Abstract
Background: Law enforcement officers have decreased life expectancy, attributed to work-related exposure to traumatic stress and circadian disruption. Autonomic dysregulation is reported with traumatic stress, and chronic insomnia. Closed-loop therapies with real time monitoring for modulation of biological function offer a precision-guided, patient-centric strategy for brain-based therapies. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®) is a noninvasive, closed-loop, allostatic, acoustic stimulation neurotechnology using software generated algorithms to identify specific brain frequencies, and translate them in real time into audible tones, to support self-optimization of brain rhythms. Objective: To evaluate benefits for autonomic function, and symptoms of insomnia and stress, in a relatively healthy cohort of law enforcement officers, who enrolled in an IRB-approved, open label feasibility study evaluating HIRREM for diverse neuropsychological disorders. Measures done before and after HIRREM included symptom inventories for insomnia (ISI), depression (CES-D), traumatic stress (PCL-C), anxiety (GAD-7), and perceived stress (PSS). Ten minute recordings of heart rate and blood pressure allowed analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV). Results: 7 participants (1 female), mean (SD) age 47 (4.5), received 10.7 (2.6) HIRREM sessions over 11.3 (4.6) days (7.3 in office days). Data were collected before, and 22.6 (1.8) days after HIRREM completion. Use of HIRREM was associated with significantly increased HRV measured as rMSSD [from 25.3 (7.0) to 43.1 (13.0) ms, p=0.02]. BRS measured by high frequency alpha index improved [from 11.3 (8.0) to 20.1 (11.0) ms/mmHg, p=0.03]. All symptom inventories improved significantly (p<0.05), even with the small cohort. There were no adverse events or drop outs. Conclusion: These pilot data provide the first report of significant autonomic cardiovascular benefits, and associated symptom improvements, with use of a closed-loop, allostatic therapy for a cohort of sworn law enforcement officers. Further studies are warranted to test the efficacy of this technology in a larger law enforcement cohort
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