Research on sleep

Below are just a few research abstracts from around the globe. I guess every country has some sleep issues. Some studies focus on sleep, while other studies focus on cancer, pain, etc., where sleep is one component of a larger issue.

The abstracts below come from PubMed.gov, which is on the website of the NIH (National Institutes of Health). If you’re a research fan, it’s a great site with advanced search options. Though I’ve not used Google Scholar on this section, scholar.google.com is also a good resource for finding research studies.

If you have any questions about hypnosis and sleep, feel free to contact me, whether you’re in San Francisco or outside of the San Francisco Bay Area. I love talking about hypnosis to clients, medical professionals, and anyone else who has a question.

Hypnotherapy for sleep disorders.
http://www.ncbi.nlm.nih.gov/pubmed/18797562
Ann Acad Med Singapore. 2008 Aug;37(8):683-8.
Ng BY, Lee TS.
Department of Psychiatry, Singapore General Hospital, Singapore.

Abstract
Hypnosis can be defined as a procedure during which changes in sensations, perceptions, thoughts, feelings or behaviour are suggested. Hypnosis can be used to amplify whatever it is about therapy that makes it therapeutic. It permits a wide range of choices regarding where and how to intervene in the patient’s problems. In this paper, we set out to examine the rationale of using hypnotherapy to manage various types of sleep disorders, and to explore the techniques, strategies and hypnotic scripts employed by various hypnotherapists. We also examine the research data available on the efficacy of hypnosis in the treatment of sleep disorders. Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions.

Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias, specifically for head and body rocking, bedwetting and sleepwalking. Hypnosis is a specialised technique, not a therapy itself, and should be used as an adjunctive intervention within a complete psychological and medical treatment package. Most of the literature is limited to case reports or studies with such a small sample that at times it is very difficult to interpret the results. There is a major placebo effect, so uncontrolled trials are of limited value. It is hard to perform a randomised, double-blind, controlled trial to evaluate hypnotherapy given that cooperation and rapport between patient and therapist is needed to achieve a receptive trance state.

Hypnosis for treatment of insomnia in school-age children: a retrospective chart review.
http://www.ncbi.nlm.nih.gov/pubmed/16914044
BMC Pediatr. 2006 Aug 16;6:23.
Anbar RD, Slothower MP.
Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY, USA.

Abstract
BACKGROUND: The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition.

METHODS: A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7-17). When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause.

RESULTS: Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis.

CONCLUSION: Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

Hypnosis: an alternate approach to insomnia.
http://www.ncbi.nlm.nih.gov/pubmed/21286205
Can Fam Physician. 1982 Apr;28:768-70.
Paterson DC.

Abstract
Insomnia, the feeling of inability to go to sleep or to stay asleep, is a pervasive clinical problem. This paper examines the relationship and similarities between sleep and hypnosis. Research on the study of EEG patterns during hypnosis shows that many authors feel hypnosis is a waking phenomenon. Why hypnosis allows for the induction of sleep is not clear.Primary and secondary sleep disorders are classified. Primary disorders have an autonomous function in the central nervous system while secondary disorders can result from depression, pain, anxiety, lifestyle change, etc. Secondary disorders are most likely to be improved by hypnotherapeutic techniques, which include progressive relaxation and ego-strengthening.

Hypnosis for symptom management in women with breast cancer: a pilot study.
http://www.ncbi.nlm.nih.gov/pubmed/22443523
Int J Clin Exp Hypn. 2012 Apr;60(2):135-59. doi: 10.1080/00207144.2012.648057.
Jensen MP, Gralow JR, Braden A, Gertz KJ, Fann JR, Syrjala KL.
University of Washington School of Medicine, Seattle, WA 98104, USA.

Abstract
Eight women who were in treatment for breast cancer (n = 4) or breast cancer survivors (n = 4), presenting with 1 or more of 4 symptoms (chronic pain, fatigue, hot flashes, and sleep difficulties), were given 4 to 5 sessions of self-hypnosis training for symptom management. Analyses revealed (a) significant pre- to posttreatment decreases in pain intensity, fatigue, and sleep problems and (b) that pain intensity continued to decrease from posttreatment to 6-month follow-up. Although there was a slight increase in fatigue severity and sleep problems from posttreatment to 6-month follow-up, the follow-up scores did not return to pretreatment levels. The findings provide initial support for using hypnosis to manage symptoms in women who are breast cancer survivors. Clinical trials evaluating hypnosis efficacy over and above other treatments are warranted.

Multicomponent cognitive-behavioral group therapy with hypnosis for the treatment of fibromyalgia: long-term outcome.
http://www.ncbi.nlm.nih.gov/pubmed/22285609
J Pain. 2012 Mar;13(3):255-65. Epub 2012 Jan 29.
Castel A, Cascón R, Padrol A, Sala J, Rull M.
Pain Clinic, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain.

Abstract
This study compared the efficacy of 2 psychological treatments for fibromyalgia with each other and with standard care. Ninety-three patients with fibromyalgia (FM) were randomly assigned to 1 of the 3 experimental conditions: 1) multicomponent cognitive-behavioral therapy (CBT); 2) multicomponent CBT with hypnosis; and 3) pharmacological treatment (standard care control group). The outcome measures of pain intensity, catastrophizing, psychological distress, functionality, and sleep disturbances were assessed before treatment, immediately after treatment, and at 3- and 6-month follow-up visits.

CBT and CBT with hypnosis participants received the standard pharmacological management plus 14 weekly, 120-minute-long sessions of psychological treatment. All but 1 session followed a group format; the remaining session was individual. The analyses indicated that: 1) patients with FM who received multicomponent CBT alone or multicomponent CBT with hypnosis showed greater improvements than patients who received only standard care; and 2) adding hypnosis enhanced the effectiveness of multicomponent CBT. This study presents new evidence about the efficacy of multicomponent CBT for FM and about the additional effects of hypnosis as a complement to CBT. The relevance and implications of the obtained results are discussed.

PERSPECTIVE: This article highlights the beneficial effects of adding hypnosis in a multicomponent cognitive-behavioral group treatment of fibromyalgia patients. Also, this research showed that by adding hypnosis the length of treatment did not increase.

Clinical research on the utility of hypnosis in the prevention, diagnosis, and treatment of medical and psychiatric disorders.
http://www.ncbi.nlm.nih.gov/pubmed/20183001
Int J Clin Exp Hypn. 2009 Oct;57(4):443-50.
Nash MR, Perez N, Tasso A, Levy JJ.
Psychology Department, University of Tennessee, Knoxville, Tennessee 37996-0900, USA.

Abstract
The authors summarize 4 articles of special interest to the hypnosis community in the general scientific and medical literatures. All are empirical studies testing the clinical utility of hypnosis, and together address the role of hypnosis in prevention, diagnosis, and treatment of medical and psychiatric disorders/conditions. The first is a randomized controlled study of smoking cessation treatments comparing a hypnosis-based protocol to an established behavioral counseling protocol. Hypnosis quit rates are superior to those of the accepted behavioral counseling protocol.

A second study with pediatric patients finds hypnosis critically helpful in differentiating nonepileptic seizure-like behaviors (pseudoseizures) from epilepsy. The remaining 2 papers are randomized controlled trials testing whether hypnosis is effective in helping patients manage the emotional distress of medical procedures associated with cancer treatment. Among female survivors of breast cancer, hypnosis reduces perceived hot flashes and associated emotional and sleep disruptions. Among pediatric cancer patients, a brief hypnotic intervention helps control venepuncture-related pain.

Mind-body treatments for the pain-fatigue-sleep disturbance symptom cluster in persons with cancer.
http://www.ncbi.nlm.nih.gov/pubmed/19900778
J Pain Symptom Manage. 2010 Jan;39(1):126-38. Epub 2009 Nov 8.
Kwekkeboom KL, Cherwin CH, Lee JW, Wanta B.
School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin 53792, USA.

Abstract
CONTEXT: Co-occurring pain, fatigue, and sleep disturbance comprise a common symptom cluster in patients with cancer. Treatment approaches that target the cluster of symptoms rather than just a single symptom need to be identified and tested.

OBJECTIVES: To synthesize evidence regarding mind-body interventions that have shown efficacy in treating two or more symptoms in the pain-fatigue-sleep disturbance cancer symptom cluster.

METHODS: A literature search was conducted using CINAHL, Medline, and PsychInfo databases through March 2009. Studies were categorized based on the type of mind-body intervention (relaxation, imagery/hypnosis, cognitive-behavioral therapy/coping skills training [CBT/CST], meditation, music, and virtual reality), and a preliminary review was conducted with respect to efficacy for pain, fatigue, and sleep disturbance. Mind-body interventions were selected for review if there was evidence of efficacy for at least two of the three symptoms. Forty-three studies addressing five types of mind-body interventions met criteria and are summarized in this review.

RESULTS: Imagery/hypnosis and CBT/CST interventions have produced improvement in all the three cancer-related symptoms individually: pain, fatigue, and sleep disturbance. Relaxation has resulted in improvements in pain and sleep disturbance. Meditation interventions have demonstrated beneficial effects on fatigue and sleep disturbance. Music interventions have demonstrated efficacy for pain and fatigue. No trials were found that tested the mind-body interventions specifically for the pain-fatigue-sleep disturbance symptom cluster.

CONCLUSION: Efficacy studies are needed to test the impact of relaxation, imagery/hypnosis, CBT/CST, meditation, and music interventions in persons with cancer experiencing concurrent pain, fatigue, and sleep disturbance. These mind-body interventions could help patients manage all the symptoms in the cluster with a single treatment strategy.

Randomized trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors.
http://www.ncbi.nlm.nih.gov/pubmed/18809612
J Clin Oncol. 2008 Nov 1;26(31):5022-6. Epub 2008 Sep 22.
Elkins G, Marcus J, Stearns V, Perfect M, Rajab MH, Ruud C, Palamara L, Keith T.
Department of Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA.

Abstract
PURPOSE: Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes.

PATIENTS AND METHODS: Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analyzed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities.

RESULTS: Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency x average severity) decreased 68% from baseline to end point in the hypnosis arm (P < .001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (P < .005) in comparison to the no treatment control group.

CONCLUSION: Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep.

Pilot evaluation of hypnosis for the treatment of hot flashes in breast cancer survivors.
http://www.ncbi.nlm.nih.gov/pubmed/17048223
Psychooncology. 2007 May;16(5):487-92.
Elkins G, Marcus J, Stearns V, Hasan Rajab M.
Mind-Body Cancer Research Program, Scott and White Memorial Hospital, Temple, TX, USA.

Abstract
This single arm, pilot study investigated the use of hypnosis to reduce hot flashes in 16 breast cancer survivors. Each patient provided baseline data and received 4 weekly sessions of hypnosis that followed a standardized transcript. Patients were also instructed in self-hypnosis. Throughout the clinical care, patients completed daily diaries of the frequency and severity of their hot flashes. Patients also completed baseline and post-treatment ratings of the degree to which hot flashes interfered with daily activities and quality of life. Results indicated a 59% decrease in total daily hot flashes and a 70% decrease in weekly hot flash scores from their baselines.

There was also a significant decrease in the degree to which hot flashes interfered with daily activities for all measures including work, social activities, leisure activities, sleep, mood, concentration, relations with others, sexuality, enjoyment of life, and overall quality of life. This pilot study suggests that clinical hypnosis may be an effective non-hormonal and non-pharmacological treatment for hot flashes. A randomized, controlled clinical trial is planned to more definitively elucidate the efficacy and applicability of hypnosis for reducing hot flashes.

Elimination of a rhythmic movement disorder with hypnosis–a case report.
http://www.ncbi.nlm.nih.gov/pubmed/8552933
Sleep. 1995 Sep;18(7):608-9.
Rosenberg C.
Department of Neurology, Case Western Reserve University, University Hospitals of Cleveland, OH 44106, USA.

Abstract
The following describes a case of rhythmic movement disorder successfully treated with hypnosis. Hypnosis and its use in sleep disorders are discussed, and it is hypothesized that hypnosis is an effective intervention in disorders that occur at the interface between waking and sleep.

Sleep-terror disorder in children: the role of self-hypnosis in management.
http://www.ncbi.nlm.nih.gov/pubmed/1580230
Am J Clin Hypn. 1992 Apr;34(4):233-44.
Kohen DP, Mahowald MW, Rosen GM.
University of Minnesota.

Abstract
This paper describes four children, ages 8 to 12 years, with frequent, prolonged, or dangerous disorders of arousal. None had any significant psychological or behavioral problems. Each had a polysomnogram that showed sudden arousals out of slow-wave sleep associated with complex behavior. All responded to a short course of imipramine, 20 to 60 mg at bedtime, followed by and in conjunction with training in relaxation and mental imagery (self-hypnosis). Once the correct diagnosis was made, the treatment strategy was to (1) demystify the symptom complex through education, (2) establish prompt control of the symptoms with the use of imipramine, (3) train the children in self-regulation with self-hypnosis, and (4) discontinue the medication while maintaining control of the arousals.

Over a 2-3 year follow-up all children remain asymptomatic. This is the first report of successful use of self-hypnosis for the treatment of polysomnogram-proven disorders of arousal in the pediatric population. Also reported are seven additional children who were treated equally successfully with hypnosis without the use of medication.

A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror.
http://www.ncbi.nlm.nih.gov/pubmed/2007894
J Nerv Ment Dis. 1991 Apr;179(4):228-33.
Hurwitz TD, Mahowald MW, Schenck CH, Schluter JL, Bundlie SR.
Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, Department of Psychiatry, Minneapolis, Minnesota 55415.

Abstract
Hypnosis has been described anecdotally to be effective in the treatment of sleepwalking and sleep terror, potentially dangerous parasomnias. The authors report the use of hypnosis in the treatment of 27 adult patients with these disorders. A total of 74% of these individuals reported much or very much improvement when followed over substantial periods after instruction in self-hypnotic exercises that were practiced in the home. Hypnosis, often preferred over pharmacotherapy by patients, required one to six office visits (mean = 1.6). This represents a very cost-effective and noninvasive means of treatment, especially when constrasted with lengthy psychotherapy and pharmacotherapy.

Clinical hypnosis with school-age children.
http://www.ncbi.nlm.nih.gov/pubmed/2357110
Arch Psychiatr Nurs. 1990 Apr;4(2):131-6.
Valente SM.
School of Nursing, University of Southern California.

Abstract
Despite the fact that nurses are in key positions to learn and use hypnosis to bolster a child’s symptom management, ability to solve problems, or self-esteem, they lack knowledge about the clinical effectiveness of hypnosis. Substantial clinical literature demonstrates that hypnosis effectively reduces anxiety, enhances coping, and has been used successfully to treat behavior disorders, school phobias, and sleep disorders. Hypnosis can effectively reduce a child’s anxiety and symptoms and has few side effects when used competently. With education and supervision, nurses can effectively use hypnosis to improve a child’s mastery and self-esteem and to reduce severe levels of anxiety.

Comparison of hypnosis with conventional relaxation for antenatal and intrapartum use: a feasibility study in general practice.
http://www.ncbi.nlm.nih.gov/pubmed/3333169
J R Coll Gen Pract. 1987 Oct;37(303):437-40.
Brann LR, Guzvica SA.

Abstract
A hypnosis programme for antenatal and intrapartum use has been developed and successfully introduced into a practice as an alternative to conventional relaxation training. Of 96 women from the practice who delivered during the 10-month period of the study 51 opted for the psychoprophylaxis and 45 for the hypnosis. Details of the pregnancy, labour and postnatal period were collected for both groups, together with a subjective assessment of their satisfaction with labour.Disparity between the ages and parity of the two groups made comparisons difficult. The duration of the first stage of labour was markedly reduced in the hypnosis group by 98 minutes for primiparas and 40 minutes for multiparas. A small (five minutes) increase in the length of the second stage may have been a result of the hypnotic relaxation.

The verbalization has been amended accordingly. The hypnosis group were more satisfied with labour than the psychoprophylaxis group (mean satisfaction score 7.4 versus 5.6) and they reported other benefits of hypnosis, for example, reduction in anxiety and help with getting to sleep.Further studies are planned.

Mind control of menopause.
http://www.ncbi.nlm.nih.gov/pubmed/12732444
Womens Health Issues. 2003 Mar-Apr;13(2):74-8.
Younus J, Simpson I, Collins A, Wang X.
London Regional Cancer Centre, Ontario, Canada.

Abstract
The primary objective of this study was to observe the effect of hypnosis on hot flashes (HF) and overall quality of life in symptomatic patients. A secondary objective was to observe the effect of hypnosis on fatigue. Ten healthy volunteers and four breast cancer patients (total 14 patients) with symptoms of HF were treated with four, 1 h/wk sessions of hypnosis. The same physician, with the help of a nurse, conducted every session. All subjects recorded frequency, duration, and severity of HF in a HF diary. The QLQ-C30 and Brief Fatigue Inventory forms were used to assess the impact on quality of life and fatigue, respectively. The statistical evaluations were performed, including analysis of variance and nonparametric procedures. The frequency (p < 0.0001), duration (p < 0.0001), and severity (p < 0.0001) of HF were significantly reduced. The overall quality of life was also improved (p = 0.05). The subjects enjoyed better sleep and had less insomnia (p = 0.012).

There was a significant improvement on current fatigue level (p = 0.017), but we did not find a statistically significant reduction in the total fatigue level. We conclude that hypnosis appears to be a feasible and promising intervention for HF, with a potential to improve quality of life and insomnia. Although improvement in current level of fatigue was observed in this pilot study, total fatigue improvement did not reach statistical significance.

 

870 Market St., Suite 851   San Francisco, CA 94102    Phone: (415) 421-7200