Does Hypnosis Improve Severe Sleepwalking ?

Assistance Publique - Hôpitaux de Paris103 enrolled

Overview

The aim of the study is to compare the benefit of two cognitive therapies in severe sleepwalking/ sleep terrors: relaxation vs. relaxation plus hypnosis. This is a monocentric, double-blind controlled study. 75 patients (aged more than 15 yo) with severe sleepwalking (defined as at least one epsidoe per week and at least two awakenings in stage N3 on video polysomngraphy) will be included. All patients will have a visit 1 for diagnosis including a medical interview, a video polysomnography, questionnaires on sleepwalking (PADSS and systematized interview), sleep quality (PSQI, MEQ) and sleepiness (Epworth scale) and suggestibility scale. 25 patients will be randomized to the relaxation group, 25 patients to the hypnosis plus relaxation group, while the 25 non-randomized patients will be non-treated controls. Randomized patients will receive the therapy on day 1, and be monitored during the subsequent night. They will have a weekly therapy for 4 additional sessions and be monitored again on Month 1, as well as they will complete the sleep and sleepwalking questionnaires. They will also complete the questionnaire by phone on Month 3. The non-randomized controls will complete the questionnaire on month 1, with no therapeutical intervention between Day 1 and Month 1. The main outcome will be the frequency of sleepwalking episodes, as assessed by the PADSS-B. Secondary outcomes include the changes in other subitems of teh PADSS, of the N3 awakenings in v-PSG between night 1 and Night 2 (short term effect) and Night 1 and Night 28 (long term effect), as well as changes in sleep quality and sleepiness scales. A comparison of spectral EEG, as well as respiration, eye movements, muscle tone and heart rate during rest, hypnosis trance, relaxation and sleepwalking episodes is also scheduled.

Extended description of the protocol, including more technical information (as compared to the Brief Summary) if desired. Do not include the entire protocol; do not duplicate information recorded in other data elements, such as eligibility criteria or outcome measures

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Interventions

Hypnosis plus relaxationBEHAVIORAL

The patient will have 20 min of Jacobson 's type relaxation, with sequential contraction and relaxation of limb muscles followed by an induction of hypnosis based on the preferential channel of each patient and, during trance, recommendation to assimilter the bed room and bed to a safe place

RelaxationBEHAVIORAL

The patient will have 20 min of Jacobson 's type relaxation, with sequential contraction and relaxation of limb muscles

Eligibility

Sex: ALLMin age: 15 Years

Medical Language ↔ Plain English

Inclusion Criteria 1. \>15 years old 2. French speaker 3. having signed the Informed consent form 4. Affiliated to National Health Insurance 5. Sleepwalking or sleep terrors (ICSD-3 criteria); 6. At least 2 awakenings from N3 on Night 1 videopolysomnography; 7. At least one episode per week. Exclusion Criteria 1. \< 15 years old 2. Patient under guardian ship 3. Patient unable to understand the protocol 4. Patient unable, from investigator's opinion, to comply to the procedures of the trial, including the ability to practice self-hypnosis.

Outcomes

Primary Outcomes

Frequency of sleepwalking episodes as assessed by the PADSS-B

PADSS-B questionnaire, including the frequency of sleepwalking/sleep terrors episodes as evaluated by the patients, from none(0) to (several par nights (6)

Time frame: at one month (long term)

Secondary Outcomes

Other subjective characteristics of sleepwalking/sleep terrors

total PADSS score

Time frame: At one and at three months

Objective measures of sleepwalking: number of N3 awakenings

Number of N3 awakenings

Time frame: Night 2 (8 hours) and at one month (long term)

Objective measures of sleepwalking :behaviors on videoPSG

scale of behaviors on videopSG

Time frame: Night 2 (8 hours) and at one month (long term)

% of sleep stages

sleep stages (% of total sleep time)

Time frame: Night 2 (8 hours) and at one month (long term)

total sleep time

total sleep time in minute

Time frame: Night 2 (8 hours) and at one month (long term)

sleep efficiency

ratio between total sleep time and total sleep period

Time frame: Night 2 (8 hours) and at one month (long term)

Spectral EEG (power)

Spectral EEG analysis during hypnotic trance, rest, relaxation and N3 awakenings