Efficacy of High‐Frequency Transcranial Magnetic Stimulation Therapy for Depression With Insomnia Symptoms: A Systematic Review and Meta‐Analysis Based on Randomized Controlled Trials
- 1Department of Rehabilitation Medicine Guangzhou First People Hospital Guangzhou Guangdong China
- 2Guangzhou University of Chinese Medicine Guangzhou Guangdong China
- 3Guangdong Food and Drug Vocational College Guangzhou Guangdong China
Abstract
Background: This meta‐analysis evaluated the efficacy of high‐frequency repetitive transcranial magnetic stimulation (HF‐rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) in patients with comorbid depression and insomnia.
Methods: This analysis incorporated 7 studies, involving 709 subjects (control: 342; repetitive transcranial magnetic stimulation [rTMS]: 367). All included studies employed left DLPFC‐targeted HF‐rTMS. Treatment effectiveness for comorbid depression and insomnia was assessed. Subgroup analyses were conducted to explore possible sources of heterogeneity.
Results: HF‐rTMS significantly improved sleep quality (standardized mean difference [SMD] [95% confidence interval (CI)]: 0.97 [0.23 to 1.71], p = 0.01) and depressive symptoms (0.61 [0.38 to 0.84], p < 0.00001). There was a non‐significant trend toward reduced sleep latency (0.50 [−0.17 to 1.18], p = 0.14). No significant difference in adverse reactions was observed (risk ratio [95% CI]: 1.09 [0.80 to 1.48], p = 0.57). Substantial heterogeneity was identified for the Pittsburgh Sleep Quality Index outcomes (I 2 = 91%). Subgroup analyses indicated that this heterogeneity was attributed to variations in stimulation frequency and baseline antidepressant use.
Conclusion: Very‑low to low certainty evidence suggests that left DLPFC‑targeted HF‑rTMS may improve sleep quality and depressive symptoms in patients with depression and insomnia symptoms, with a favorable safety profile. However, due to substantial heterogeneity and methodological limitations, these findings should be considered exploratory and warrant confirmation by future high‑quality trials.
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BibTeX
@article{yang2026efficacy,
title = {{Efficacy of High‐Frequency Transcranial Magnetic Stimulation Therapy for Depression With Insomnia Symptoms: A Systematic Review and Meta‐Analysis Based on Randomized Controlled Trials}},
author = {Wenqing Yang and Songbin Chen and Xiaotong Li and Junhui Chen and Li Li and Jin Yu},
journal = {Brain and Behavior},
year = {2026},
month = oct,
doi = {10.1002/brb3.71808},
url = {https://doi.org/10.1002/brb3.71808},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Efficacy of High‐Frequency Transcranial Magnetic Stimulation Therapy for Depression With Insomnia Symptoms: A Systematic Review and Meta‐Analysis Based on Randomized Controlled Trials
AU - Wenqing Yang
AU - Songbin Chen
AU - Xiaotong Li
AU - Junhui Chen
AU - Li Li
AU - Jin Yu
PY - 2026
DA - 2026/10/27
JO - Brain and Behavior
DO - 10.1002/brb3.71808
UR - https://doi.org/10.1002/brb3.71808
AB - Background: This meta‐analysis evaluated the efficacy of high‐frequency repetitive transcranial magnetic stimulation (HF‐rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) in patients with comorbid depression and insomnia. Methods: This analysis incorporated 7 studies, involving 709 subjects (control: 342; repetitive transcranial magnetic stimulation [rTMS]: 367). All included studies employed left DLPFC‐targeted HF‐rTMS. Treatment effectiveness for comorbid depression and insomnia was assessed. Subgroup analyses were conducted to explore possible sources of heterogeneity. Results: HF‐rTMS significantly improved sleep quality (standardized mean difference [SMD] [95% confidence interval (CI)]: 0.97 [0.23 to 1.71], p = 0.01) and depressive symptoms (0.61 [0.38 to 0.84], p < 0.00001). There was a non‐significant trend toward reduced sleep latency (0.50 [−0.17 to 1.18], p = 0.14). No significant difference in adverse reactions was observed (risk ratio [95% CI]: 1.09 [0.80 to 1.48], p = 0.57). Substantial heterogeneity was identified for the Pittsburgh Sleep Quality Index outcomes (I 2 = 91%). Subgroup analyses indicated that this heterogeneity was attributed to variations in stimulation frequency and baseline antidepressant use. Conclusion: Very‑low to low certainty evidence suggests that left DLPFC‑targeted HF‑rTMS may improve sleep quality and depressive symptoms in patients with depression and insomnia symptoms, with a favorable safety profile. However, due to substantial heterogeneity and methodological limitations, these findings should be considered exploratory and warrant confirmation by future high‑quality trials.
SN - 2162-3279
ER -