatment of Central Disorders of Hypersomnolence: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment. Journal of Clinical Sleep Medicine, 17, 1895-1945. [Google Scholar] [CrossRef] [PubMed]
[8] Biscarini, F., Barateau, L., Pizza, F., Plazzi, G. and Dauvilliers, Y. (2025) Present and Future of Central Disorders of Hypersomnolence. Journal of Sleep Research, 34, e70118. [Google Scholar] [CrossRef] [PubMed]
[9] Trotti, L.M. (2020) Central Disorders of Hypersomnolence. Continuum, 26, 890-907. [Google Scholar] [CrossRef] [PubMed]
[10] Maski, K., Trotti, L.M., Kotagal, S., Robert Auger, R., Rowley, J.A., Hashmi, S.D., et al. (2021) Treatment of Central Disorders of Hypersomnolence: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 17, 1881-1893. [Google Scholar] [CrossRef] [PubMed]
[11] Spiegelhalder, K., Nissen, C. and Riemann, D. (2019) Clinical Sleep-Wake Disorders II: Focus on Insomnia and Circadian Rhythm Sleep Disorders. In: Handbook of Experimental Pharmacology, Springer, 261-276. [Google Scholar] [CrossRef] [PubMed]
[12] Martinez, D. and Lenz, M.D.C.S. (2010) Circadian Rhythm Sleep Disorders. The Indian Journal of Medical Research, 131, 141-149.
[13] Gao, S., Ye, X., Zhang, L. and Zhang, Y. (2025) The Interplay among Circadian Rhythm, Pain and Affective Disorders and the Underlying Mechanisms. Chinese Science Bulletin, 70, 3406-3416. [Google Scholar] [CrossRef] 
[14] Sun, S.Y. and Chen, G.H. (2022) Treatment of Circadian Rhythm Sleep—Wake Disorders. Current Neuropharmacology, 20, 1022-1034.
[15] Fleetham, J.A. and Fleming, J.A.E. (2014) Parasomnias. Canadian Medical Association Journal, 186, E273-E280. [Google Scholar] [CrossRef] [PubMed]
[16] Bruni, O., DelRosso, L.M., Melegari, M.G. and Ferri, R. (2024) The Parasomnias. Psychiatric Clinics of North America, 47, 135-146. [Google Scholar] [CrossRef] [PubMed]
[17] Sobreira-Neto, M.A., Stelzer, F.G., Gitaí, L.L.G., Alves, R.C., Eckeli, A.L. and Schenck, C.H. (2023) REM Sleep Behavior Disorder: Update on Diagnosis and Management. Arquivos de Neuro-Psiquiatria, 81, 1179-1194. [Google Scholar] [CrossRef] [PubMed]
[18] Merlino, G. and Gigli, G.L. (2012) Sleep-Related Movement Disorders. Neurological Sciences, 33, 491-513. [Google Scholar] [CrossRef] [PubMed]
[19] Wong, S.G., Vorakunthada, Y., Lee-Iannotti, J., et al. (2023) Sleep-Related Motor Disorders. In: Younger, D.S., Handbook of Clinical Neurology, Elsevier, 383-397.
https://www.sciencedirect.com/science/article/pii/B9780323988186000121
[20] Trotti, L.M. (2017) Restless Legs Syndrome and Sleep-Related Movement Disorders. Continuum, 23, 1005-1016. [Google Scholar] [CrossRef] [PubMed]
[21] Khan, M. (2023) Restless Legs Syndrome and Other Common Sleep-Related Movement Disorders. Continuum, 29, 1130-1148. [Google Scholar] [CrossRef] [PubMed]
[22] Lanza, G., Fisicaro, F., Cantone, M., Pennisi, M., Cosentino, F.I.I., Lanuzza, B., et al. (2023) Repetitive Transcranial Magnetic Stimulation in Primary Sleep Disorders. Sleep Medicine Reviews, 67, Article 101735. [Google Scholar] [CrossRef] [PubMed]
[23] Klomjai, W., Katz, R. and Lackmy-Vallée, A. (2015) Basic Principles of Transcranial Magnetic Stimulation (TMS) and Repetitive TMS (rTMS). Annals of Physical and Rehabilitation Medicine, 58, 208-213. [Google Scholar] [CrossRef] [PubMed]
[24] Beynel, L., Appelbaum, L.G., Luber, B., Crowell, C.A., Hilbig, S.A., Lim, W., et al. (2019) Effects of Online Repetitive Transcranial Magnetic Stimulation (rtms) on Cognitive Processing: A Meta-Analysis and Recommendations for Future Studies. Neuroscience & Biobehavioral Reviews, 107, 47-58. [Google Scholar] [CrossRef] [PubMed]
[25] Zheng, X., Zhao, Q., Fang, Q., Wang, R., Ma, B., Williams, J.P., et al. (2025) Feasibility of Rtms Combined with Dexmedetomidine in Chronic Insomnia Disorder. Scientific Reports, 15, Article No: 33507. [Google Scholar] [CrossRef] 
[26] Nardone, R., Sebastianelli, L., Versace, V., Brigo, F., Golaszewski, S., Pucks-Faes, E., et al. (2020) Effects of Repetitive Transcranial Magnetic Stimulation in Subjects with Sleep Disorders. Sleep Medicine, 71, 113-121. [Google Scholar] [CrossRef] [PubMed]
[27] Qi, S., Zhang, Y., Li, X., Sun, C., Ma, X., Li, S., et al. (2022) Improved Functional Organization in Patients with Primary Insomnia after Individually-Targeted Transcranial Magnetic Stimulation. Frontiers in Neuroscience, 16, Article 859440. [Google Scholar] [CrossRef] [PubMed]
[28] Krone, L.B., Fehér, K.D., Rivero, T. and Omlin, X. (2023) Brain Stimulation Techniques as Novel Treatment Options for Insomnia: A Systematic Review. Journal of Sleep Research, 32, e13927. [Google Scholar] [CrossRef] [PubMed]
[29] Li, M., Zhu, Y., Zhang, X., Yang, H., Zhang, S., Liu, J., et al. (2022) 1Hz rTMS over Left DLPFC Rewired the Coordination with Hippocampus in Insomnia Patients: A Pilot Study. Brain Stimulation, 15, 437-440. [Google Scholar] [CrossRef] [PubMed]
[30] Zhang, H., Huang, X., Wang, C. and Liang, K. (2022) Alteration of Gamma-Aminobutyric Acid in the Left Dorsolateral Prefrontal Cortex of Individuals with Chronic Insomnia: A Combined Transcranial Magnetic Stimulation-Magnetic Resonance Spectroscopy Study. Sleep Medicine, 92, 34-40. [Google Scholar] [CrossRef] [PubMed]
[31] Feng, J., Zhang, Q., Zhang, C., Wen, Z. and Zhou, X. (2019) The Effect of Sequential Bilateral Low-Frequency rTMS over Dorsolateral Prefrontal Cortex on Serum Level of BDNF and GABA in Patients with Primary Insomnia. Brain and Behavior, 9, e1206. [Google Scholar] [CrossRef] [PubMed]
[32] Song, P.H., Lin, H., Li, S.R., Wang, L., Liu, J.H., Li, N. and Wang, Y.P. (2019) Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Time-Varying Electroencephalography (EEG) Network in Primary Insomnia Patients: A TMS-EEG Study. Sleep Medicine, 56, 157-163. [Google Scholar] [CrossRef] [PubMed]
[33] Zhu, L., Dang, G., Wu, W., Zhou, J., Shi, X., Su, X., et al. (2023) Functional Connectivity Changes Are Correlated with Sleep Improvement in Chronic Insomnia Patients after rTMS Treatment. Frontiers in Neuroscience, 17, Article 1135995. [Google Scholar] [CrossRef] [PubMed]
[34] Shi, X., Guo, Y., Zhu, L., Wu, W., Hordacre, B., Su, X., et al. (2021) Electroencephalographic Connectivity Predicts Clinical Response to Repetitive Transcranial Magnetic Stimulation in Patients with Insomnia Disorder. Sleep Medicine, 88, 171-179. [Google Scholar] [CrossRef] [PubMed]
[35] Gossard, T.R., Trotti, L.M., Videnovic, A. and St Louis, E.K. (2021) Restless Legs Syndrome: Contemporary Diagnosis and Treatment. Neurotherapeutics, 18, 140-155. [Google Scholar] [CrossRef] [PubMed]
[36] Nardone, R., Sebastianelli, L., Versace, V., Brigo, F., Golaszewski, S., Pucks-Faes, E., et al. (2020) Contribution of Transcranial Magnetic Stimulation in Restless Legs Syndrome: Pathophysiological Insights and Therapeutical Approaches. Sleep Medicine, 71, 124-134. [Google Scholar] [CrossRef] [PubMed]
[37] Lanza, G., Cantone, M., Aricò, D., Lanuzza, B., Cosentino, F.I.I., Paci, D., et al. (2018) Clinical and Electrophysiological Impact of Repetitive Low-Frequency Transcranial Magnetic Stimulation on the Sensory-Motor Network in Patients with Restless Legs Syndrome. Therapeutic Advances in Neurological Disorders, 11, Article 1756286418759973. [Google Scholar] [CrossRef] [PubMed]
[38] Lin, Y.C., Feng, Y., Zhan, S.Q., et al. (2015) Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome. Chinese Medical Journal, 128, 1728-1731. [Google Scholar] [CrossRef] [PubMed]
[39] Afshari Saleh, L., Asadpour, H., Amini, M., Hojjat, S.K., Talaei, A. and Raji, H. (2025) Investigating of Mood and Sleep Disorders in Patients with Restless Legs Syndrome: A Cross-Sectional Study. Jundishapur Journal of Chronic Disease Care, 14, e158353. [Google Scholar] [CrossRef] 
[40] Rogić Vidaković, M., Šoda, J., Jerković, A., Benzon, B., Bakrač, K., Dužević, S., et al. (2020) Obstructive Sleep Apnea Syndrome: A Preliminary Navigated Transcranial Magnetic Stimulation Study. Nature and Science of Sleep, 12, 563-574. [Google Scholar] [CrossRef] [PubMed]
[41] Lanza, G., Lanuzza, B., Aricò, D., Cantone, M., Cosentino, F.I.I., Pennisi, M., et al. (2015) Direct Comparison of Cortical Excitability to Transcranial Magnetic Stimulation in Obstructive Sleep Apnea Syndrome and Restless Legs Syndrome. Sleep Medicine, 16, 138-142. [Google Scholar] [CrossRef] [PubMed]
[42] Das, A., Anupa, A.V. and Radhakrishnan, A. (2013) Reduced Plastic Brain Responses to Repetitive Transcranial Magnetic Stimulation in Severe Obstructive Sleep Apnea Syndrome. Sleep Medicine, 14, 636-640. [Google Scholar] [CrossRef] [PubMed]
[43] Shinde, A.B., Lerud, K.D., Munsch, F., Alsop, D.C. and Schlaug, G. (2021) Effects of tDCS Dose and Electrode Montage on Regional Cerebral Blood Flow and Motor Behavior. NeuroImage, 237, Article 118144. [Google Scholar] [CrossRef] [PubMed]
[44] Hao, W., Liu, Y., Gao, Y., Gong, X. and Ning, Y. (2023) Transcranial Direct Current Stimulation for the Treatment of Post-Stroke Depression: A Systematic Review. Frontiers in Neurology, 13, Article 955209. [Google Scholar] [CrossRef] [PubMed]
[45] 刘洋, 钱苏, 孙文琳, 等. 经颅直流电刺激联合镜像疗法对脑卒中后上肢及手功能恢复的影响[J]. 哈尔滨医科大学学报, 2023, 57(5): 575-579.
[46] Ebajemito, J.K., Furlan, L., Nissen, C. and Sterr, A. (2016) Application of Transcranial Direct Current Stimulation in Neurorehabilitation: The Modulatory Effect of Sleep. Frontiers in Neurology, 7, Article 54. [Google Scholar] [CrossRef] [PubMed]
[47] 张懿. 经颅直流电刺激在精神疾病治疗中应用的研究进展[J]. 临床合理用药杂志, 2020, 13(18): 178-180.
[48] Lefaucheur, J., Antal, A., Ayache, S.S., Benninger, D.H., Brunelin, J., Cogiamanian, F., et al. (2017) Evidence-Based Guidelines on the Therapeutic Use of Transcranial Direct Current Stimulation (tDCS). Clinical Neurophysiology, 128, 56-92. [Google Scholar] [CrossRef] [PubMed]
[49] Herrero Babiloni, A., Bellemare, A., Beetz, G., Vinet, S., Martel, M.O., Lavigne, G.J., et al. (2021) The Effects of Non-Invasive Brain Stimulation on Sleep Disturbances among Different Neurological and Neuropsychiatric Conditions: A Systematic Review. Sleep Medicine Reviews, 55, Article 101381. [Google Scholar] [CrossRef] [PubMed]
[50] Saebipour, M.R., Joghataei, M.T., Yoonessi, A., Sadeghniiat-Haghighi, K., Khalighinejad, N. and Khademi, S. (2015) Slow Oscillating Transcranial Direct Current Stimulation during Sleep Has a Sleep-Stabilizing Effect in Chronic Insomnia: A Pilot Study. Journal of Sleep Research, 24, 518-525. [Google Scholar] [CrossRef] [PubMed]
[51] Frase, L., Selhausen, P., Krone, L., Tsodor, S., Jahn, F., Feige, B., et al. (2019) Differential Effects of Bifrontal tDCS on Arousal and Sleep Duration in Insomnia Patients and Healthy Controls. Brain Stimulation, 12, 674-683. [Google Scholar] [CrossRef] [PubMed]
[52] Cavinato, M., Genna, C., Formaggio, E., Gregorio, C., Storti, S.F., Manganotti, P., et al. (2019) Behavioural and Electrophysiological Effects of tDCS to Prefrontal Cortex in Patients with Disorders of Consciousness. Clinical Neurophysiology, 130, 231-238. [Google Scholar] [CrossRef] [PubMed]
[53] Zhou, Q., Yu, C., Yu, H., Zhang, Y., Liu, Z., Hu, Z., et al. (2020) The Effects of Repeated Transcranial Direct Current Stimulation on Sleep Quality and Depression Symptoms in Patients with Major Depression and Insomnia. Sleep Medicine, 70, 17-26. [Google Scholar] [CrossRef] [PubMed]
[54] 董强利, 欧阳萱, 谌红献, 等. 失眠物理治疗的研究进展[J]. 精神医学杂志, 2022, 35(6): 653-656.
[55] Tortella, G., Sampaio-Junior, B., Moreno, M.L., Moffa, A.H., da Silva, A.F., Lafer, B., et al. (2021) Cognitive Outcomes of the Bipolar Depression Electrical Treatment Trial (BETTER): A Randomized, Double-Blind, Sham-Controlled Study. European Archives of Psychiatry and Clinical Neuroscience, 271, 93-100. [Google Scholar] [CrossRef] [PubMed]
[56] Minichino, A., Bersani, F.S., Spagnoli, F., Corrado, A., De Michele, F., Calò, W.K., et al. (2014) Prefronto-Cerebellar Transcranial Direct Current Stimulation Improves Sleep Quality in Euthymic Bipolar Patients: A Brief Report. Behavioural Neurology, 2014, 1-3. [Google Scholar] [CrossRef] [PubMed]
[57] Bersani, F.S., Minichino, A., Fattapposta, F., et al. (2015) Prefrontocerebellar Transcranial Direct Current Stimulation Increases Amplitude and Decreases Latency of P3b Component in Patients with Euthymic Bipolar Disorder. [Google Scholar] [CrossRef] 
[58] Gálvez, V., Alonzo, A., Martin, D., Mitchell, P.B., Sachdev, P. and Loo, C.K. (2011) Hypomania Induction in a Patient with Bipolar II Disorder by Transcranial Direct Current Stimulation (tDCS). The Journal of ECT, 27, 256-258. [Google Scholar] [CrossRef] [PubMed]
[59] 王玉明, 宫慧明, 张俊义, 等. 脊髓灰质炎后综合征的临床表现及诊断[J]. 中国康复理论与实践, 2017, 23(5): 501-504.
[60] Acler, M., Bocci, T., Valenti, D., Turri, M., Priori, A. and Bertolasi, L. (2013) Transcranial Direct Current Stimulation (tDCS) for Sleep Disturbances and Fatigue in Patients with Post-Polio Syndrome. Restorative Neurology and Neuroscience, 31, 661-668. [Google Scholar] [CrossRef] [PubMed]
[61] Bakhshayesh Eghbali, B., Ramezani, S., Sedaghat Herfeh, S., Emir Alavi, C., Najafi, K., Esmaeeli Lipaei, P., et al. (2023) Transcranial Direct Current Stimulation Improves Sleep Quality in Patients with Insomnia after Traumatic Brain Injury. Brain Injury, 37, 63-73. [Google Scholar] [CrossRef] [PubMed]
[62] 刘观秀, 孙伟铭, 董香丽, 等. 经颅直流电刺激患者不良反应的表现、原因与规避[J]. 精准医学杂志, 2023, 38(4): 373-376.
[63] D’Urso, G., Toscano, E., Barone, A., Palermo, M., Dell’Osso, B., Di Lorenzo, G., et al. (2023) Transcranial Direct Current Stimulation for Bipolar Depression: Systematic Reviews of Clinical Evidence and Biological Underpinnings. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 121, Article 110672. [Google Scholar] [CrossRef] [PubMed]
[64] Lanza, G. and Scalise, A. (2020) The Present and the Future of Transcranial Magnetic Stimulation in Restless Legs Syndrome. Sleep Medicine, 71, 122-123. [Google Scholar] [CrossRef] [PubMed]
[65] Lanza, G. (2020) Repetitive TMS for Sleep Disorders: Are We Ready? Sleep Medicine, 71, 111-112. [Google Scholar] [CrossRef] [PubMed]
[66] Zhou, Q., Liu, Z., Zhao, S., Yu, J., Zhou, D., Xu, W., et al. (2022) Transcranial Magnetic Stimulation Combined with Transcranial Direct Current Stimulation in Patients with Chronic Insomnia: A Case Report. Journal of Clinical Sleep Medicine, 18, 2871-2874. [Google Scholar] [CrossRef] [PubMed]