Effect of Hypnosis on Adherence to Continuous Positive Airway Pressure.

The registry criteria, word for word

What the trial wants to find out

The prevalence of sleep-disordered breathing is high, with an apnea-hypopnea index of over 15 per hour found in 49.7% of men and 23.4% of women in the general population (1). The gold standard treatment for sleep-disordered breathing is continuous positive airway pressure (CPAP) therapy (2). However, nearly 30% of patients are considered non-adherent to CPAP treatment (3). Moreover, the number of hours of CPAP usage has been shown to be directly associated with a reduction in objective and subjective sleepiness, and improvement in daytime functioning (4). A recent prospective study conducted in a French clinical population cohort of 5138 participants found an effect of CPAP treatment duration on reducing the risk of developing a major cardiovascular event (stroke, myocardial infarction, all-cause mortality) (5). Therefore, the poor adherence to CPAP treatment represents a public health challenge for healthcare professionals managing these patients. Several predictors for non-adherence can be identified, such as using CPAP for less than 4 hours per night during the initial treatment phase, moderate to severe obstructive sleep apnea, or low self-esteem (6). Measures aimed at promoting patient adaptation from the initiation of treatment are crucial as this period determines long-term adherence to CPAP therapy (7). Among these measures, there is the management of "physical" adverse effects such as xerostomia (using a humidifier), feeling too much or too little air (modifying CPAP pressure profiles), skin problems, and mask air leaks (interface adjustment), which are well-known and applied by health care organization providing the CPAP machines (2).

The 2 groups in the trial

• HypnosisTreatment being tested

  Baseline study visit (V1): signature of the informed consent form, verification of eligibility criteria, collection of demographic data, polygraphy or polysomnography features, data provided by the CPAP machine (one month), questionnaires. During the second visit (V2), the patient randomized in HYP group will come for the hypnosis sessions. Follow-up visit (V4): 28-42 days (4-6 weeks) after V3 for HYP group and 2 months (+/- 14 days) after V1 for SOC group. Collection of data provided by the CPAP machine (one month), questionnaires.

  Treatment: medical hypnosis

• standard of careNo study treatment, for comparison

  Baseline study visit (V1): signature of the informed consent form, verification of eligibility criteria, collection of demographic data, polygraphy or polysomnography features, data provided by the CPAP machine (one month), questionnaires. Usual management of CPAP treatment by the home care provider and the prescribing doctor without any change in management. Follow-up visit (V4): 28-42 days (4-6 weeks) after V3 for HYP group and 2 months (+/- 14 days) after V1 for SOC group. Collection of data provided by the CPAP machine (one month), questionnaires.