Case Report: Multimodal clinical and neurophysiological effects of cranial electrotherapy stimulation in a patient with chronic stress and sleep disturbance

Introduction Cranial Electrotherapy Stimulation (CES) is a non-invasive brain stimulation (NIBS) technique used for anxiety and sleep disorders; however, case-level evidence linking clinical improvement with objective neurophysiological change remains limited. This case presents a multimodal examination of the therapeutic and neurophysiological effects of CES in a patient with sleep disturbances and chronic stress. Methods A 51-year-old woman with chronic stress, anxiety, and persistent sleep disturbance following thyroid and parathyroid surgery, refractory to pharmacological treatment, underwent a 16-week CES intervention. Outcomes were assessed at baseline and follow-up using EQ-5D-5L, DASS-21, GAD-7, PSQI, and resting-state Electroencephalography (EEG). Results Anxiety, stress, and depressive symptoms improved to within normal ranges, alongside significant improvements in mental health-related quality of life. EEG demonstrated increased posterior alpha activity and improved frontal symmetry. Sleep quality showed modest improvement. Conclusion This case suggests that CES may be a safe adjunctive intervention associated with symptomatic improvement and changes in neurophysiological patterns in stress-related conditions, supporting further controlled investigation.