Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency

Martijn Arns*, Ilse Feddema, J. Leon Kenemans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Recent studies suggest a role for sleep and sleep problems in the etiology of attention deficit hyperactivity disorder (ADHD) and a recent model about the working mechanism of sensori-motor rhythm (SMR) neurofeedback, proposed that this intervention normalizes sleep and thus improves ADHD symptoms such as inattention and hyperactivity/impulsivity. In this study we compared adult ADHD patients (N = 19) to a control group (N = 28) and investigated if differences existed in sleep parameters such as Sleep Onset Latency (SOD, Sleep Duration (DUR) and overall reported sleep problems (PSQI) and if there is an association between sleep-parameters and ADHD symptoms. Secondly, in 37 ADHD patients we investigated the effects of SMR and Theta/Beta (TBR) neurofeedback on ADHD symptoms and sleep parameters and if these sleep parameters may mediate treatment outcome to SMR and TBR neurofeedback. In this study we found a clear continuous relationship between self-reported sleep problems (PSQI) and inattention in adults with- and without-ADHD. IBA neurofeedback resulted in a small reduction of SQL, this change in SQL did not correlate with the change in ADHD symptoms and the reduction in SQL only happened in the last half of treatment, suggesting this is an effect of symptom improvement not specifically related to TBR neurofeedback. SMR neurofeedback specifically reduced the SQL and PSQI score, and the change in SQL and change in PSQI correlated strongly with the change in inattention, and the reduction in SQL was achieved in the first half of treatment, suggesting the reduction in SQL mediated treatment response to SMR neurofeedback. Clinically, TBR and SMR neurofeedback had similar effects on symptom reduction in ADHD (inattention and hyperactivity/impulsivity). These results suggest differential effects and different working mechanisms for TBR and SMR neurofeedback in the treatment of ADHD.

Original languageEnglish
Article number1019
Number of pages10
JournalFrontiers in Human Neuroscience
Publication statusPublished - 23 Dec 2014
Externally publishedYes


  • ADHD
  • neurofeedback
  • theta
  • SMR
  • theta/beta
  • sleep
  • sleep onset insomnia
  • EEG


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