BRIEF RESEARCH REPORT article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1601821
Smartphone-Based Non-Invasive Biofeedback Therapy for Post-Stroke Sleep Disorders: Short Report
Provisionally accepted
- 1College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
- 2Bell theraupetic Inc, Seoul, Republic of Korea
- 3Korea Institute of Science and Technology, Seoul, Republic of Korea
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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.
Keywords: biofeedback, Stroke, stroke rehabilitation, Sleep Initiation and Maintenance Disorders, insomnia, Digital Health, digital therapeutics
Received: 28 Mar 2025; Accepted: 06 Jun 2025.
Copyright: © 2025 Park, Jung, Ha, Park and Im. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sun Im, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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