Transcranial magnetic stimulation combined with transcranial direct current stimulation in patients with chronic insomnia: a case report

Long-term insomnia affects the normal life and work of individuals and increases the risk of various health problems, including mental illness. Therefore, there is an urgent need for an efficient and safe treatment for improving sleep. In this study, we report the case a 52-year-old woman who received repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) after agreeing to publish her case. In order to evaluate the quality of sleep and the stability of emotional symptoms, clinical evaluations were conducted at baseline, after 10 treatment sessions, after 20 treatment sessions, and 1 month after the end of treatment. After completing rTMS combined with tDCS, the patient showed an overall clinical improvement, with clinical changes mainly observed in the Pittsburgh Sleep Quality Index, Hamilton Depression Scale, Hamilton Anxiety Scale scores and polysomnography, and this improvement was maintained 1 month after the intervention. This case provides the first evidence for the feasibility, tolerability, and safety of combined rTMS and tDCS in a patient with chronic insomnia.