Science

Relaxation and Audiovisual Stimulation (AVS)

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Relaxation is one of the frequently used non-pharmacological methods of physical and mental calming and relaxation used to fall asleep, reduce and overcome pain, anxiety, and prevent possible negative states.

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The relaxed state achieved by relaxation often includes feelings of psychological and bodily well-being and tranquility. The goal of relaxation is to reduce the activity of the sympathetic nervous system. The practice of relaxation is associated with a decrease in blood pressure, oxygen consumption, respiratory rate, heart rate, and muscle tension. Relaxation techniques have several physiologic effects - lowering cortisol levels and inhibiting inflammation. The effectiveness of relaxation depends on the length of time practiced.

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There are several different types of relaxation techniques - meditation, breathing techniques, visualization, autogenic training, and progressive muscle relaxation. One possible explanation for why relaxation techniques relieve chronic pain is that chronic pain is maintained and intensified by psychological stress and physical tension.

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It has been estimated that it takes three months of regular relaxation practice to achieve pain reduction, and its effectiveness depends on both individual differences and types of chronic pain.

Various relaxation techniques related to reducing muscle and psycho-emotional tone, calming down and slowing down breathing are the gold standard for non-medication to achieve falling asleep quickly and sleeping soundly, reducing pain, preventing migraines, anxiety and panic attacks. With the exception of acute forms of psychiatric disorders, relaxation has no contraindications and is effective to use. The obstacle for many is the long period of time to learn relaxation techniques (three months or more) and the need to follow simple rules of healthy lifestyle and sleep hygiene.

Relaxation is mastered faster and more effectively with synchronous external sensory influence accompanied by positive emotions of the user (i.e. with the production of pleasure hormones) - pleasant quiet music with the rhythm of breathing or audiovisual stimulation with biofeedback.

Audio-visual stimulation (AVS) is used to improve psycho-emotional state or cognitive functions and more often refers to physiotherapy - non-therapeutic influence on the human senses to achieve beneficial results.

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The principle of AVS is based on stimulation of the central nervous system (CNS) with specific visual and sound signals of different frequencies. These signals affect the brain in different ways, depending on the sounds coming from speakers or headphones, and the light signals and video images displayed on a screen or through special glasses.

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The effects of AVS on humans have been studied in many scientific monographs, reviews and articles. Electroencephalogram (EEG) studies have shown changes in brain activity when exposed to visual and acoustic signals. AVS is effective for insomnia, pain reduction, migraine prevention, and sedation, one of the problems for AVS research is the lack of standards, making it difficult to systematically review and consolidate the scientific literature.

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The development of relaxation and AVS has been facilitated by advances in portable EEG devices, which have become available for use not only in hospitals and laboratories, but also in the home, eliminating uncomfortable masks with gel-smeared electrodes.

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AVS is usually used in conjunction with breathing exercises to promote relaxation, but there are techniques in which AVS is a stand-alone way to achieve results.

AVS devices and apps for falling asleep and sleeping:

- Hatch smart lamps and lights with music (www.hatch.co)

- Mija Bedside Lamp smart lights (www.mijia-shop.com)

- AVS smartphone app Calm (www.calm.com)

- Galaxy & Star Projectors smart nightlights with music from various manufacturers

- Mindalive audio visual stimulation products (www.mindalive.com)

- AVS smartphone apps Mesmerize (www.mesmerizeapp.com)

- AVS sleep mask LC-dolida (www.thelcdolida.com)

- Elemind headphone foreheadband (www.elemindtech.com)

- Caputron Neuromodulation Devices (www.caputron.com)

- Modius Sleep Neuromodulation Device (www.neurovalens.com)

- Nervous system toning device with sound and infrasound Sensate (www.getsensate.com).

Pain countermeasures devices with AVS:

- The Sana Health device mask (www.sana.io)

- Roxiva lamp (www.roxiva.com)

- David Premier,Delight,Delight Plus complexes (www.mindalive.com)

- Complexes EMDR (https://emdrtech.com)

- Soterix Medical Complexes (www.soterixmedical.com)

- INTO device (www.in.to).

Devices for migraine countermeasures:

- Cefaly (www.cefaly.com) is a headband-like device that sends electrical impulses that stimulate nerve cells associated with migraine.

- Spring TMS or eNeura sTM (www.eneura.co.uk) - a device for people with pre-migraine aura that delivers a magnetic pulse that stimulates the part of the brain associated with migraines

- GammaCore (www.gammacore.com) non-invasive vagus nerve stimulator (NVN) - a hand-held device placed over the vagus nerve in the neck that stimulates nerve fibers to relieve pain

- Nerivio (www.nerivio.com) - a wireless nerve-altering device worn on the forearm for migraines.

Anxiety and Stress Prevention Devices and Devices:

- Modius Stress Neuromodulation Device (www.neurovalens.com)

- Neuromodulation device sound and infrasound Sensate (www.getsensate.com)

- Apollo (www.apolloneuro.com) Vagus nerve toning sound wave vibration calming and sleep device (www.apolloneuro.com)

- Wearable tactile stimulation devices The Touch Point (www.thetouchpointsolution.com)

- Alpha-Stim cranial electrotherapy (CES) and mycortical electrotherapy (MET) devices (www.alpha-stim.com)

- Biofeedback sedation and sleep devices (www.bio-medical.com)

- GoRoga Stress Reduction Devices (www.corporate.goroga.in)

- Smartphone apps «Worry Tree», «Moodfit», «Freedom», «Alan Minnd», «HeadGear», «Calm». 

The phenomenon of rocking

People have always rocked their babies. First they did it in their hands, then they invented cradles, bassinets, rocking beds, screwed to them different mechanisms, attached motors, video cameras, wireless communication, sound and motion sensors, forming a multi-billion dollar market of good children's sleep. For a long time, no one thought about the reasons for the positive effect of rocking on children, everyone just knew that when rocking children stop crying, calm down and fall asleep.

With the development of science it became clear that rocking is not just rhythmic rocking of the child, but a psychophysiological phenomenon formed in the womb and fixed during breastfeeding, which forms a sense of peace, comfort and safety that remains throughout a person's life. Every person has a memory of rocking as a state of peace, comfort and security, because rocking, cuddling, and feeding produce the pleasure hormones serotonin, endorphin, oxytocin and dopamine, which are the cause of feelings of happiness, peace and serenity.

Rocking in the womb is experienced by absolutely all people: when a pregnant woman walks, vertical movements of her torso are made, causing uniform vertical rocking of the water sac, picked up by the otolithic system of the vestibular apparatus of the human embryo. There are scientific hypotheses that the memories of a comfortable state of rest and security, received in the womb, accompany a person throughout his life.

It is the pleasure of rocking and the associated hormonal activity explains the popularity of furniture for rocking - rocking chairs, recliners, home swings, which are bought by millions, and on which are spent tens of billions of $US.

But children mostly sleep well, and teenagers also sleep well, and young people, in general, with sleep all right. But after 40 - as luck would have it, and after 60, sleep becomes a problem for most people. What can you do, age-related neurodegenerative changes can't be avoided by anyone.

It is surprising that adults, wanting to sleep like babies in the figurative sense, do not think about the actual possibility of such sleep and do not make any effort to achieve such sleep. Habit is a stubborn thing.

In scientific literature and medical journals there are many articles about the positive effect of cyclic vestibular stimulation (rocking) on rocking to sleep and sleep of adults, about the reduction of the time of falling asleep with rocking, about the possibility of forming breathing in sleep due to external stimuli. In university laboratories, devices have been created to study falling asleep and sleep under conditions of vestibular stimulation.

But while cradles, bassinets and rocking beds are leading the way in the infant sleep products industry, modern technology has left rocking without proper attention in the adult sleep products industry.

Since 2010, the Sensory Systems Laboratory (SMS Lab) at ETH Zurich has been conducting scientific research on the effects of rocking to sleep with the creation of several Somnomat laboratory rocking machines, which has led to a surge of interest in the effects of rocking to sleep and a large number of scientific publications and studies.

Scientific studies have confirmed the positive effects of vestibular stimulation (rocking to sleep) on the time of falling asleep and on sleep in general. Important are the positive results of the effects of rocking on the duration of the deep slow-wave sleep phase N3 and on memory consolidation (the transition of memory from short-term to long-term).

With an imperfect test methodology and a limited number of subjects, the positive results of rocking to sleep were published in Current Biology in 2010-2021 and in other scientific journals linked below.

Sleep breathing

The problems of breathing during falling asleep and during sleep are topical in medicine and physiology. Currently, specialized scientific journals “Sleep and Breathing” and “Sleep and Biological Rhythms” are published, the titles of which reveal their topics.

The problems of sleep respiratory failure - snoring and obstructive sleep apnea - are massive, with Obstructive sleep apnea (OSA) alone affecting more than 74 million Americans, nearly 22% of the total U.S. population, most of whom have undiagnosed OSA. Sleep apnea causes spontaneous awakenings, reduces blood oxygen saturation, causes pressure spikes, and carries negative cardiac consequences and risk of sudden death.

At the World Sleep Forum held in Rio de Janeiro (Brazil) on 20-25.10.2023, more than half of the participants specialized in the treatment of sleep apnea, which best characterizes the urgency of the problem.

Sleep-disordered breathing is primarily managed with continuous pressure air mask (CPAP). In addition, there are surgical methods, special jaw or peri-mandibular mouth guards, implants, devices that elevate the upper torso, and smartphone apps. All of these devices and treatments have varying degrees of effectiveness that are significantly lower than CPAP masks, the use of which is effective but extremely uncomfortable.

The possibilities of shaping the breathing of a falling asleep or sleeping person under the influence of external stimuli, described in scientific articles, have spurred entrepreneurs to create consumer devices to improve or restore breathing:

- Moonbird (www.moonbird.life) is an expanding and contracting device placed in the palm of a person falling asleep. The external stimulus is cyclic tactile stimulation in the hand. Initially the respiratory reflex is formed consciously synchronously with the cyclic tactile stimulation, later the reflexive breathing is unconsciously synchronized with the sensory stimulation.

- Somnox (www.somnox.com) is a robotic bag pressed against the abdomen that stimulates the diaphragm to contract and shape the breathing of a falling asleep and sleeping person. Direct stimulation of breathing is carried out in conjunction with the formed conditioned respiratory reflex. The external stimulus is cyclic tactile stimulation in the region of the umbilicus. Initially, the respiratory reflex is formed consciously synchronously with acting with cyclic stimulation of touch and direct stimulation of breathing, later the reflexive breathing is carried out unconsciously synchronously with sensory stimulation and direct stimulation of breathing.

- Dodow (www.mydodow.com) is a rhythmic light source that pulsates in time with breathing and shapes the breathing of the falling asleep and sleeping person. The external stimulus is the cyclic stimulation of the falling asleep person's vision. Initially, the breathing reflex is formed consciously synchronously with the cyclic stimulation of vision, later the reflexive breathing is unconsciously synchronized with sensory stimulation.

- 2 breathe (www.2breathe.com) - a smartphone app to help you breathe slowly and deeply has evolved into resperate.com, a wearable device that rhythmically influences hearing and shapes breathing to counteract hypertension.

- SleepCogni (www.sleepcogni.com) - a device placed in the palm of a person falling asleep. The external stimulus is cyclic tactile stimulation of the hand. Initially, the respiratory reflex is formed consciously synchronously with cyclic tactile stimulation, and later reflexive breathing is unconsciously synchronized with sensory stimulation.

Scientific publications in the field of rocking bed and vestibular stimulation during sleep:

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- Non-Pharmacological Intervention for Personalizing Sleep Quality through Gentle Rocking Motion. Vulturar DM, Moacă LȘ, Chețan IM, Vesa ȘC, Alexescu TG, Grigorescu C, Trofor AC, Stoia MA, Nemes AF, Todea DA.J Pers Med. 2024 Feb 19;14(2):218. doi: 10.3390/jpm14020218.PMID: 3839265

- Effect of a Recliner Chair with Rocking Motions on Sleep Efficiency. Baek S, Yu H, Roh J, Lee J, Sohn I, Kim S, Park C.Sensors (Basel). 2021 Dec 8;21(24):8214. doi: 10.3390/s21248214.PMID: 34960304 Free PMC article

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- Effect of Rocking Movements on Afternoon Sleep. van Sluijs RM, Rondei QJ, Schluep D, Jäger L, Riener R, Achermann P, Wilhelm E.Front Neurosci. 2020 Jan 21;13:1446. doi: 10.3389/fnins.2019.01446. eCollection 2019.PMID: 32038144 Free PMC article

- Whole-Night Continuous Rocking Entrains Spontaneous Neural Oscillations with Benefits for Sleep and Memory. Perrault AA, Khani A, Quairiaux C, Kompotis K, Franken P, Muhlethaler M, Schwartz S, Bayer L.Curr Biol. 2019 Feb 4;29(3):402-411.e3. doi: 10.1016/j.cub.2018.12.028. Epub 2019 Jan 24.PMID: 30686735

- Woodward, S.; Tauber, E.S.; Spielman, A.J.; Thorpy, M.J. Effects of Otolithic Vestibular Stimulation on Sleep. Sleep 1990, 13, 533–537.

- Chalmers, R.; Howard, R.; Wiles, C.; Spencer, G. Use of the Rocking Bed in the Treatment of Neurogenic Respiratory Insufficiency. QJM Int. J. Med. 1994, 87, 423–429.

- Bayer, L.; Constantinescu, I.; Perrig, S.; Vienne, J.; Vidal, P.-P.; Mühlethaler, M.; Schwartz, S. Rocking Synchronizes Brain Waves during a Short Nap. Curr. Biol. 2011, 21, R461–R462.

- Mölle, M.; Born, J. Slow Oscillations Orchestrating Fast Oscillations and Memory Consolidation. In Progress in Brain Research; Elsevier: Amsterdam, The Netherlands, 2011; Volume 193, pp. 93–110. ISBN 978-0-444-53839-0.

- Ngo, H.-V.V.; Martinetz, T.; Born, J.; Mölle, M. Auditory Closed-Loop Stimulation of the Sleep Slow Oscillation Enhances Memory. Neuron 2013, 78, 545–553.

- Morita, Y.; Yamaguchi, K.; Ashida, K.; Ikeura, R.; Yokoyama, K. Verification of Sleep-Inducing Effect by Excitation Apparatus Simulating Mother’s Embrace and Rocking Motion. In Proceedings of the 9th International Workshop on Robot Motion and Control, Kuslin, Poland, 3–5.07. 2013; pp. 80–85.

- Del Vecchio, F.; Nalivaiko, E.; Cerri, M.; Luppi, M.; Amici, R. Provocative Motion Causes Fall in Brain Temperature and Affects Sleep in Rats. Exp. Brain Res. 2014, 232, 2591–2599.

- Ashida, K.; Morita, Y.; Ikeura, R.; Yokoyama, K.; Ding, M.; Mori, Y. Effective Rocking Motion for Inducing Sleep in Adults - Verification of Effect of Mothers Embrace and Rocking Motion. J. Robot. Netw. Artif. Life 2015, 1, 285.

- Crivelli, F.; Omlin, X.; Rauter, G.; Von Zitzewitz, J.; Achermann, P.; Riener, R. Somnomat: A Novel Actuated Bed to Investigate the Effect of Vestibular Stimulation. Med. Biol. Eng. 2016, 54, 877–889.

- Omlin, X.; Crivelli, F.; Heinicke, L.; Zaunseder, S.; Achermann, P.; Riener, R. Effect of Rocking Movements on Respiration. PLoS ONE 2016, 11, e0150581.

- Shibagaki, H.; Ashida, K.; Morita, Y.; Ikeura, R.; Yokoyama, K. Verifying the Sleep-Inducing Effect of a Mother’s Rocking Motion in Adults. J. Robot. Netw. Artif. Life 2017, 4, 129–133.

- Kimura, H.; Kuramoto, A.; Inui, Y.; Inou, N. Mechanical Bed for Investigating Sleep-Inducing Vibration. J. Healthc. Eng. 2017, 2017, 2364659.

- Omlin, X.; Crivelli, F.; Näf, M.; Heinicke, L.; Skorucak, J.; Malafeev, A.; Fernandez Guerrero, A.; Riener, R.; Achermann, P. The Effect of a Slowly Rocking Bed on Sleep. Sci. Rep. 2018, 8, 2156.

- Perrault, A.A.; Khani, A.; Quairiaux, C.; Kompotis, K.; Franken, P.; Muhlethaler, M.; Schwartz, S.; Bayer, L. Whole-Night Continuous Rocking Entrains Spontaneous Neural Oscillations with Benefits for Sleep and Memory. Curr. Biol. 2019, 29, 402–411.e3.

- Kompotis, K.; Hubbard, J.; Emmenegger, Y.; Perrault, A.; Mühlethaler, M.; Schwartz, S.; Bayer, L.; Franken, P. Rocking Promotes Sleep in Mice through Rhythmic Stimulation of the Vestibular System. Curr. Biol. 2019, 29, 392–401.e4.

- van Sluijs, R.M.; Rondei, Q.J.; Schluep, D.; Jäger, L.; Riener, R.; Achermann, P.; Wilhelm, E. Effect of Rocking Movements on Afternoon Sleep. Front. Neurosci. 2020, 13, 1446.

- van Sluijs, R.; Wilhelm, E.; Rondei, Q.; Omlin, X.; Crivelli, F.; Straumann, D.; Jäger, L.; Riener, R.; Achermann, P. Gentle Rocking Movements during Sleep in the Elderly. J. Sleep Res. 2020, 29.

- Muto, T.; Yoshizawa, M.I.; Kim, C.; Kume, K. Sleep-Improving Effects of a Novel Motion Mattress. Sleep Biol. Rhythm. 2021, 19, 247–253.

- Baek, S.; Yu, H.; Roh, J.; Lee, J.; Sohn, I.; Kim, S.; Park, C. Effect of a Recliner Chair with Rocking Motions on Sleep Efficiency. Sensors 2021, 21, 8214.

- Park, K.S.; Choi, S.H.; Yoon, H. Modulation of Sleep Using Noninvasive Stimulations during Sleep. Biomed. Eng. Lett. 2023, 13, 329–341.

- A.Subramaniam, A.K.Eberhard-Moscicka, M.Ertl and F.W. Mast. Rocking Devices and the Role of Vestibular Stimulation on Sleep—A Systematic Review. Clin. Transl. Neurosci. 2023, 7, 40.

Restoration and normalization of breathing in sleep due to external stimuli - research and publications in peer-reviewed scientific journals:

- Closed-Loop Auditory Stimulation to Guide Respiration: Preliminary Study to Evaluate the Effect on Time Spent in Sleep Initiation during a Nap. Yoon H, Choi SH.Sensors (Basel). 2023 Jul 17;23(14):6468. doi: 10.3390/s23146468.PMID: 37514760

- Respiration-triggered olfactory stimulation reduces obstructive sleep apnea severity: A prospective pilot study. Perl O, Kemer L, Green A, Arish N, Corcos Y, Arzi A, Dagan Y.J Sleep Res. 2024 May 13:e14236. doi: 10.1111/jsr.14236. Online ahead of print.PMID: 38740050

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- Gentle rocking movements during sleep in the elderly.

van Sluijs R, Wilhelm E, Rondei Q, Omlin X, Crivelli F, Straumann D, Jäger L, Riener R, Achermann P.J Sleep Res. 2020 Dec;29(6):e12989. doi: 10.1111/jsr.12989. Epub 2020 Feb 15.PMID: 32061115 

- Respiratory impact on rocking induced by linear motion. Mert A, Klopping-Ketelaars I, Bles W.Ann N Y Acad Sci. 2009 May;1164:173-9. doi: 10.1111/j.1749-6632.2008.03735.x.PMID: 19645896

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- Entrainment of respiration to rocking in premature infants: coherence analysis. Sammon MP, Darnall RA.J Appl Physiol (1985). 1994 Sep;77(3):1548-54. doi: 10.1152/jappl.1994.77.3.1548.PMID: 7836164 

- Rassler B, Raabe J (2003) Co-ordination of breathing with rhythmic head and eye movements and with passive turnings of the body. European Journal of Applied Physiology 90: 125–130. - PubMed

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Scientific publications on the effects of AVS on falling asleep and sleep quality:

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- Research Article| December 09 2020. “Audio-visual stimulation for improving sleep quality” Muhammad Irsyad; Prihartini Widiyanti; Akif Rahmatillah. Author & Article Information

AIP Conf. Proc. 2314, 030016 (2020) https://doi.org/10.1063/5.0034989

- Hyeyeoun Joo, Hyunwoo Nam, Dae Lim Koo, Jeh-Kwang Ryu, Sunkyue Kim, Kyoung-Min Lee «The effect of audio–visual stimulation on sleep quality» September 2019 IBRO Reports 6:S436 DOI:10.1016/j.ibror.2019.07.1383

- MEASUREMENT SCIENCE REVIEW, Volume 6, Section 2, No. 4, 2006 67 Short-term effects of audio-visual stimulation on EEG M. Teplan, A. Krakovská, S. Štolc Institute of Measurement Science, Slovak Academy of Sciences, Dúbravská cesta 9, 841 01 Bratislava, Slovakia.

- 0393 «Open-Loop Audio-Visual Stimulation for Insomnia in Older Adults with Osteoarthritis Pain» 

J Tang, S M McCurry, B Riegel, K C Pike, M V Vitiello. Sleep, Volume 41, Issue suppl_1, April 2018, Pages A149–A150, https://doi.org/10.1093/sleep/zsy061.392 Published: 27.04.2018

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- «Pre-sleep alpha brainwave entrainment by audio or visual stimulation for people with chronic pain and sleep disturbance; a feasibility study» Stephen J. Halpin, NIcole Tang, Alex Casson, Anthony Jones, Rory J. O'Connor, Manoj Sivan. EEE - Academic & Research, Division of Neuroscience, University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds Community Healthcare NHS Trust.

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- Tang, HY., Vitiello, M.V., Perlis, M. et al. Open-Loop Neurofeedback Audiovisual Stimulation: A Pilot Study of Its Potential for Sleep Induction in Older Adults. Appl Psychophysiol Biofeedback 40, 183–188 (2015). https://doi.org/10.1007/s10484-015-9285-x

- Tang, H. Y., Vitiello, M. V., Perlis, M., Mao, J. J., & Riegel, B. (2014). A pilot study of audio–visual stimulation as a self-care treatment for insomnia in adults with insomnia and chronic pain. Applied Psychophysiology and Biofeedback, 39(34), 219–225. doi:10.1007/s10484-014-9263-8.

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- “The effect of auditory stimulation using delta binaural beat for a better sleep and post-sleep mood: A pilot study” Roya Dabiri, Mohammad Reza Monazzam Esmaielpour, Mojahede Salmani Nodoushan, Farin khaneshenas, Seyed Abolfazl Zakerian Digit Health. 2022 Jan-Dec; 8: 20552076221102243. Published online 2022 May 20. doi: 10.1177/20552076221102243

PMCID:PMC9125055

- “A feasibility study of pre-sleep audio and visual alpha brain entrainment for people with chronic pain and sleep disturbance” Stephen J. Halpin, Alexander J. Casson, Nicole K. Y. Tang, Anthony K. P. Jones, Rory J. O’Connor, Manoj Sivan. Front Pain Res (Lausanne) 2023; 4: 1096084. Published online 2023 Feb 23.  doi: 10.3389/fpain.2023.1096084 PMCID:PMC9996154

- “Lightening the mind with audiovisual stimulation as an accessible alternative to breath-focused meditation for mood and cognitive enhancement” Micah Alan Johnson, Ninette Simonian, Nicco Reggente Sci Rep. 2024; 14: 25553. Published online 2024 Oct 26. doi: 10.1038/s41598-024-75943-8 PMCID:PMC11513117.

Scientific publications on the effects of AVS on pain control:

- https://www.nature.com/articles/s41598-024-75943-8 Johnson, M., Simonian, N. & Reggente, N. «Lightening the mind with audiovisual stimulation as an accessible alternative to breath-focused meditation for mood and cognitive enhancement». Nature Sci Rep 14, 25553 (2024). https://doi.org/10.1038/s41598-024-75943-8

- https://www.sciencedirect.com/science/article/abs/pii/S0169260722002802 Computer Methods and Programs in Biomedicine Volume 223, August 2022, 106898 Salvatore Saiu, Enrico Grosso “Controlled audio-visual stimulation for anxiety reduction”.

- https://www.sciencedirect.com/science/article/abs/pii/S0169260720317259

Computer Methods and Programs in Biomedicine Volume 200, March 2021, 105892 Diana Barsasella, Megan F. Liu, Shwetambara  Malwade, Cooper J Galvin, Eshita Dhar, Chia-Chi Chang, Yu-Chuan Jack Li, Shabbir Syed-Abdul “Effects of Virtual Reality Sessions on the Quality of Life, Happiness, and Functional Fitness among the Older People: A Randomized Controlled Trial from Taiwan”

- https://www.sciencedirect.com/science/article/abs/pii/S0169260710002890

Computer Methods and Programs in Biomedicine Volume 102, Issue 1, April 2011, Pages 17-24 Teplan, A. Krakovská, S. Štolc “Direct effects of audio-visual stimulation on EEG”

- https://doi.org/10.1007/s11916-024-01246-2

Moreau, S., Thérond, A., Cerda, I.H. et al. ”Virtual Reality in Acute and Chronic Pain Medicine: An Updated Review”. Curr Pain Headache Rep 28, 893–928 (2024).

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- https://link.springer.com/article/10.1007/s11916-024-01258-y

Hou, TW., Yang, CC., Lai, TH. et al. Light Therapy in Chronic Migraine. Curr Pain Headache Rep 28, 621–626 (2024). https://doi.org/10.1007/s11916-024-01258-y

- https://www.spandidos-publications.com/10.3892/etm.2021.10055

Experemental and Therapeutic Medicine Weihua Hu, Ke Yang, Li Zhang, Xu Lu. Published online on: April 14, 2021     https://doi.org/10.3892/etm.2021.10055 Article Number: 623  “Effect of media distraction (audiovisual and music) for pain and anxiety control in patients undergoing shockwave lithotripsy: A systematic review and metaanalys”

- https://link.springer.com/article/10.1007/s10484-014-9263-8

Tang, HY., Vitiello, M.V., Perlis, M. et al. A Pilot Study of Audio–Visual Stimulation as a Self-Care Treatment for Insomnia in Adults with Insomnia and Chronic Pain. Appl Psychophysiol Biofeedback 39, 219–225 (2014). https://doi.org/10.1007/s10484-014-9263-8

- Budzynski, T., Budzynski, H., Sherlin, L., & Tang, H. Y. (2011). Audio–visual stimulation: Research and clinical practice. In J. Berger & G. Turow (Eds.), Music, science, and the rhythmic brain (pp. 137–153). New York: Routledge.

- https://pmc.ncbi.nlm.nih.gov/articles/PMC9996154/

«A feasibility study of pre-sleep audio and visual alpha brain entrainment for people with chronic pain and sleep disturbance» Stephen J. Halpin, Alexander J. Casson, Nicole K. Y. Tang, Anthony K. P. Jones, Rory J. O’Connor, Manoj Sivan. Front Pain Res (Lausanne) 2023; 4: 1096084. Published online 2023 Feb 23. doi: 10.3389/fpain.2023.1096084

- https://onlinelibrary.wiley.com/doi/10.1002/ejp.960

European Journal of pain Volume21, Issue3 March 2017 Pages 562-572. K. Ecsy, A.K.P. Jones, C.A. Brown “Alpha-range visual and auditory stimulation reduces the perception of pain”. First published: 02 November 2016 https://doi.org/10.1002/ejp.960

- https://pmc.ncbi.nlm.nih.gov/articles/PMC8405991/

Heliyon. 2021 Aug 20;7(8):e07837. doi: 10.1016/j.heliyon.2021.e07837 “Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials”.

Sara Magelssen Vambheim , Tonje Merete Kyllo, Sanne Hegland, Martin Bystad  PMCID: PMC8405991  PMID: 34485731

- Cochrane Database Syst Rev. 2018 Mar 28;2018(3):CD009514.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6494625/ «Relaxation techniques for pain management in labour» Caroline A Smith, Kate M Levett, Carmel T Collins, Mike Armour, Hannah G Dahlen, Machiko Suganuma Editor: Cochrane Pregnancy and Childbirth Group PMCID: PMC6494625  PMID: 29589650

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- Bair M.J., Robinson R.L., Katon W., Kroenke K. Depression and pain comorbidity: a literature review. Arch. Intern. Med. 2003;163(20):2433–2445. doi: 10.1001/archinte.163.20.2433.

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- Benson H. William Morrow and company; New York: 2000. Relaxation Response.

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- Benson H. Simon & Schuster; New York: 2010. Relaxation Revolution.

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- Bhasin M.K., Dusek J.A., Chang B.H., Joseph M.G., Denninger J.W., Fricchione G.L., Libermann T.A. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PloS One. 2013;8(5) doi: 10.1371/journal.pone.0062817.

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- Breivik H., Collett B., Ventafridda V., Cohen R., Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur. J. Pain. 2006;10:287–333. doi: 10.1016/j.ejpain.2005.06.009.

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- Bush V., Magerl W., Kern U., Haas J., Hajak G., Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing – an experimental study. Pain Med. 2012;13(2):215–228. doi: 10.1111/j.1526-4637.2011.01243.x.

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Bushnell C.M., Čeko M., Low L.A. Cognitive and emotional control of pain and its disruption in chronic pain. Nat. Rev. Neurosci. 2013;14:502–511. doi: 10.1038/nrn3516. 

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- Chang B.H., Dusek J.A., Benson H. Psychobiological changes from relaxation response elicitation: long-term practitioners versus novices. Psychosomatics. 2011;52:550–559. doi: 10.1016/j.psym.2011.05.001. 

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- Chen Y.L.E., Francis A.J. Relaxation and imagery for chronic, nonmalignant pain: effects on pain symptoms, quality of life, and mental health. Pain Manag. Nurs. 2010;11(3):159–168. doi: 10.1016/j.pmn.2009.05.005. 

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- Concato J., Shah N., Horwitz R.I. Randomized controlled trials, observational studies and the hierarchy of research designs. N. Engl. J. Med. 2000;342:1887–1892. doi: 10.1056/NEJM200006223422507. 

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- Coppieters I., Cagnie B., Nijs J., Van Oosterwijck J., Danneels L., De Pauw R., Meeus M. Effects of stress and relaxation on central pain modulation in chronic whiplash and fibromyalgia patients compared to healthy controls. Pain Physician. 2016;19(3):119–130. 

- Dunford E., Thompson M. Relaxation and mindfulness in pain: a review. Reviews in Pain. 2010;4:18–22. doi: 10.1177/204946371000400105. 

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- Edwards P., Clarke M., DiGuiseppi C., Pratap S., Roberts I., Wentz R. Identification of randomized controlled trials in systematic reviews: accuracy and reliability of screening records. Stat. Med. 2002;21:1635–1640. doi: 10.1002/sim.1190. 

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- Edwards R.R., Dworkin R.H., Sullivan M.D., Turk D.C., Wasan A.D. The role of psychosocial processes in the development and maintenance of chronic pain. Am Pain Soc. 2016;17(9):70–92. doi: 10.1016/j.jpain.2016.01.001. 

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- Fillingim R.B. Individual differences in pain: understanding the mosaic that makes pain personal. Pain. 2017;158(1):11–18. doi: 10.1097/j.pain.0000000000000775. 

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- Finnerup N.B. Nonnarcotic methods of pain management. N. Engl. J. Med. 2019;380:2440–2448. doi: 10.1056/NEJMra1807061.

Scientific publications on the effects of relaxation on migraine counteraction:

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- Psychological therapies for the prevention of migraine in adults

https://pmc.ncbi.nlm.nih.gov/articles/PMC6603250/

Louise Sharpe, Joanne Dudeney, Amanda C de C Williams, Michael Nicholas, Ingrid McPhee, Andrew Baillie, Miriam Welgampola, Brian McGuire, Cochrane Pain, Palliative and Supportive Care Group Cochrane Database Syst Rev. 2019; 2019(7): CD012295. Published online 2019 Jul 2. doi: 10.1002/14651858.CD012295.pub2 PMCID:PMC6603250

- Migraine and sleep disorders: a systematic review

https://pmc.ncbi.nlm.nih.gov/articles/PMC7590682/ Cindy Tiseo, Alessandro Vacca, Anton Felbush, Tamara Filimonova, Annalisa Gai, Tatyana Glazyrina, Irina Anna Hubalek, Yelena Marchenko, Lucas Hendrik Overeem, Serena Piroso, Alexander Tkachev, Paolo Martelletti, Simona Sacco, on behalf of the European Headache Federation School of Advanced Studies (EHF-SAS) J Headache Pain. 2020; 21(1): 126. Published online 2020 Oct 27. doi: 10.1186/s10194-020-01192-5 PMCID:PMC7590682

- Regular Practice of Autogenic Training Reduces Migraine Frequency and Is Associated With Brain Activity Changes in Response to Fearful Visual Stimuli  https://pmc.ncbi.nlm.nih.gov/articles/PMC8814632/ Dóra Dobos, Edina Szabó, Dániel Baksa, Kinga Gecse, Natália Kocsel, Dorottya Pap, Terézia Zsombók, Lajos R. Kozák, Gyöngyi Kökönyei, Gabriella Juhász Front Behav Neurosci. 2021; 15: 780081. Published online 2022 Jan 21. doi: 10.3389/fnbeh.2021.780081 PMCID:PMC8814632

- The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Ailani J, Burch RC, Robbins MS; Board of Directors of the American Headache Society.Headache. 2021 Jul;61(7):1021-1039. doi: 10.1111/head.14153. Epub 2021 Jun 23.PMID: 34160823

- Anxiety and depression symptoms and migraine: a symptom-based approach research.

Peres MFP, Mercante JPP, Tobo PR, Kamei H, Bigal ME.J Headache Pain. 2017 Dec;18(1):37. doi: 10.1186/s10194-017-0742-1. Epub 2017 Mar 21.PMID: 28324317 Free PMC article.

- Relaxation training for management of paediatric headache: A rapid review.

Thompson AP, Thompson DS, Jou H, Vohra S.Paediatr Child Health. 2019 May;24(2):103-114. doi: 10.1093/pch/pxy157. Epub 2019 Feb 7.PMID: 30996601 Free PMC article. Review.

- Biofeedback and relaxation-response training in the treatment of pediatric migraine.

Fentress DW, Masek BJ, Mehegan JE, Benson H.Dev Med Child Neurol. 1986 Apr;28(2):139-46. doi: 10.1111/j.1469-8749.1986.tb03847.x.PMID: 3519327 Clinical Trial.

- Relaxation training and written emotional disclosure for tension or migraine headaches: a randomized, controlled trial. D'Souza PJ, Lumley MA, Kraft CA, Dooley JA.Ann Behav Med. 2008 Aug;36(1):21-32. doi: 10.1007/s12160-008-9046-7. Epub 2008 Aug 12.PMID: 18696172 Free PMC article. Clinical Trial. Scientific articles on the effects of relaxation on overcoming stress, anxiety, worry and panic attacks:

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- Antidepressants versus placebo for panic disorder in adults

Irene Bighelli, Mariasole Castellazzi, Andrea Cipriani, Francesca Girlanda, Giuseppe Guaiana, Markus Koesters, Giulia Turrini, Toshi A Furukawa, Corrado Barbui, Cochrane Common Mental Disorders Group Cochrane Database Syst Rev. 2018; 2018(4): CD010676. Published online 2018 Apr 5. doi: 10.1002/14651858.CD010676.pub2 PMCID: PMC6494573

- Biobehavioral approach to distinguishing panic symptoms from medical illness

Natalie C. Tunnell, Sarah E. Corner, Andres D. Roque, Juliet L. Kroll, Thomas Ritz, Alicia E. Meuret

Front Psychiatry. 2024; 15: 1296569. Published online 2024 May 8. doi: 10.3389/fpsyt.2024.1296569

PMCID:PMC11109415

- Panic disorder in general medical practice- A narrative review

Narayana Manjunatha, Dushad Ram J Family Med Prim Care. 2022 Mar; 11(3): 861–869. Published online 2022 Mar 10. doi: 10.4103/jfmpc.jfmpc_888_21 PMCID:PMC9051703

- Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta‐analysis Alessandro Pompoli, Toshi A Furukawa, Hissei Imai, Aran Tajika, Orestis Efthimiou, Georgia Salanti, Cochrane Common Mental Disorders Group Cochrane Database Syst Rev. 2016 Apr; 2016(4): CD011004. Published online 2016 Apr 13. doi: 10.1002/14651858.CD011004.pub2PMCID:PMC7104662

- Panic-Focused Psychodynamic Psychotherapy in a Woman with Panic Disorder and Generalized Anxiety Disorder Larry Sandberg, Fredric Busch, Franklin Schneier, Andrew Gerber, Eve Caligor, Barbara Milrod Harv Rev Psychiatry. Author manuscript; available in PMC 2016 May 18. Published in final edited form as: Harv Rev Psychiatry. 2012 Sep-Oct; 20(5): 268–276. doi: 10.3109/10673229.2012.726527PMCID:PMC4871148

- Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults Hissei Imai, Aran Tajika, Peiyao Chen, Alessandro Pompoli, Toshi A Furukawa, Cochrane Common Mental Disorders Group Cochrane Database Syst Rev. 2016; 2016(10): CD011170. Published online 2016 Oct 12. doi: 10.1002/14651858.CD011170.pub2 PMCID:PMC6457876

- Anxiety as a disorder of uncertainty: implications for understanding maladaptive anxiety, anxious avoidance, and exposure therapy Vanessa M. Brown, Rebecca Price, Alexandre Y. Dombrovski Cogn Affect Behav Neurosci. Author manuscript; available in PMC 2024 Jun 1. Published in final edited form as: Cogn Affect Behav Neurosci. 2023 Jun; 23(3): 844–868. Published online 2023 Mar 3. doi: 10.3758/s13415-023-01080-w

PMCID:PMC10475148

- Sleep and anxiety disorders Luc Staner Dialogues Clin Neurosci. 2003 Sep; 5(3): 249–258. doi: 10.31887/DCNS.2003.5.3/lstaner

PMCID:PMC3181635