In an innovative breakthrough bridging psychology and emergency medicine, hypnosis has been found to considerably enhance patient compliance and comfort during non-invasive ventilation (NIV) for acute respiratory failure, as revealed by a pioneering pilot study presented at the European Emergency Medicine Congress. Acute respiratory failure is a severe and urgent health condition characterized by the lungs’ inability to adequately oxygenate blood and expel carbon dioxide, frequently necessitating immediate intervention. Typical underlying causes span chronic obstructive pulmonary disease (COPD), pneumonia, heart failure, infections, and thoracic injuries. NIV, typically delivered via a tightly-fitted mask connected to a ventilator, remains a frontline respiratory support strategy. Nevertheless, many patients experience significant distress and mask intolerance, often requiring sedation or anxiolytic medication, which can complicate care.
The research was spearheaded by Dr. Tobi Hamza, a resident emergency medicine physician at Mohammed V Military Teaching Hospital in Rabat, Morocco. Confronted with recurrent challenges in NIV tolerance linked to anxiety and discomfort during acute respiratory distress, Dr. Hamza and his colleagues hypothesized that hypnosis—a non-pharmacological technique—could mitigate such barriers and improve both tolerance and clinical outcomes. Over a six-month recruitment period, twenty patients presenting with acute respiratory failure at the hospital’s emergency department were enrolled in a rigorous prospective pilot trial. They were randomized into two equal groups: one receiving conventional NIV coupled with sedation and anti-anxiety medication as required, and the other receiving hypnosis sessions synchronized with NIV, without routine sedative drugs.
The hypnosis intervention was methodical and tailored. It began with a calming induction phase employing voice-guided relaxation, synchronized breathing, and vivid visual imagery to anchor patients’ focus and alleviate anxiety. Subsequently, a deepening phase aimed to facilitate dissociation from physical distress, aiming to diminish the psychological discomfort associated with mask-wearing. The final therapeutic suggestion phase was crafted to instill a profound sense of safety, trust in the treatment, and active cooperation with NIV. Crucially, all hypnosis sessions were conducted by an emergency physician trained extensively in medical hypnosis, enhancing fidelity and patient engagement.
Tolerance to NIV was quantified using a comprehensive comfort score ranging from zero to ten, supplemented by objective measurements of arterial blood gases including oxygen, carbon dioxide, and pH levels at one and four-hour intervals. Additionally, sedation and anti-anxiety medication requirements, levels of agitation, respiratory distress scores, and any need to abort NIV were carefully documented. The results were striking: the hypnosis cohort demonstrated significantly enhanced tolerance, with 80% completing their NIV treatment successfully without sedation or transitioning to invasive ventilation, in contrast to only 50% in the control group.
Beyond improved compliance, hypnosis yielded tangible clinical benefits. Notably, patients receiving hypnosis exhibited faster normalization of acid-base balance—demonstrated by improved pH—and more effective reduction of carbon dioxide retention after four hours. A reduction in agitation and respiratory distress scores, a decrease in emergency room length of stay, and a diminished reliance on anti-anxiety medications collectively underscored the therapeutic promise of hypnosis. Furthermore, patients subjected to the hypnotic intervention consistently provided higher comfort ratings, averaging 7.5 versus 4.3 in the control group, highlighting the subjective efficacy of this approach.
This study represents one of the earliest prospective clinical evaluations of hypnosis as an adjunct during NIV in acute respiratory failure, an area historically unexplored within emergency medicine. While hypnosis has found applications in pain management, procedural anxiety, and chronic disease care, its deployment in acute respiratory emergencies stands as a novel frontier. The pilot nature and small sample size of this trial warrant cautious interpretation, but the magnitude of observed benefits has galvanized further research efforts. Dr. Hamza and his team have initiated a larger, multicenter trial designed to validate these findings and examine long-term endpoints including hospitalization duration, intubation rates, and mortality.
The study’s strengths include its prospective design within a real-world emergency department, where the hypnosis was administered by a trained emergency physician, reflecting clinical feasibility. Limitations include single-center enrollment, potential selection bias as extreme emergencies and patients unable to consent were excluded, and lack of blinding for clinicians and patients, which could introduce placebo effects or observer bias. The specialized skills required to perform medical hypnosis may restrict immediate scalability until more healthcare providers receive appropriate training.
Independent expert Dr. Felix Lorang, head of the emergency department at SRH Zentralklinikum Suhl in Germany, emphasized the importance of communication in NIV adherence. Expressing intrigue about the findings, he noted that hypnosis intensifies patient-clinician interaction beyond standard verbal reassurance and shows promise in improving both patient comfort and the physiological efficacy of ventilation. Dr. Lorang advocated for larger-scale studies to confirm these encouraging results.
The convergence of hypnotic technique with emergency respiratory care heralds an exciting paradigm shift toward integrative, patient-centric management of acute respiratory distress. By harnessing the mind-body connection, hypnosis offers a low-cost, non-invasive, and drug-free complement to existing NIV protocols. Such innovations carry potential not only to improve therapeutic adherence and clinical outcomes but to reduce pharmacologic side effects and healthcare resource utilization. As respiratory diseases like COPD and pneumonia remain leading causes of morbidity and mortality globally, augmenting emergency interventions with hypnosis could substantially impact patient care.
Looking ahead, broader adoption of hypnosis in emergency settings hinges on rigorous evidence from multicenter randomized trials, standardization of hypnotic protocols, and incorporation into medical training curricula. If substantiated, hypnosis could redefine supportive care for patients suffering from life-threatening respiratory compromise. This study thus opens a vital research avenue at the intersection of cognitive psychology and emergency medicine, inviting ongoing exploration of non-conventional techniques to optimize critical care delivery.
The pilot study’s findings are poised to resonate across both clinical and academic communities, sparking dialogue on novel, integrative approaches to managing acute respiratory failure. The intersection of neuroscience and respiratory therapy exemplifies the future of medicine where holistic patient care enhances physiological healing. As investigations continue, the medical community awaits validation of hypnosis as a transformative adjunct in life-saving respiratory treatments.
Subject of Research: People
Article Title: Hypnosis to improve tolerance and efficacy of non-invasive ventilation in acute respiratory failure: a prospective controlled study
News Publication Date: 29-Sep-2025
References:
- Abstract no: OA019, “Hypnosis to improve tolerance and efficacy of non-invasive ventilation in acute respiratory failure: a prospective controlled study” by Tobi Hamza, Best Abstracts session, Monday 29 September, 14:45-16:15-hrs CEST, Schubert 4 room.
- Medical insights on the impact of carbon dioxide on blood acidity.
Image Credits: Tobi Hamza
Keywords:
Emergency medicine, Hypnosis, Respiratory disorders, Asthma, Bronchitis, Chronic obstructive pulmonary disease, Emphysema, Respiratory failure, Emergency rooms, Hospitals, Medical facilities
