Hypnosis intervention effects on sleep outcomes: a systematic review

May combine two claims.

The most commonly missed quality items were SASQI-CAM item 6 on assessing subject expectations of benefit and item 10 on monitoring and reporting side effects and adverse events.

“The most commonly missed quality items were SASQI-CAM item 6, related to assessing subject's expectations of benefits from the intervention, with only one publication 33 explicitly describing this, and item 10, which focused on monitoring and reporting side effects and adverse events; this information was included in only 2 publications.33,39”

• cites [33] Elkins G, Johnson A, Fisher W, Sliwinski J, Keith T A pilot investigation of guided self-hypnosis in the treatment of hot flashes among postmenopausal women. Int J Clin Exp Hypn. 2013;61(3):342–350. sourceNot checked — no full text of the source
• cites [39] Mendoza ME, Capafons A, Gralow JR, et al. Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors. Psychooncology. 2016 Jul 28. [Epub ahead of print]. doi: https://doi.org/10.1002/pon.4232. sourceDisputed

  The citing sentence identifies this paper as the one publication that assessed participants’ expectations of benefit. In the Discussion (page unavailable), the authors say they did not measure treatment expectancies—the opposite of that attribution. Searches for adverse events and side effects found no passage establishing that the paper monitored and reported them. (LLM, conf=0.86)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Hypnosis has gained recognition as an effective therapy for managing pain and for relieving cancer treatment side effects and stress-related disorders.

“Hypnosis has gained recognition as an effective therapy for managing pain and for relieving cancer treatment side effects and stress-related disorders.[13][14][15][16]”

• cites [13] Vanhaudenhuyse A, Gillet A, Malaise N, et al. Efficacy and cost-effectiveness: A study of different treatment approaches in a tertiary pain centre. Eur J Pain. 2015;19(10):1437–1446. sourcePartly supported

  The Discussion and conclusions (page not provided) reports reduced pain intensity, anxiety, and depression in chronic-pain patients receiving self-hypnosis/self-care. It also mentions reduced anxiety and depression in patients with cancer receiving palliative care, but does not establish relief of cancer-treatment side effects or stress-related disorders. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [14] Adachi T, Fujino H, Nakae A, Mashimo T, Sasaki J A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions. Int J Clin Exp Hypn. 2014;62(1):1–28. sourceNot checked — no full text of the source
• cites [15] Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ. Psychological and behavioral approaches to cancer pain management. J Clin Oncol. 2014;32(16):1703–1711. sourcePartly supported

  The Introduction (Hypnosis; page unavailable) describes hypnosis as increasingly used in cancer symptom management and reports evidence that it reduces pain and distress associated with cancer treatment. It does not establish hypnosis as a therapy for stress-related disorders generally; its findings concern patients with cancer and treatment-related distress. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

Some studies found that only highly susceptible participants benefitted from hypnotic suggestions for sleep improvement and those with low hypnotic susceptibility did not.

“Some studies found that only highly susceptible participants benefitted from hypnotic suggestions for sleep improvement and those with low hypnotic susceptibility did not.30,31”

• cites [30] Cordi MJ, Hirsiger S, Merillat S, Rasch B. Improving sleep and cognition by hypnotic suggestion in the elderly. Neuropsychologia. 2015;69:176–182. sourceNot checked — no full text of the source
• cites [31] Cordi MJ, Schlarb AA, Rasch B. Deepening sleep by hypnotic suggestion. Sleep. 2014;37(6):1143–1152. sourceSupported

May combine two claims.

In breast cancer survivors with hot flashes, the hypnosis intervention group showed significant improvements in primary outcomes (hot flash frequency and severity) and benefits for sleep (P < .005).

“primary outcomes (hot flash”

• Also stated in: § A BBRE V I ATI O NS · plain

  “intervention group, P < .005”

• cites Elkins et al. 2008 sourceSupported

May combine two claims. The quote only partly states this claim.

In that fibromyalgia trial, the CBT+hypnosis group showed significant effects on improving sleep, the effects persisted through 6 months posttreatment, and were similar to the CBT-alone group.

“significant effects on improving”

• Also stated in: § A BBRE V I ATI O NS · plain

  “through 6 months posttreatment”

• cites Castel, Cascon, Padrol, Sala, Rull 2012 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

In that study, increased slow wave activity due to hypnosis (P = .03) correlated with time spent in slow wave sleep.

“to hypnosis, P = .03 correlated”

• Also stated in: § A BBRE V I ATI O NS · plain

  “with time spent in SWS”

• cites Cordi, Schlarb, Rasch 2014 sourceSupported

May combine two claims.

Only some studies showed the importance of hypnotic susceptibility for the success of the intervention whereas others failed to show it or did not assess it.

“Only some studies showed the importance of hypnotic susceptibility for the success of the intervention 30,31 whereas others failed to show it or did not assess it.”

• cites [30] Cordi MJ, Hirsiger S, Merillat S, Rasch B. Improving sleep and cognition by hypnotic suggestion in the elderly. Neuropsychologia. 2015;69:176–182. sourceNot checked — no full text of the source
• cites [31] Cordi MJ, Schlarb AA, Rasch B. Deepening sleep by hypnotic suggestion. Sleep. 2014;37(6):1143–1152. sourceSupported

May combine two claims.

Sleep problems are typically treated with sleep medications that have known unpleasant side effects and have an unknown efficacy for long-term use.

“Sleep problems are typically treated with sleep medications that have known unpleasant side effects and have an unknown efficacy for long-term use.2,7”

• cites [2] Morin CM, Benca R. Chronic insomnia. Lancet. 2012;379(9821):1129–1141. sourceNot checked — no full text of the source
• cites [7] Ford ES, Wheaton AG, Cunningham TJ, Giles WH, Chapman DP, Croft JB. Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care survey 1999-2010. Sleep. 2014;37(8):1283–1293. sourcePartly supported

  The Introduction describes concern about serious side effects, and the conclusion notes potential harm from hypnotics. But the results report that visits for a sleep-related reason without a hypnotic prescription vastly outnumbered those with one, so the paper does not establish that sleep problems are typically treated with medication. Our copy also does not address whether these medications are effective for long-term use. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

SASQI has been specifically designed for evaluating integrative medicine approaches and has been increasingly used in systematic reviews assessing efficacy of integrative approaches.

“though SASQI has been specifically designed for evaluating integrative medicine approaches and has been increasingly used in systematic reviews assessing efficacy of integrative approaches, 18,22,71”

• cites [18] Meeks TW, Wetherell JL, Irwin MR, Redwine LS, Jeste DV. Complementary and alternative treatments for late-life depression, anxiety, and sleep disturbance: a review of randomized controlled trials. J Clin Psychiatry. 2007;68(10):1461–1471. sourceNot checked — no full text of the source
• cites [22] D'Silva S, Poscablo C, Habousha R, Kogan M, Kligler B. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53(5):407–423. sourceNot checked — no full text of the source
• cites [71] Carim-Todd L, Mitchell SH, Oken BS. Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. Drug Alcohol Depend. 2013;132(3):399–410. sourcePartly supported

  Section 2.4 says SASQI-CAM was devised specifically to assess the quality of studies using complementary and alternative medicine interventions, and this systematic review used it. The paper does not establish that its use in systematic reviews has been increasing. Page numbers are not available in the supplied copy. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

May combine two claims.

In post-menopausal women with hot flashes, the hypnosis group significantly improved on the primary outcome (hot flash reduction) compared to control (P < .001), sustaining the benefit at 12-week follow-up.

“improved on primary outcome”

• Also stated in: § A BBRE V I ATI O NS · plain

  “the benefit at 12-week follow-up.”

• cites Elkins, Fisher, Johnson, Carpenter, Keith 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

One hundred thirty-nine nonduplicate abstracts were screened, and 24 papers were included for qualitative analysis.

“One hundred thirty-nine nonduplicate abstracts were screened, and 24 of the reviewed papers were included for qualitative analysis.”

• Also stated in: § Overview of the Included Studies · plain

  “We identified 139 studies via searches, of which 24 met our inclusion criteria.”

May combine two claims.

Overall, 58.3% of included studies reported hypnosis benefit on sleep outcomes, 12.5% reported mixed results, and 29.2% reported no hypnosis benefit.

“Overall, 58.3% of the included studies reported hypnosis benefit on sleep outcomes, with 12.5% reporting mixed results, and 29.2% reporting no hypnosis benefit”

• Also stated in: § Comparison of Positive, Mixed, and Negative Studies · plain

  “Of 24 of the included studies, more than half (58.3%) reported a positive effect of the hypnosis intervention on the assessed sleep outcome over time.Mixed results indicating improvements in some but not all sleep outcomes were presented in 12.5% of the included studies.The rest of the publications (29.2%) demonstrated negative results, with no effects of hypnosis or comparable effects of hypnosis”

May combine two claims.

Among studies with negative hypnosis effects on sleep outcomes, 85.7% were randomized controlled trials and 85.7% used an active control group.

“Among studies with negative hypnosis effects on sleep outcomes, 85.7% were RCTs and 85.7% used an active control group.”

May combine two claims.

Two studies (16.7%) showed mixed results, indicating improvements in some but not all sleep outcomes.

“Two studies (16.7%) showed mixed results, indicating improvements in some but not all sleep outcomes.”

May combine two claims.

Sleep was the primary outcome in 57.1% of positive studies and 42.9% of negative studies.

“Next, sleep was the primary outcome in 57.1% of the studies showing benefits of hypnosis for sleep and in 42.9% of the studies showing no hypnosis effect on sleep.”

May combine two claims.

Samples with sleep complaints were recruited in 35.7% of positive studies and 28.6% of negative studies.

“Samples with sleep complaints were recruited in 35.7% of the studies reporting a positive effect of hypnosis on sleep and in 28.6% of the studies reporting negative hypnosis effects on sleep.”

May combine two claims.

Eighty percent of positive sleep-problem studies recruited samples with psychiatric comorbidities such as PTSD, anxiety, or depression, while none of the negative studies indicated significant comorbidities.

“Eighty percent of the positive studies from this subset recruited samples with psychiatric comorbidities such as PTSD, anxiety, or depression; none of the studies reporting negative results indicated significant comorbidities in their participants.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The studies varied greatly in the lengths of hypnosis intervention, from 13-minute audio recordings to 8 sessions of 1 hour.

“The studies varied greatly in the lengths of hypnosis intervention: from 13-minute audio recordings with hypnosis for deep sleep to 8 sessions of hypnosis, each lasting 1 hour.”

May combine two claims.

Average sample sizes were 36.4, 108.0, and 29.5 for positive, mixed, and negative sleep-problem studies, respectively.

“Average sample sizes were 36.4 ± 14.7, 108.0 ± 0, and 29.5 ± 7.5 for positive, mixed, and negative studies, respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Hypnosis interventions were primarily delivered as separate treatment programs in several individual sessions with increasing interest in using tailored suggestions.

“The hypnosis interventions were primarily delivered as separate treatment programs in several individual sessions with increasing interest in using tailored suggestions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The number of sessions averaged 4 ± 1.2 (range, 1 to 8).

“The number of sessions averaged 4 ± 1.2 (range, 1 to 8)”

May combine two claims.

Samples with sleep complaints were recruited in one of the studies reporting a positive effect of hypnosis on sleep and in none of the studies reporting negative hypnosis effects on sleep.

“Samples with sleep complaints were recruited in one of the studies reporting a positive effect of hypnosis on sleep and in none of the studies reporting negative hypnosis effects on sleep.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Using sleep hygiene instructions along with hypnosis was reported in few hypnosis interventions for sleep improvement.

“Using sleep hygiene instructions along with hypnosis was reported in few hypnosis interventions for sleep improvement.”

May combine two claims.

Among studies recruiting samples with sleep problems, 62.5% reported positive findings, 12.5% reported mixed results, and 25.0% reported negative results.

“Considering only the studies recruiting samples with sleep problem, most of them (62.5%) reported positive findings, 12.5% reported mixed results, and 25.0% reported negative results.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The included studies collectively assessed 1,330 participants.

“The included studies collectively assessed 1,330 participants.”

May combine two claims.

The hypnosis interventions described in the review targeted sleep disturbance (25%), pain symptoms (29.2%), immune system (4.2%), focused on increase of relaxation and reduction stress (12.5%), symptoms associated with hot flashes (12.5%), and the remaining studies provided no specific intervention focus.

“The hypnosis interventions described in the review targeted sleep disturbance (25%), pain symptoms (29.2%), and immune system (4.2%),focused on increase of relaxation and reduction stress (12.5%), symptoms associated with hot flashes (12.5%), and the remaining studies provided no specific intervention focus.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The average study sample size was 55.3 (standard deviation 43.7), with a range of 14 to 187.

“The average study sample size was 55.3 (standard deviation = 43.7)with the range of 14 to 187.”

May combine two claims.

Among studies reporting positive effects, 50% were randomized controlled trials, 50% used an active control group, 14.3% used a nonactive control group, and 35.7% employed no control group.

“Among the studies reporting positive effects, only 50% were RCTs, and an active control group was used in 50% of the positive studies, with 14.3% using a nonactive control group and 35.7% employing no control group.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Treatment duration averaged 2.5 for positive and 2.5 for negative sleep-problem studies.

“Treatment duration averaged 2.5 ± 2.5 for positive and 2.5 ± 0.5 for negative studies.”

May combine two claims.

Sleep was the primary outcome in 57.1% of the studies showing benefits of hypnosis for sleep and in none of the studies showing no hypnosis effect on sleep.

“sleep was the primary outcome in 57.1% of the studies showing benefits of hypnosis for sleep and in none of the studies showing no hypnosis effect on sleep.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Home practice was encouraged in 54.2% of included studies, with most offering audio recordings.

“Home practice was encouraged in 54.2% of the included studies, with most of these studies offering audio recordings for such a practice.”

May combine two claims.

Sleep was the primary outcome in 62.5% of positive sleep-problem studies and in both negative sleep-problem studies.

“Sleep was the primary outcome in 62.5% of the studies showing benefits of hypnosis for sleep and in both of the studies showing no hypnosis effect on sleep.”

May combine two claims.

Most sleep-problem studies assessed sleep with subjective assessments, except one positive study.

“Most of the studies enrolling samples with sleep problems assessed sleep with subjective assessments, except one study reporting positive outcomes of hypnosis on sleep.”

May combine two claims.

Forty-five percent of included studies assessed hypnosis effects immediately after intervention and at follow-up, with follow-up periods ranging from 1 to 24 months postintervention.

“Forty-five percent of the included studies assessed hypnosis effects not only immediately following the intervention but also included additional follow-up assessments.Follow-up periods ranged from 1 month to 24 months postintervention.”

May combine two claims.

The remaining three studies (25%) demonstrated negative results, with no beneficial effects of hypnosis or comparable effects of hypnosis and control conditions on sleep outcomes.

“The remaining three studies (25%) demonstrated negative results, with no beneficial effects of hypnosis or comparable effects of hypnosis and control conditions on sleep outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Among controlled studies (75.0% of all included studies), 72.2% used active control groups, 16.7% used nonactive control groups, and 11.1% used both active and nonactive control groups.

“Among the controlled studies (75.0% of all included studies), 72.2% used active control groups (eg, relaxation, sedativehypnotic medication, therapy, simple monitoring, structured attention, education, stimulus response), 16.7% employed nonactive control groups (eg, standard treatment, waitlist), and 11.1% employed both active and nonactive control groups.”

May combine two claims.

Custom instruments were used in 29.2% of included studies, and the exact nature of assessed outcomes with such instruments is difficult to ascertain.

“The custom instruments used in 29.2% of the included studies were primarily diary-like assessments; however, it is difficult to ascertain the exact nature of the assessed outcomes when such custom instruments have been used.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Most included studies (66.7%) did not require sleep complaints for study inclusion.

“Most of the included studies (66.7%) did not require sleep complaints for study inclusion.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Adherence to home practice instructions was not typically assessed.

“Adherence to the home practice instructions was not typically assessed.”

May combine two claims.

Except for two crossover placebo-controlled studies reporting positive results, the rest of the high-quality studies were RCTs.

“Except for two crossover placebo-controlled studies reporting positive results, the rest of the high-quality studies were RCTs.”

May combine two claims.

All high-quality studies used a control group, with most including active controls.

“All high-quality studies used a control group, with most including active controls.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Most studies (83.3%) used individual hypnosis sessions.

“Most of the studies (83.3%) used individual hypnosis sessions.”

May combine two claims.

More than 80% of the negative studies were controlled trials and a similar percentage had an active control group compared to only half of the positive studies having an RCT design and using an active control group.

“more than 80% of the negative studies were controlled trials and a similar percentage had an active control group compared to only half of the positive studies having an RCT design and using an active control group.”

May combine two claims.

Studies reporting positive effects of hypnosis on sleep outcomes were more likely to have a sample with sleep problems and focus on a sleep outcome as a primary outcome measure.

“the studies reporting positive effects of hypnosis on sleep outcomes were more likely to have a sample with sleep problems and focus on a sleep outcome as a primary outcome measure.”

May combine two claims.

Most studies assessed in this review did not include the assessment of hypnotic susceptibility or tested its relation to the study outcomes.

“Most of the studies assessed in this review did not include the assessment of hypnotic susceptibility or tested its relation to the study outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Few included studies (8.3%) reported using sleep hygiene instructions along with hypnosis training.

“Few of the included studies (8.3%) 25,43 reported using sleep hygiene instructions along with hypnosis training.”

• cites [25] Abramowitz EG, Barak Y, Ben-Avi I, Knobler HY. Hypnotherapy in the treatment of chronic combat-related PTSD patients suffering from insomnia: a randomized, zolpidem-controlled clinical trial. Int J Clin Exp Hypn. 2008;56(3):270–280. sourceNot checked — no full text of the source
• cites [43] Stanton HE. Hypnotic relaxation and the reduction of sleep onset insomnia. Int J Psychosom. 1989; 36(1-4):64–68.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

All except one of the sleep-problem studies were controlled, and two focused on mechanistic aspects of hypnosis for sleep outcomes rather than efficacy.

“All except one of these studies were controlled, and two studies focused on mechanistic aspects of hypnosis for sleep outcomes rather than efficacy.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Total time spent in intervention averaged 3.6 ± 1.9 hours (0.23-to 8-hour range).

“with the total time spent in intervention averaging 3.6 ± 1.9 hours (0.23-to 8-hour range).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Sleep-related outcomes were primary in 50% of the included studies.

“Sleep-related outcomes were primary in 50% of the included studies.”

May combine two claims.

The studies reporting positive findings had a similar average methodological quality and sample sizes compared to those reporting negative hypnosis effects.

“The studies reporting positive findings had a similar average methodological quality and sample sizes compared to those reporting negative hypnosis effects.”

May combine two claims.

Average intervention duration was 2.9 ± 2.2 hours for positive studies and 4.7 ± 0.5 hours for negative studies.

“average intervention duration was 2.9 ± 2.2 hours for positive studies and 4.7 ± 0.5 hours for negative studies.”

May combine two claims.

For studies targeting sleep and conditions affected by sleep (pain, stress, hot flashes), home practice was encouraged in most included studies, though adherence to such practice and its influence on outcomes was rarely assessed.

“For the studies targeting sleep and conditions affected by sleep (pain, stress, hot flashes) home practice was encouraged in most of the included studies, though adherence to such practice and its influence on the outcomes was rarely assessed.”

The quote only partly states this claim.

Following hypnosis, patients with chronic low back pain reported reduced time to fall asleep (P < .001).

“reported reduced time to fall”

• Also stated in: § A BBRE V I ATI O NS · plain

  “asleep, P < .001”

• cites Crawford et al. 1998 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Among the subset of studies with lower risk of bias, mean bias score was 13.1 (SD 1.8) for positive studies, 16.1 (SD 1.0) for mixed studies, and 14.3 (SD 0.9) for only negative studies.

“Bias score, mean (SD) | 13.1 (1.8), range 11-16 16.1 (1.0), range 15-17 14.3 (0.9), range 13-15”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In that trial of patients with persistent idiopathic orofacial pain, sleep quality improved from baseline to the last treatment, with no differences between the hypnosis and control groups.

“Improvement in sleep quality from”

• Also stated in: § A BBRE V I ATI O NS · plain

  “no differences between hypnosis”

• cites Abrahamsen, Baad-Hansen, Svensson 2008 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Of the studies reporting positive findings, 8 had a primary sleep outcome; of those reporting mixed findings, 0; and of those reporting only negative findings, 3.

“Studies with primary sleep outcome, number of studies | 8 | 0 | 3”

May combine two claims.

The adverse event rate was very low given that more than 200 participants from two RCTs reported no adverse events; however, information about adverse events was not reported in most studies.

“The adverse event rate was very low given that more than 200 participants from two RCTs reported no adverse events; however, the information about adverse events was not reported in most studies.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Among the subset of studies enrolling samples with sleep complaints, mean bias score was 6 (SD 3.2) for studies reporting positive findings, 17 for the mixed study, and 6 (SD 3.0) for only negative studies.

“Bias score, mean (SD) | 6 (3.2), range 3-11 | 17(0.0) | 6 (3.0), range 3-9”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Among the included studies, mean sample size was 53.7 (SD 41.7) for studies reporting positive findings, 74.0 (SD 46.5) for mixed findings, and 50.7 (SD 48.4) for only negative findings.

“Sample size, mean (SD) | 53.7 (41.7) | 74.0 (46.5) | 50.7 (48.4)”

May combine two claims.

In that study of healthy elderly women, hypnosis was associated with a shorter latency to slow wave sleep (P = .039) and an increase in prefrontal slow wave sleep power (P = .044).

“shorter latency to SWS, P = .039,”

• Also stated in: § A BBRE V I ATI O NS · plain

  “power, P = .044”

• cites Cordi, Hirsiger, Merillat, Rasch 2015 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

In patients with persistent idiopathic orofacial pain, hypnosis produced statistically and clinically significant reductions in the primary outcome of pain.

“significant reductions in primary”

• Also stated in: § A BBRE V I ATI O NS · plain

  “outcome pain with hypnosis.”

• cites Abrahamsen, Baad-Hansen, Svensson 2008 sourceNot checked — no full text of the source

May combine two claims.

In patients with chronic low back pain, both self-hypnosis and relaxation were effective, but neither was superior to the other.

“were effective but no one was”

• Also stated in: § A BBRE V I ATI O NS · plain

  “superior to another. Self-hypnosis”

• cites McCauley, Thelen, Frank, Willard, Callen 1983Not checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

An objectively measured sleep outcome was present in 4 studies reporting positive findings, 1 reporting mixed findings, and 0 reporting only negative findings.

“Objectively measured sleep outcome, number of studies | 4 | 1 | 0”

May combine two claims.

Among the subset of studies with lower risk of bias (SASQI-CAM score higher than 9), 7 reported positive findings, 2 reported mixed findings, and 3 reported only negative findings.

“| Characteristic | Findings (n = 7) | Findings (n = 2) | Findings (n = 3) |”

May combine two claims.

Mean bias score was 9.4 (SD 4.7) for studies reporting positive findings, 13.3 (SD 4.7) for mixed findings, and 9.9 (SD 4.6) for only negative findings.

“Bias score, mean (SD) | 9.4 (4.7), range 3-16 | 13.3 (4.7), range 8-17 | 9.9 (4.6), range 3-15”

May combine two claims.

In that trial, the self-hypnosis group reported less time to sleep onset over time (P < .01), and their medication use rate was less problematic.

“onset over time, P < .01, and”

• Also stated in: § A BBRE V I ATI O NS · plain

  “less problematic”

• cites McCauley, Thelen, Frank, Willard, Callen 1983Not checked — no full text of the source

May combine two claims.

The included studies assessed relatively small samples of predominantly middle-aged female participants who may or may not have sleep complaints.

“The included studies assessed relatively small samples of predominantly middle-aged female participants who may or may not have sleep complaints.”

May combine two claims.

Our review indicates that beneficial hypnosis for sleep improvement included sleep-specific suggestions, suggestions for relaxation and stress reduction, and age regressions.

“Our review indicates that beneficial hypnosis for sleep improvement included sleep-specific suggestions, suggestions for relaxation and stress reduction, and age regressions.”

May combine two claims.

Empirical evidence from published research indicates either a beneficial effect of hypnosis interventions on sleep or hypnosis effects comparable to those of control interventions with a low rate of adverse experiences from hypnosis.

“Empirical evidence from published research indicates either a beneficial effect of hypnosis interventions on sleep or hypnosis effects comparable to those of control interventions with a low rate of adverse experiences from hypnosis.”

May combine two claims.

That meta-analysis indicated hypnotherapy and hypnotherapy-like treatments shortened sleep latency compared to waitlist but not to sham intervention.

“This meta-analyses indicated hypnotherapy and hypnotherapy-like treatments shortened sleep latency compared to waitlist but not to sham intervention.”

• cites [17] Lam TH, Chung KF, Yeung WF, Yu BY, Yung KP, Ng TH. Hypnotherapy for insomnia: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2015;23(5):719–732. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Hypnosis for sleep problems is a promising treatment that merits further investigation.

“Hypnosis for sleep problems is a promising treatment that merits further investigation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Discrepancies in risk-of-bias assessment were resolved by consensus.

“Any discrepancies were resolved by consensus.”

Probably not a substantial claim: may not pass S3 (load-bearing).

For each study, data were extracted by one trained staff member and then reviewed by a second member.

“For each study, data were extracted by one of the trained staff and then reviewed by a second member.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Timely treatment of sleep disturbances can contribute to prevention and modification of many health conditions often comorbid with sleep problems.

“Therefore, timely treatment of sleep disturbances can contribute to prevention and modification of many health conditions often comorbid with sleep problems.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Sleep problems may be precursors to many health issues, including cardiovascular disease, diabetes, mental health problems, and dementia.

“Sleep problems may be precursors to many health issues, including cardiovascular disease, diabetes, mental health problems, and dementia.[3][4][5][6]”

• cites [3] National Institutes of Health NIH state-of-the-science conference statement on manifestations and management of chronic insomnia in adults. NIH Consens State Sci Statements. 2005;22(2):1–30.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [4] Yaffe K, Laffan AM, Harrison SL, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA. 2011;306(6):613–619. sourceNot checked — no full text of the source
• cites [5] Budhiraja R, Roth T, Hudgel DW, Budhiraja P, Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. Sleep. 2011;34(7):859–867. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Full texts of studies meeting inclusion/exclusion criteria were retrieved and reviewed by two authors for determination of inclusion.

“The full text of studies meeting the inclusion/exclusion criteria, the relevant review articles, and the articles with insufficient information to determine eligibility from the abstract were retrieved and reviewed by two authors for determination for inclusion in this review (Figure 1).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Two reviewers independently assessed the risk of bias of each study.

“Two reviewers independently assessed the risk of bias of each study in accordance with the guidelines provided for complementary and integrative approaches.18”

• cites [18] Meeks TW, Wetherell JL, Irwin MR, Redwine LS, Jeste DV. Complementary and alternative treatments for late-life depression, anxiety, and sleep disturbance: a review of randomized controlled trials. J Clin Psychiatry. 2007;68(10):1461–1471. sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Methodological quality of included publications was evaluated using the modified SASQI-CAM scale.

“The methodological quality of the included publications was evaluated using the modified Scale for Assessing Scientific Quality of Investigation-Complementary and Alternative Medicine (SASQI-CAM) version.18”

• cites [18] Meeks TW, Wetherell JL, Irwin MR, Redwine LS, Jeste DV. Complementary and alternative treatments for late-life depression, anxiety, and sleep disturbance: a review of randomized controlled trials. J Clin Psychiatry. 2007;68(10):1461–1471. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Discrepancies in data extraction were resolved by consensus.

“Again, any discrepancies were resolved by consensus.”

May combine two claims.

Twelve of the included studies received a score higher than 9 on SASQI-CAM, indicating adequate study quality and lower risk of bias.

“Twelve of the included studies received a score higher than 9 on SASQI-CAM, indicating adequate study quality and lower risk of bias.22”

• cites [22] D'Silva S, Poscablo C, Habousha R, Kogan M, Kligler B. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53(5):407–423. sourceNot checked — no full text of the source

May combine two claims.

Despite the limitations associated with the current review and the overall state of research, hypnotherapy for sleep problems appears to be a promising treatment to explore with little evidence of any adverse events.

“Despite the limitations associated with the current review and the overall state of research, hypnotherapy for sleep problems appears to be a promising treatment to explore with little evidence of any adverse events.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A recent systematic review and meta-analysis evaluating cognitive behavioral therapies for treatment of insomnia indicated that CBT-I is efficacious for some but not all dimensions of sleep problems.

“A recent systematic review and meta-analysis evaluating cognitive behavioral therapies for treatment of insomnia indicated that CBT-I is efficacious for some but not all dimensions of sleep problems.64”

• cites [64] van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2017 Feb 9. [Epub ahead of print]. doi: https://doi.org/10.1016/j.smrv.2017.02.001. sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Hypnosis can be provided by any clinician (physician, nurse, psychologist) trained in hypnotherapy.

“Hypnosis can be provided by any clinician (physician, nurse, psychologist) trained in hypnotherapy”

• cites 33,[65][66][67][68][69]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Currently, a nonpharmacological approach of choice for treating insomnia is CBT-I.

“Currently, a nonpharmacological approach of choice for treating insomnia is CBT-I.8,64”

• cites [8] McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): what is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5. [Epub ahead of print]. doi:https://doi.org/10.1016/j.smrv.2017.05.001. sourceNot checked — no full text of the source
• cites [64] van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2017 Feb 9. [Epub ahead of print]. doi: https://doi.org/10.1016/j.smrv.2017.02.001. sourceNot checked — no full text of the source

May combine two claims.

Some limitations of CBT-I include the need for 5 or more sessions of therapy to observe most optimal response and a shortage of trained therapists to provide CBT-I.

“some limitations noted in the recent work include the need for 5 or more sessions of therapy to observe most optimal response and a shortage of trained therapists to provide the CBT-I.8,64”

• cites [8] McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): what is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5. [Epub ahead of print]. doi:https://doi.org/10.1016/j.smrv.2017.05.001. sourceNot checked — no full text of the source
• cites [64] van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2017 Feb 9. [Epub ahead of print]. doi: https://doi.org/10.1016/j.smrv.2017.02.001. sourceNot checked — no full text of the source

May combine two claims.

Overall the quality of the included research was modest, with only half of the included studies receiving a score higher than 9, indicating lower risk of bias on SASQI-CAM.

“Overall the quality of the included research was modest, with only half of the included studies receiving a score higher than 9, indicating lower risk of bias on SASQI-CAM.”

Probably not a substantial claim: may not pass S3 (load-bearing).

CBT-I has been considered a reliable treatment for chronic insomnia for the past 25 years.

“Though CBT-I has been considered a reliable treatment for chronic insomnia for the past 25 years”

• cites [8] McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): what is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5. [Epub ahead of print]. doi:https://doi.org/10.1016/j.smrv.2017.05.001. sourceNot checked — no full text of the source
• cites [64] van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2017 Feb 9. [Epub ahead of print]. doi: https://doi.org/10.1016/j.smrv.2017.02.001. sourceNot checked — no full text of the source

May combine two claims.

The research suggests that home practice supported by audio recordings of sessions may boost the efficacy of treatment and reduce the number of treatment sessions.

“The research also suggests that home practice supported by audio recordings of sessions may boost the efficacy of treatment and reduce the number of treatment sessions.”

May combine two claims.

Though most studies reporting benefits of hypnosis on sleep used individual sessions, benefits of hypnosis were also observed in studies utilizing group sessions and audio recording only, highlighting that sleep improvements can be achieved with more efficient interventions.

“Though most of the studies reporting benefits of hypnosis on sleep were using individual sessions, benefits of hypnosis were also observed in studies utilizing group sessions and audio recording only, highlighting that sleep improvements can be achieved with more efficient interventions.”

Probably not a substantial claim: may not pass S2 (checkable).

Our review indicates that research on using hypnosis for sleep problems is still in the early stages.

“Our review indicates that research on using hypnosis for sleep problems is still in the early stages.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

A recent review assessing the efficacy, safety, and applications of medical hypnosis did not list sleep problems among the applications.

“A recent review assessing efficacy, safety, and applications of medical hypnosis did not list sleep problems among the”

• cites [58] Hauser W, Hagl M, Schmierer A, Hansen E. The efficacy, safety and applications of medical hypnosis. Dtsch Ärztebl Int. 2016;113(17):289–296. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The authors entered no agreements with the funding organization that limited their ability to analyze data or publish the work.

“The authors have not entered any agreements with the funding organization that limited their ability to analyze data or publish this work.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The methodological quality (risk of bias) of each included study was scored on a 0-20 scale.

“(range 0-20)”