Showing posts with label sleep disorder. Show all posts
Showing posts with label sleep disorder. Show all posts

Wednesday, June 17, 2015

[Review] Slow Learner Intervention & Training Program in Malaysia - Lai Case




Lai is having slow learner issue. For years she could not find any help. 

During the Senior Wellness Exhibition at Viva Mall November, 2014, she visited Spectrum of Life booth and did a Brain Assessment. 20 sessions of Brain Trainer was advised for her. 

Within 10 sessions she could see great results. 
She is now more alert; concentration and focus were a lot better than before, memory improved, sleeping quality improved drastically, and anxiety level reduced comparatively. 

These observations were made physically by herself and her parents. The post brainwave assessment showed great results too.







Remark: Our client's information will be kept strictly confidential all the time. All reviews and photos have been acknowledged and provided by past and current clients of Spectrum of Life proactive healthcare centre (Clinical Hypnotherapist Hiro Koo). Clients names have been changed to protect their identity. 

Sunday, June 7, 2015

[Exhibitor] National Cancer Survivors Day 2015


I am here and I care!

It is an honour to be invited to participate in National Cancer Survivors Day 2015 which organized by the National Cancer Society Malaysia. Managing mental health needs is a crucial part for cancer patients or survivors. My role today is to provide brain assessment, support and treatment advice if necessary. 

There is a healthtalk on how the clinical hypnotherapy able to help cancer patients and cancer survivors. In fact, clinical hypnotherapy has proven to be extremely valuable in the treatment of cancer. Hypnosis has been shown to be effective for decreasing chemotherapy-related nausea and vomiting in children with cancer. 

Indeed, hypnotherapy is an effective supplement therapy in the management of terminally ill cancer patients in a hospice setting. It is useful in addressing: 
(1) management of anxiety, depression, anger, and frustration; 
(2) management of pain, fatigue, and insomnia; 
(3) management of side-effects of chemotherapy and radiotherapy; 
(4) visualization to promote health improvement. 
By successfully addressing these areas, studies have shown that hypnotherapy improves the individual quality of life and life expectancy. Further, there is a quantifiable cost savings to the hospital in terms of reduced medication and need for medical care.
One of the most well-known techniques involves the use of “positive mental images” of a strong army of white blood cells killing cancer cells. One 10-year follow-up study involving 86 women with cancer showed that a year of weekly “supportive/ expressive” group therapy significantly increased survival duration and time from recurrence to death. Postoperative complications and hospitalizations for the hypnotic intervention group are significantly shorter than the norm.

You can read this review:
"Hypnosis for Cancer Care: Over 200 Years Young" - The goal of this review was to summarize the empirical literature on hypnosis as an integrative cancer prevention and control technique. We have reviewed where hypnosis has strong support for its efficacy (surgery and other invasive procedures), where it holds promise (weight loss, chemotherapy, radiotherapy, metastatic disease), and where more work is needed.
Neuro-hypnotherapy is first of its kind in Malaysia developed by myself by combining technology (EEG biofeedback) and art of science (Clinical Hypnotherapy) which is best of two worlds. 
Feel free to contact me for a free brain assessment session. 





For more information on volunteering opportunities, you can contact the NCSM.




Source:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755455/
http://web.wellness-institute.org/blog/bid/399323/The-Use-of-Hypnosis-in-Treating-Cancer

Monday, May 25, 2015

睡眠障礙引頭痛 自律神經失調元凶

「一覺到天亮,一暝大一吋」,但是,如果有失眠入睡困難、半夜醒來不易再睡等情況,恐罹患睡眠障礙,根據台灣睡眠醫學會一項「國人睡眠大調查」結果發現,台灣15至59歲的人口中,平均每5人就有1人深受失眠之苦。尤其值得注意的是,睡眠障礙會會引發偏頭痛。要揪出睡眠障礙造成頭痛的元凶,醫師建議必需兼顧生理與心理健康,尤其是要調整自自律神經失調的困擾。

睡眠障礙元凶 自律神經失調惹禍
為什麼睡眠障礙會引起頭痛?精神科醫師楊聰財表示,其實睡眠障礙只是冰山一角,冰山下的狀況要特別關注,睡眠障礙要從生理因素與心理因素去解決。其中生理因素主要來自自律神經失調,一旦自律神經不穩定,交感神經與副交感神經不協調,交感神經會過盛,引起血壓升高、肌肉緊繃、呼吸心跳加快,在交互影響下,便容易引起頭痛。
至於心理因素引起睡眠障礙,則常見出現慢性焦慮、憂鬱,或慢性壓力感如怒氣。焦慮、憂鬱與怒氣此三種統稱為「情緒障礙」,容易造成頭痛不適。臨床發現,10個有睡眠障礙問題的民眾,約有7、8個與情緒障礙有關。
自律神經失調 女多於男
楊聰財醫師表示,門診曾經收治許多因為出現頭暈、頭重、頭痛的患者求診,主訴特別的是頭痛位置有移動情況,有時頭頂痛,有時單側痛,有時兩邊同時痛,甚至疼痛會往下發展,合併肌肉緊繃、眼睛乾澀、呼吸不順、腹痛等不適症狀,但是進行腦波、心電圖、X光等檢查,卻發現都正常,一時找不到病因,經過進一步診斷才發現是慢性自律神經失調。

自律神經失調該怎麼改善?建議要兼顧生理與心理,照顧身心四個大支柱:即「能睡、能笑、能動、能吃」:
【調整自律神經失調方法】:
1.「能睡」:是指每天最好晚上11點睡覺,早上6點起床,維持正常睡眠。
2.「能笑」:指常保笑容能使腦內啡分泌,有益健康避免頭痛。
3.「能動」:指每周維持333規律運動,每週運動至少3天、每次30分鐘、心跳達到130下。 
4.「能吃」:指睡覺前適度食用包括鮮奶、香蕉與深海魚油等食物,有助於自律神經安定。
此外,平時要養成「說唱做寫」紓壓好方法4要訣,例如每天做深呼吸吐氣、睡前寫快樂日記等。
【醫師小叮嚀】:
楊聰財醫師表示,自律神經失調調整好,睡眠障礙即可降低,但是如果出現睡眠障礙,例如一周中有3天以上睡眠時間不到6小時,或是有入睡困擾,且情況連續兩周以上,影響日常生活,就可能是與情緒障礙影響到睡眠有關,建議可至精神科就醫檢查。
若是明明睡眠超過9小時以上,卻怎麼睡都覺得睡不夠,上班仍容易打瞌睡、精神不濟,則可能與生理有關,例如有睡眠呼吸中止症、打鼾等呼吸道問題,建議到睡眠中心進行睡眠檢查。

资料来源:

Monday, April 20, 2015

[Insomnia Specialist Malaysia] Sleep loss tied to emotional reactions


A person's loss of sleep can be connected to their likelihood of reacting emotionally to a stressful situation.

That is one of the recent findings included in a new book, "Sleep and Affect: Assessment, Theory and Clinical Implications," co-edited by a University of Arkansas psychology professor and his former doctoral student. Affect is a term in psychology that describes a broad range of .
"In our study, we wanted to find out if there was a link between the loss of sleep and our ," said Matthew T. Feldner, a professor of psychology in the J. William Fulbright College of Arts and Sciences. "We saw that if a person lost a night of sleep they responded with more emotion to a laboratory 'stressor.' This finding extended previous work that had linked chronic  to anxiety and mood disorders."
Feldner co-edited Sleep and Affect with Kimberly A. Babson, a health science specialist at the National Center for Post Traumatic Stress Disorder in Menlo Park, California. Babson earned her doctorate in clinical psychology at the University of Arkansas.
Sleep and Affect summarizes research on the interplay of sleep and various components of emotion and affect that are related to mood disorders, anxiety disorders, bipolar disorder and depression.
"One of the themes that emerged across these chapters is that certain components of emotion seem particularly linked to sleep," Feldner said. "What we call 'stressors' tend to be more emotionally arousing for people who haven't slept well, and emotional arousal also appears to interfere with ."
Babson conducted sleep-and-affect studies at the U of A under a National Institutes of Health research training fellowship. That research spurred her's and Feldner's interest in a book that synthesizes the latest research into the interrelationships between sleep and affect.
"We present this information in a way that will help clinicians both assess for  and problems related to anxiety or mood, when a patient is seeking treatment for one and maybe not the other," he said. "By improving sleep, we might improve our treatments for anxiety problems."
This book also includes the latest findings in neuroscience related to sleep loss. There appear to be effects of sleep loss on the functioning of the emotional regulation circuit of the brain, Feldner said.
"Some of the neurobiological structures that we think are involved in regulating emotional or affective experiences don't seem to function the same after we lose sleep as they do when we are fully rested," he said.
"Sleep and Affect" is published by Elsevier Publishing.


Source:
http://medicalxpress.com/news/2015-03-loss-tied-emotional-reactions.html

Friday, April 17, 2015

[Sleep Specialist Malaysia] Brain waves predict our risk for insomnia


There may not yet be a cure for insomnia, but Concordia University researchers are a step closer to predicting who is most likely to suffer from it—just in time for World Sleep Day on March 13.


In his study published in Frontiers in Human Neuroscience, Thien Thanh Dang-Vu, from Concordia's Center for Studies in Behavioral Neurobiology and PERFORM Center, explores the impact of stress on sleep. Although researchers already know that stressful events can trigger insomnia, the experiment reveals that some people are more vulnerable than others to developing the condition.
To determine the role of stress, the study examined the sleep cycles of 12 Concordia students as they went through the nerve-racking experience of finals. Measuring students' brain waves at the beginning of the school semester, Dang-Vu and his team found that students showing a lower amount of a particular pattern of brain waves were more at risk for developing insomnia afterwards in response to the stress of the exams.
The brain—specifically the deep, inner parts of the brain called the thalamus and cortex—produces electromagnetic activity during sleep. When monitored by diagnostic tools, this activity appears as patterns of squiggly lines that scientists refer to as spindles.
In a previous experiment, Dang-Vu and his team discovered that greater spindle activity helps sleepers resist waking, despite noise. The new study aimed to test whether there would be a similar relationship between spindles and stress.
The hypothesis proved true. "We found that those who had the lowest spindle activity tended to develop more disturbances in response to stress, when comparing sleep quality at the beginning of the semester and the end of the school semester," Dang-Vu says.
"We are not all equally armed when facing stress, in terms of how we can manage our sleep. Some people are more vulnerable than others."

How to increase spindle?
The preliminary studies carried out for the FWF project showed the positive effects of EEG biofeedback training on healthy people. This method has therefore now been tested in a pilot study on patients aged between 19 and 50 who suffer from sleep disorders. "The brain oscillations are trained during waking to a frequency range of between 12 and 15 hertz, known as the sensorimotor rhythm. This frequency range is also prominent in light sleep and manifests itself as sleep spindles, particularly when a person is falling asleep", explains Schabus. The patients were able to observe and learn to control their own sensorimotor rhythm (measured using EEG electrodes) on the computer screen. They were tasked with moving a compass needle on the screen to a green dot using only the power of mental relaxation. They received positive visual feedback each time they reached this dot, i.e. to increase the band power between 12 and 15 hertz.
"Using the training, we managed to strengthen the sensorimotor rhythm in a waking state and the sleep spindles in 16 out of 24 patients with mild insomnia. Those who responded well to the training reported an improvement in the quality of their sleep. This was ascertained by self-monitoring methods like sleep diaries and importantly also verified in our sleep laboratory", says Schabus, outlining the process. Each of the participants visited the sleep laboratory a total of 21 times, which meant that the effects could be studied in great detail. The researchers were also able to establish positive effects on memory consolidation when word pairs were retested after sleep following earlier learning. Interestingly, the subjective sleep quality among patients who successfully completed this type of biofeedback training also showed improvement

What is sleep spindle?

A sleep spindle is a burst of oscillatory brain activity visible on an EEG that occurs during stage 2 sleep. It consists of 12–14 Hz waves that occur for at least 0.5 seconds. Sleep spindles are generated in the reticular nucleus of the thalamus.


How newmindcentre.com can help you? 
1) Neuro-Hypnotherapy:
Doctors at Harvard University found that hypnotherapy actually promotes faster healing. Get hypnotized. Many insomniacs have tried this with great success. Under hypnosis, you might work out any personal issues that are robbing you of sleep. A clinical hypnotherapist can also "program" you to sleep. Our neuro-hypnotherapy technique able to help you! Personalized self-hypnosis method to fall asleep will be developed based on your brainwave response.

2) EEG biofeedback therapy/Neurotherapy 
Our EEG biofeedback/Neurotherapy is based on the international standardized 10-20 electrode location system. it is essentially a way of teaching you how to self-regulate your own electrical activity in the brain. A powerful tool for helping people fall asleep and stay asleep. Over 3,000 licensed health professionals such as psychologists, therapists, and doctors now use this new technology daily with patients. As a group, they report significant and consistent improvements for client sleep problems.


Call to schedule an appointment to meet me.
Based on your condition, I can help you to find the cause and suggest appropriate treatment.
Contact me now for more information.



Source:
http://medicalxpress.com/news/2015-04-brain-medication-counter-insomnia.html
http://medicalxpress.com/news/2015-03-brain-insomnia.html#nRlv

EEG biofeedback therapy instead of medication to counter insomnia


The ability to finally enjoy a good night's sleep is something that can be learned. An Austrian Science Fund FWF project has investigated how this can best be learned and who responds best to such "brain training".

Dark circles around the eyes, tired limbs, absent-mindedness – most people have experienced the effects on the body of a short night. "Roughly one-third of the Austrian population as a whole suffers from recurrent insomnia", says Manuel Schabus from the University of Salzburg. For years now, the psychologist has been studying a diverse range of states of consciousness. In a project funded by the Austrian Science Fund FWF, Schabus and his team have now studied how the state of mind of people with  can be improved without administering medication.

Training vs. chemistry
"People who suffer from sleeplessness, also known as insomnia, are often in a state of 'hyperarousal'. Resorting to tablets seems to be the obvious solution", explains the researcher. However, medication-based treatments are usually for short-term use only and confine themselves to fighting this state of arousal, resulting in undesirable side effects including dependence, morningness, drowsiness or amnesia. "Medication often just reduces nocturnal brain activities and thus also helpful functions such as 'memory consolidation', which is the nocturnal stabilisation of information so that recall is easier the next day", says Manuel Schabus. The neurofeedback training deployed within the framework of the FWF project, a type of biofeedback training for the brain, guides the affected persons into sleep. So-called "sleep spindles" are used in this process. These are patterns identified in EEG measurements which are characterised by "spindle-like" rapid rising and falling brain oscillations, and which occur especially during light sleep.
Crucial rhythm
The preliminary studies carried out for the FWF project showed the positive effects of neurofeedback training on healthy people. This method has therefore now been tested in a pilot study on patients aged between 19 and 50 who suffer from sleep disorders. "The brain oscillations are trained during waking to a frequency range of between 12 and 15 hertz, known as the sensorimotor rhythm. This frequency range is also prominent in light sleep and manifests itself as sleep spindles, particularly when a person is falling asleep", explains Schabus. The patients were able to observe and learn to control their own sensorimotor rhythm (measured using EEG electrodes) on the computer screen. They were tasked with moving a compass needle on the screen to a green dot using only the power of mental relaxation. They received positive visual feedback each time they reached this dot, i.e. to increase the band power between 12 and 15 hertz.
"Using the training, we managed to strengthen the sensorimotor rhythm in a waking state and the sleep spindles in 16 out of 24 patients with mild insomnia. Those who responded well to the training reported an improvement in the quality of their sleep. This was ascertained by self-monitoring methods like sleep diaries and importantly also verified in our sleep laboratory", says Schabus, outlining the process. Each of the participants visited the sleep laboratory a total of 21 times, which meant that the effects could be studied in great detail. The researchers were also able to establish positive effects on memory consolidation when word pairs were retested after sleep following earlier learning. Interestingly, the subjective sleep quality among patients who successfully completed this type of biofeedback training also showed improvement, but so did people in a pure placebo condition. In general, the researcher cautions against generalising the results: in an even more extensive follow-up protocol, people with more persistent or more pronounced insomnia did not respond to the brainwave training, nor did they exhibit any positive changes in sleep or memory.
Hippocampus fitness
"When you consider the amount of information encountered by the brain, especially the hippocampus, on a daily basis, and how sensitively it responds to stress, it is important to be mindful of treating our thinking-organ with care. Systematic training and sufficient 'sleep hygiene' not only promote well-being but also protect newly learned information from disruptive influences", says Schabus. The studies conducted as part of the FWF project play an important role in encouraging of this vital human faculty and act as a reminder to adopt a more conscious approach to .

More information: Schabus et.al: "Enhancing sleep quality and memory in insomnia using instrumental sensorimotor rhythm conditioning." Biological Psychology 95 (2014) 126 –134. 
www.ncbi.nlm.nih.gov/pubmed/23548378


Source:
http://medicalxpress.com/news/2015-04-brain-medication-counter-insomnia.html

Thursday, April 9, 2015

[Light Sleeper Treatment Malaysia] What makes someone a light sleeper?


What makes someone a light sleeper? 

For some people, the slightest noise awakens them at night. For others, the wailing siren of a passing fire truck doesn’t disturb their slumber. Just why, though, remains a bit of a mystery. Although many people are self-proclaimed light sleepers or heavy sleepers, researchers have found that little is actually known about why people react differently to noises and other stimuli during sleep. Genetics, lifestyle choices, and undiagnosed sleep disorders may all play a role. In addition, some studies suggest that differences in brainwave activity during sleep may also make someone a light or heavy sleeper.

Light and Deep Sleep During sleep, you alternate between cycles of REM (rapid eye movement) and NREM (non-rapid eye movement) that repeat about every 90 minutes. You spend about 75 percent of the night in NREM sleep, which consists of four stages of increasing relaxation. 

Stage one, or the phase between being awake and asleep, is considered light sleep. 
Deeper sleep begins in stage two, as your breathing and heart rate become regular and your body temperature drops. 
Stages three and four are the deepest and most restorative stages of sleep, in which breathing slows, muscles relax, and tissue growth and repair occurs. 

Someone who gets eight hours of sleep a night may not experience as much slow-wave, deep sleep as the person who get six hours of sleep.

What Contributes to Light Sleep?
A small study, published in 2010 in Current Biology, suggests that differences in how sleeping people respond to noise may be related to levels of brain activity called sleep spindles. The researchers found that people whose brains produced the most of these high-frequency sleep spindles were more likely to sleep through loud noises. But more research is needed to confirm the results. Dr. Neubauer said that if someone is complaining of not feeling rested because of being a light sleeper, they should look at the factors that might be contributing to the inability to achieve a deep sleep.


Now, for the first time, sleep researchers at Harvard Medical School and Massachusetts General Hospital, led by neurologist Dr. Jeffrey Ellenbogen, have isolated the brain-wave pattern that predicts where an individual's brain has struck a balance between those demands — a window into how likely noises are to wake people from deep sleep.
For the three-night study, Ellenbogen's group invited 12 volunteers who reported being deep and healthy sleepers into a sleep lab with a comfy queen-size bed outfitted with enormous speakers at the headboard. The researchers recorded the participants' brain waves as they slept normally the first night, and then on subsequent nights as they were bombarded with 14 different noises — from the din of car traffic and the roar of airplane engines to flushing toilets and slamming doors — which were played at progressively louder volumes.
Ellenbogen paid particular attention to the patterns generated by the thalamus, a region deep in the brain that processes incoming visual and auditory stimuli. He found that the number of pulses, known as sleep spindles, generated by this organ and measured by an electroencephalogram (EEG), which records electrical activity in the brain, varied among the sleepers. Those with the highest number of spindles were able to sleep through more sounds without waking than those whose brains showed fewer spindles. "We wanted to know, if we counted the spindles the first night, did that predict anything about their subsequent sleep?" says Ellenbogen. "And indeed it did. More spindles meant they were more likely to be protected from sleep disruption."

How newmindcentre.com can help you? 
1) Neuro-Hypnotherapy:
Doctors at Harvard University found that hypnotherapy actually promotes faster healing. Get hypnotized. Many insomniacs have tried this with great success. Under hypnosis, you might work out any personal issues that are robbing you of sleep. A clinical hypnotherapist can also "program" you to sleep. Our neuro-hypnotherapy technique able to help you! Personalized self-hypnosis method to fall asleep will be developed based on your brainwave response.

2) EEG biofeedback therapy/Neurotherapy 
EEG biofeedback/Neurotherapy is based on the international standardized 10-20 electrode location system. it is essentially a way of teaching you how to self-regulate your own electrical activity in the brain. A powerful tool for helping people fall asleep and stay asleep. Over 3,000 licensed health professionals such as psychologists, therapists, and doctors now use this new technology daily with patients. As a group, they report significant and consistent improvements for client sleep problems.


Call to schedule an appointment to meet me.
Based on your condition, I can help you to find the cause and suggest appropriate treatment.
Contact me now for more information.





Source:
http://www.ehow.com/how_7828707_cure-light-sleeping.html
http://content.time.com/time/health/article/0,8599,2009401,00.html
http://www.clearmindofcolorado.com/research-on-sleep-disorders/

Wednesday, April 8, 2015

[Review] Anxiety management Malaysia: Neuro-hypnotherapy helped me to fall asleep faster and reduce anxiety symptoms



ST (40 years old), a highly anxious woman, turned to neuro-hypnotherapy when everything else failed. Through medical doctor advice, she learnt how neuro-hypnotherapy could deal with the issues that disrupting her sleep pattern. 
Before she was undergoing therapeutic sessions for her own anxiety symptoms, she obtained the score of 41 (High anxiety) on Beck Anxiety Inventory. At the end of her neuro-hypnotherapy session, her score reduced to 13(Low Anxiety) on Beck Anxiety Inventory.
The Pittsburgh Sleep Quality Index (PSQI) is designed to measure sleep quality and disturbance over a 1-month period. All scores are combined according to the scoring criteria included with the form to produce a Global PSQI Score. Scores above 5 indicate clinically meaningfully disturbed or poor sleep. The global score on the PSQI was reduced significantly from 10 (very poor sleep quality) to 4 (better sleep quality).




ST:
I can't stop worrying about death and dying. I've been constantly imagining about death and how then everyone will care about me. I can't sleep because I'm afraid I'm going to die. My medical doctor told me to avoid taking sleeping pills because he knows how addictive they can be.
The other thing is I always have a horrible sharp pain under my shoulder, My medical doctor gave me painkiller and advised me to see a mental health care professional.

I met Hiro Koo during a corporate health talk. After the EEG brainwaves analysis session, I know myself better and able to find a way to treat the root cause of my issues. I choose the neuro-hypnotherapy because my issues can be managed without medications and no side effects.

The biggest difference before and after neuro-hypnotherapy? Well, now it takes me 15 minutes on average to fall asleep! Previously, it takes more than 30 minutes for me to fall asleep. I become happier, less fearful about death, less anxious and feel calmer than ever.
I also learned personalized self hypnosis method from Hiro Koo for pain management. I see a very noticeable improvement after a month of treatment. Absolutely no pain now with no noticeable side effects. I am impressed!

I would definitely recommend your services to any friend who need help. I am very pleased with neuro-hypnotherapy, which have significantly improved the functions of my health and quality of my life. I am very thankful to Hiro Koo for good help at the needful time.



Remark: Our client's information will be kept strictly confidential all the time. All reviews have been acknowledged and provided by past and current clients of Spectrum of Life proactive healthcare centre (Clinical Hypnotherapist Hiro Koo). Clients names have been changed to protect their identity. 

Monday, April 6, 2015

How Long to Nap?

Napping isn't just for children. Understand the pros and cons of napping and the best way to take a nap.
If you're sleep deprived or just looking for a way to relax, you might be thinking about taking a nap. Napping at the wrong time of day or for too long can backfire, though. Understand how to get the most out of a nap.

What are the benefits of napping?

Napping offers various benefits for healthy adults, including:
  • Relaxation
  • Reduced fatigue
  • Increased alertness
  • Improved mood
  • Improved performance, including quicker reaction time, better memory, less confusion, and fewer accidents and mistakes

What are the drawbacks to napping?

Napping isn't for everyone. Some people have trouble sleeping in places other than their own beds, while others simply can't sleep during the day. Napping can also have negative effects, such as:
  • Sleep inertia. You might feel groggy and disoriented after waking up from a nap.
  • Nighttime sleep problems. Short naps generally don't affect nighttime sleep quality for most people. However, if you experience insomnia or poor sleep quality at night, napping might worsen these problems. Long naps might interfere with nighttime sleep.



Source:
http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/napping/art-20048319?pg=2

Monday, March 30, 2015

Hypnotherapy Malaysia for cancer pain management, cancer care and coping skills for cancer

Clinical hypnosis has been defined as a mind-body therapy that involves a deeply relaxed state, individualized mental imagery, and therapeutic suggestion. Clinical hypnosis has a very long history, with reports of medical application dating back to the 18th century. Some have suggested that there is even evidence for the use of clinical hypnosis since ancient times, with inscriptions of hypnotic-like phenomena on a stone stele from Egypt during the reign of Ramses XII, some 3,000 years ago. The word hypnosis, derived from the Greek word for sleep, was coined by James Braid in 1841. Clinical hypnosis is a mind-body therapy, one of the fastest-growing and most commonly employed categories of complementary and alternative medicines (CAM), as defined by the NCCAM (National Center for Complementary and Alternative Medicine) of the National Institutes of Health. A national health interview survey of medical usage in 2007 found that 4 out of 10 US respondents reported having used complementary and alternative medical treatments in the previous year.[1] Further, research suggests that CAM use continues to be highest among those with chronic diseases (eg, cancer).[2,3] Mind-body interventions such as clinical hypnosis are also becoming popular for their ease of integration into an overall cancer survivorship treatment plan with relatively low risks.[4]
Hypnosis produces an altered state of consciousness, awareness, or perception. The hypnotic state is a highly relaxed state in which the patient’s mind (conscious and subconscious) is focused and receptive to therapeutic suggestion. It involves learning to use one’s mind and thoughts to manage emotional distress, (eg, anxiety, stress), unpleasant physical symptoms (eg, pain, nausea), or to help change certain habits or behaviors (eg, smoking). While hypnosis sessions may vary depending on a patient’s needs, a clinical hypnosis session typically comprises two basic phases:
Induction. During this phase, the therapist helps the patient to relax, and may ask the patient to imagine a peaceful scene that helps him or her to become more focused and concentrate on what is to be accomplished during the session.
Application. During this phase, the patient receives suggestions. Hypnotic suggestions, the key ingredient of hypnosis, are special statements that are designed to suggest relief from troubling symptoms.

A meta-analysis of randomized controlled studies of clinical hypnosis identified 57 studies that demonstrated hypnosis as an effective treatment for a number of health disorders and conditions including pain, smoking cessation, migraines, allergies, analgesia in labor, asthma, dermatology, dentistry, anxiety, hypertension, tinnitus, and postoperative recovery in surgery.[6]

What is the Evidence Related to Hypnosis and Cancer?

Clinical hypnosis has been described in the medical literature to relieve a broad spectrum of symptoms, including treatment of common symptoms associated with cancer care, as discussed below.

Pain

Hypnosis is the most frequently cited form of nonpharmacologic cognitive pain control.[7] Hypnotherapy for the management of chronic pain has been demonstrated to provide relief for the symptoms of pain in cancer, arthritis, sickle cell disease, temporomandibular disorder, and fibromyalgia. Hypnosis has demonstrated positive outcomes for the reduction of chronic and procedural-related pain in oncology.
A study of breast cancer patients found that those assigned to treatment (standard care or expressive-supportive therapy) that included clinical hypnosis demonstrated significantly less pain. In addition, patients who underwent hypnosis reported significantly less of an increase in pain over time.[8] Another study of advanced-stage cancer patients with malignant bone disease was conducted by randomizing patients to receive either hypnotherapy or supportive attention (eg, encouragement, active listening).[9] Results showed the hypnosis intervention group had a significant overall decrease in pain.
Syrjala and colleagues studied 45 cancer patients to evaluate the efficacy of hypnosis for pain relief following chemotherapy.[10] Participants were randomized into the following conditions: hypnosis, cognitive behavioral therapy (CBT), attention control, and standard care. There were no reported significant differences among the groups for nausea, presence of emesis, nor opioid intake; however, the hypnosis group showed a significant reduction in oral pain. Montgomery and colleagues studied 200 patients undergoing excisional breast biopsy or lumpectomy.[11] Participants in this study were randomly assigned to a hypnosis session or to a control condition involving nondirective empathic listening. The hypnosis group had significant reductions in pain intensity, self-reported pain unpleasantness, nausea, fatigue, and discomfort compared with the control. Moreover, the per-patient cost to the medical institution was $772.71 less for those in the hypnosis group compared with patients in the control group, because of reduced surgical time. Lang and colleagues conducted a randomized controlled trial evaluating hypnosis for women (n = 236) undergoing large core breast biopsy.[12] During the procedure, in addition to standard of care, participants received either empathetic attention or a hypnotic relaxation treatment. Results indicated that hypnosis reduced pain and anxiety compared to empathetic attention, which only showed a reduction in pain.
A recently published review examined the evidence from clinically controlled trials, evaluating hypnosis for procedural-related pain in pediatric oncology.[13] Eight randomized controlled trials were analyzed, demonstrating positive outcomes in clinical hypnosis for pain management in pediatric oncology.

Nausea

It has been reported that 70% to 80% of all cancer patients who receive chemotherapy experience nausea and vomiting.[14] Clinical hypnosis has been studied for relief of nausea and vomiting secondary to chemotherapy. In a randomized study of the efficacy of hypnosis in reducing nausea and vomiting in children receiving chemotherapy, researchers found children participating in hypnosis had less anticipatory nausea and vomiting and less overall vomiting compared with controls who did not undergo hypnosis.[15] This finding was replicated in a later study also demonstrating that patients using clinical hypnosis showed a reduced need for antiemetic medication.[16] A review by Richardson and colleagues of six randomized, controlled trials suggests there were large effect sizes for hypnotic treatments when compared with treatment as usual, and these were at least as large as the effects of CBT.[13] In a study of mediators of a brief hypnosis intervention to control side effects in breast cancer surgery patients, Montgomery and colleagues concluded that clinical hypnosis works to a significant extent through the two psychological mechanisms of cognition and emotion. Results of a study of a 200 breast cancer patients who underwent a presurgical hypnosis intervention to improve postsurgical side effects suggest that, to reduce postsurgical nausea, clinical hypnotic interventions should be designed to specifically target patient expectancies and distress.[17]

Fatigue

Cancer-related fatigue has long been recognized as one of the most difficult symptoms to manage during cancer treatment, and it remains the most common unrelieved symptom of cancer.[18] Research suggests that fatigue is a multidimensional syndrome which results from both cancer and cancer therapies, such as chemotherapy and radiotherapy. Estimates of the prevalence of fatigue in cancer patients undergoing radiotherapy are diverse. Literature suggests that fatigue can affect 60% to 90% of patients receiving chemotherapy or radiation therapy.[19] This condition is managed through education of patients and caregivers about current evidence-based strategies to reduce fatigue, nonpharmacological interventions including exercise, and pharmacological therapies.[18] Despite the high prevalence of cancer-related fatigue, few intervention options exist.[20] A study was conducted to test the effectiveness of CBT and hypnosis for radiotherapy-related fatigue.[21] Breast cancer patients were randomly assigned to receive either standard care or CBT and hypnosis. Results show that with the cognitive-behavioral/hypnosis intervention, patients’ fatigue did not increase over the course treatment, whereas fatigue among patients receiving standard care increased linearly. Although this initial result is promising, additional research is critically needed in this area. To determine relative contributions of various interventions to fatigue relief in cancer patients, future studies should be designed with subjects assigned to groups providing hypnosis-only, CBT only, and combined cognitive-behavioral hypnotherapy, as well as a control group offering structured attention.

Hot Flashes

Clinical hypnosis for the treatment of hot flashes has been investigated. In two studies of breast cancer survivors, participants received five sessions of hypnotherapy, (provided approximately weekly) and were instructed in self-hypnosis. The hypnotic intervention was individualized to facilitate a hypnotic state, feelings of coolness, and control of symptoms. The results showed a 69% reduction of hot flashes relative to baseline,[22,23] and are comparable or superior to results from open-label studies with paroxetine and venlafaxine.[24] In a large ongoing randomized clinical trial of hypnosis for hot flashes, 184 post-menopausal women have been randomized to either clinical hypnosis or to structured-attention control that provides supportive, non-directive counseling. Preliminary unpublished results concur with earlier studies suggesting that hot flashes can be reduced by 70% at 3 months follow-up among post-menopausal women.[25]

Sleep

Hypnosis can also be an effective treatment option for cancer patients suffering from sleep problems. Cancer patients experience sleeping difficulties for a number of reasons, including anxiety related to diagnosis, depression, pain, fatigue, and other treatment-related side effects. Cancer patients have been reported to be nearly three times more likely than members of the general population to meet diagnostic criteria for insomnia.[26]
While sleep disorders can be treated with pharmacotherapy, this treatment modality carries with it the inherent risks of dependence and potentially dangerous drug interactions. Furthermore, pharmacotherapy does not treat the underlying source of the sleep disturbance. Hypnosis provides cancer patients with a safe alternative treatment option that not only improves the ability to obtain restful sleep, but also leads to improvements in other symptom areas.
A study conducted by Elkins et al supports the efficacy of clinical hypnosis in improving the quality of sleep for cancer patients.[23] During this study, 51 breast cancer patients (all female) were assigned to either five weekly sessions of hypnosis or a waitlist control group. The main outcome for this study was a reduction in hot flash occurrence. At the conclusion of the 5-week treatment period, not only did cancer patients report fewer hot flash related daily disturbances, but they also reported significant improvements in sleep quality, as well as fewer symptoms of anxiety and depression. This study provides an example of how hypnosis may be effective at treating a target symptom and improving the patient’s overall quality of life.

How Is Hypnosis Currently Used in Cancer Care?

Hypnosis has been specifically employed in the palliative care of cancer patients to reduce symptoms associated with radiation and chemotherapy, such as pain, nausea, fatigue, hot flashes, and sleep dysfunction. Length of hypnotic treatment varies depending on the nature and severity of the problem. Clinical hypnosis treatment for cancer patients may range from a single session to multiple sessions. In research, cancer patients undergoing clinical hypnotherapy typically receive approximately five sessions or more of clinical hypnosis, each involving a hypnotic induction and instruction in self-hypnosis. The practice of self-hypnosis helps patients achieve a relaxed, therapeutic, hypnotic state. Professionals serve as facilitators of self-hypnosis, often providing hypnosis audio recordings for patients to use between sessions.
Hypnosis is frequently offered in conjunction with other therapies such as cognitive behavioral therapy (CBT). Research suggests that using a combination of hypnosis and CBT improved outcomes more than those achieved for at least 70% of patients who used CBT alone.[27] Additionally, CBT techniques can be utilized in a hypnotic context by preceding the CBT technique with a hypnotic induction.[28]

What Are the Potential Risks?

Clinical hypnosis has been commonly described as a safe method when used correctly, having few harmful side effects.[8] However, individuals may initially feel drowsy following hypnosis, due to its focus on increasing relaxation and decreasing anxiety. Unexpected delusional thoughts and trancelike states are also possible. Therefore, clinical hypnosis for patients with psychological disorders involving delusions is unadvisable. The clinical hypnosis literature has commonly listed exclusions for study participants with diagnoses of schizophrenia or borderline personality disorder.

What's the Bottom-Line Message?

Clinical hypnosis is a viable option for cancer patients, who, once trained in self-hypnosis, may employ these techniques to manage myriad symptoms.
In particular, hypnosis as an adjunct treatment for cancer patients and survivors can be effective in treating pain, nausea, fatigue, hot flashes, and sleep disorders. While current research into the efficacy of clinical hypnosis for the palliative treatment of cancer patients is extremely encouraging, some studies have been limited by less-than-desirable sample sizes, and there is a dearth of large randomized controlled trials. Additional research will be needed for clinical hypnosis to become a well-established evidence-based treatment for the palliative care of cancer patients. However, the existing evidence from all clinical research supports inclusion of clinical hypnosis as an effective adjunct therapy in the palliative cancer treatment milieu, and therefore hypnosis should be considered for patients with cancer on a case-by-case basis.
Financial Disclosure: The authors have no significant financial interest or other relationship with the manufacturers of any products or providers of any service mentioned in this article.
Acknowledgment: Dr. Elkins is supported by NCCAM grant 5U01AT004634 and NCI grant R21CA131795.




Source:
http://www.cancernetwork.com/oncology-nursing/clinical-hypnosis-palliative-care-cancer-patients#sthash.GWd1NYqx.dpuf