Hypnosis and the relaxation response

Effects of dynamic and static relaxation therapy on cancer-induced fatigue and sleep disorders in patients with breast cancer undergoing chemotherapy: a randomized control trial

PURPOSE

To investigate the effects of dynamic-static combined relaxation therapy on fatigue and sleep disorders in breast cancer patients undergoing chemotherapy.

METHODS

A total of 114 patients receiving chemotherapy at Tangshan People's Hospital (September 2023-June 2024) were randomly divided into three groups: control (routine nursing), experiment group 1 (static Benson relaxation), and experiment group 2 (dynamic yoga + static Benson relaxation). The intervention lasted 8 weeks. Cancer-related fatigue and sleep disorders were assessed before and after intervention using the Revised Piper Fatigue Scale and the Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Prior to intervention, there were no significant differences in fatigue and sleep quality across groups (P > 0.05). Post-intervention, both experiment groups showed significant improvements in fatigue and sleep quality compared to the control (P < 0.001). Experiment group 2 showed greater reductions in behavior, body, and total fatigue scores compared to experiment group 1 (P < 0.001). Sleep quality also improved significantly in both experiment groups, with experiment group 2 demonstrating superior outcomes in sleep quality, duration, daytime dysfunction, and total PSQI score (P < 0.05).

CONCLUSION

The Benson relaxation technique and dynamic-static combined relaxation therapy are effective in reducing fatigue and improving sleep quality in breast cancer chemotherapy patients, with the dynamic-static combined relaxation therapy offering greater benefits.

TRIAL NUMBER

RMYY-LLKS-2024068.

Clinical Hypnosis for Pediatric Gastrointestinal Disorders: A Practical Guide for Clinicians

Functional abdominal pain disorders (FAPDs) are common in the pediatric population and are associated with a significant reduction in quality of life. Bidirectional communication of the brain-gut axis plays an important role in pain generation and perception in FAPDs. There is a paucity of data on the best approach to treat this group of disorders, with no Food and Drug Administration (FDA)-approved drugs and scarce research to substantiate the use of most medications. Use of hypnosis in pediatric FAPDs is supported by evidence and has long-term benefits of up to at least 5 years beyond completion of treatment, highlighting the importance of incorporating this therapy into the care of these patients. The mechanisms by which clinical hypnosis is beneficial in the treatment of FAPDs is not completely understood, but there is growing evidence that it impacts functioning of the brain-gut axis, potentially through influence on central pain processing, visceral sensitivity, and motility. The lack of side effects or potential for significant harm and low cost makes it an attractive option compared to pharmacologic therapies. This review addresses current barriers to clinical hypnosis including misconceptions among patients and families, lack of trained clinicians, and questions around insurance reimbursement. The recent use of telemedicine and delivery of hypnosis via audio-visual modalities allow more patients to benefit from this treatment. As the evidence base for hypnosis grows, acceptance and training will likely increase as well. Further research is needed to understand how hypnosis works and to develop tools that predict who is most likely to respond to hypnosis. Studies on cost-effectiveness in comparing hypnosis to other therapies for FAPDs will increase evidence for appropriate healthcare utilization. Because hypnosis has applications beyond pain and is child-friendly with minimal to no risk, hypnosis could be an important therapeutic tool in the wider pediatric gastrointestinal population.

Hypnosis and upper digestive function and disease

Hypnosis is a therapeutic technique that primarily involves attentive receptive concentration. Even though a small number of health professionals are trained in hypnosis and lingering myths and misconceptions associated with this method have hampered its widespread use to treat medical conditions, hypnotherapy has gained relevance as an effective treatment for irritable bowel syndrome not responsive to standard care. More recently, a few studies have addressed the potential influence of hypnosis on upper digestive function and disease. This paper reviews the efficacy of hypnosis in the modulation of upper digestive motor and secretory function. The present evidence of the effectiveness of hypnotherapy as a treatment for functional and organic diseases of the upper bowel is also summarized, coupled with a discussion of potential mechanisms of its therapeutic action.

Prokinetic effect of gut-oriented hypnosis on gastric emptying

BACKGROUND

No data are available on the effect of hypnosis on gastric emptying.

AIM

To determine the effect of a hypnosis session on gastric emptying and dyspeptic symptoms.

METHODS

We studied emptying by ultrasonography and epigastric sensations in 11 healthy subjects and in 15 patients affected by functional dyspepsia under three conditions according to a fixed schedule: (a) basal, (b) after cisapride and (c) during a 90 min hypnotic trance. Eight healthy subjects repeated an emptying study listening to relaxing music. Statistical analysis was performed using the Friedman test or RM-ANOVA.

RESULTS

In dyspeptics, the postprandial increase in the antral area was significantly smaller during the hypnosis trance than under the basal and the cisapride conditions. For the patients gastric emptying was significantly shortened by cisapride, and even more by hypnosis (basal 274 +/- 16.8 min; cisapride 227 +/- 13.2; hypnosis 150 +/- 9.7) whereas for healthy subjects it was shortened only by hypnosis. The repeated study in healthy subjects listening to relaxing music showed no significant difference compared with the basal. Epigastric sensations were improved in dyspeptics by hypnosis, but not by cisapride.

CONCLUSIONS

Gut-oriented hypnosis is effective in shortening gastric emptying both in dyspeptic and in healthy subjects.

Hypnotherapy in the treatment of irritable bowel syndrome

There is accumulating and compelling evidence that hypnotherapy is an effective treatment for irritable bowel syndrome. Recently, studies have shown that hypnotherapy has beneficial effects that are long lasting, with most patients maintaining improvement, and with decreased consultation and medication needs in the long term. The particular gut directed approach used, which is aimed at normalizing and controlling gut function, is also described. While the mechanisms of how hypnotherapy brings about its therapeutic effect are not fully known, changes in colonic motility and rectal sensitivity have been demonstrated, although changes in central processing and psychological effects may also play a role.

Medical hypnosis and orthopedic hand surgery: pain perception, postoperative recovery, and therapeutic comfort

Orthopedic hand-surgery patients experience severe pain postoperatively, yet they must engage in painful exercises and wound care shortly after surgery; poor patient involvement may result in loss of function and disfigurement. This study tested a hypnosis intervention designed to reduce pain perception, enhance postsurgical recovery, and facilitate rehabilitation. Using a quasi-experimental research design, 60 hand-surgery patients received either usual treatment or usual treatment plus hypnosis. After controlling for gender, race, and pretreatment scores, the hypnosis group showed significant decreases in measures of perceived pain intensity (PPI), perceived pain affect (PPA), and state anxiety. In addition, physician's ratings of progress were significantly higher for experimental subjects than for controls, and the experimental group had significantly fewer medical complications. These results suggest that a brief hypnosis intervention may reduce orthopedic hand-surgery patients' postsurgical PPI, PPA, and anxiety; decrease comorbidity; and enhance postsurgical recovery and rehabilitation. However, true experimental research designs with other types of controls must be employed to determine more fully the contribution of hypnosis to improved outcome.

Treatment alternatives for patients with masticatory myofascial pain

Alternative therapies are used by many people, and the dental literature has reported that some alternative therapies are comparable to splint therapy in the effective treatment of masticatory myofascial pain. The authors review the efficacy of alternative therapies and discuss their clinical implications. This review is intended to help dental practitioners to select alternative therapies they can use with or instead of splint therapy for treating patients who have a primary diagnosis of myofascial pain.