Hypnosis for the management of anxiety and dyspnea in COPD: A randomized, sham-controlled crossover trial

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) are prone to dyspnea, increased respiratory rate and other anxiety-inducing symptoms. Hypnosis constitutes a complementary procedure capable of improving subjective feelings of anxiety. Objective: Assessing the efficacy of a 15-minute hypnosis intervention for immediate improvement of anxiety in severe COPD patients. Methods: Twenty-one participants, COPD patients (mean FEV1 < 32.3%), were randomly assigned to two individual sessions in crossover (sham and hypnosis, 24-h washout period, arms: Hypnosis-sham [n=11]/sham-hypnosis [n=10]). We tracked pre- and post-intervention anxiety (STAI-6 score) as primary endpoint. Results: Nineteen (90.5%) participants completed the study. Anxiety diminished significantly after hypnosis (STAI-6 scores −23.8% [SD = 18.4%] hypnosis vs −3.1% [32.8%] sham; χ2=8, P<0.01, Bayes Factor 5.5). Respiratory rate also decreased after hypnosis. Improvements in SpO2 and Borg exertion scores were registered after both conditions. Conclusion: A 15-minute hypnosis session improved participants’ anxiety and lowered respiratory rate (as opposed to sham). Improvements in anxiety were correlated with an alleviation in respiratory strain. Results imply that hypnosis can contribute to the improvement of anxiety levels and breathing mechanics in severe COPD patients. Registration Id: ISRCTN10029862.