Evaluation of the Benefits of Hypnosis in Improving the Quality of Life of Patients With Chronic Obstructive Pulmonary Disease (COPD) Suffering From Persistent Dyspnea (HYPNODYS)

Evaluation of the Benefits of Hypnosis in Improving the Quality of Life of Patients With Chronic Obstructive Pulmonary Disease (COPD) Suffering From Persistent Dyspnea: a Multicenter Randomized Controlled Trial

Chronic Obstructive pulmonary Disease (COPD) is a common progressive disorder characterized by persistent airflow limitation. It is usually caused by exposure to tobacco smoke, toxic particles, or toxic gases. COPD is characterized by cough, sputum production, and dyspnea, which is the cardinal symptom and is included in the criteria for severity. Dyspnea is a major source of suffering and disability, especially when it persists at rest.

Despite proper medical treatment, many patients continue to suffer from persistent dyspnea that significantly impairs their daily functioning and quality of life. Complementary approaches such as yoga and relaxation techniques are therefore recommended by some experts. Hypnosis is one of these practices. It has been shown to be effective in the management of both acute and chronic pain and it can abolish several types of experimentally induced dyspnea in healthy volunteers. In adults with COPD, a single hypnosis session has been shown to reduce anxiety immediately, though only temporarily. However, according to a recent retrospective study, a median of three hypnosis sessions increases the distance covered in the 6-minute walk test in COPD patients.

The investigators therefore hypothesize that several hypnosis sessions will improve the quality of life of adult outpatients with COPD who suffer from persistent dyspnea. The study plans to recruit 154 patients with severe dyspnea (mMRC(modified Medical Research Council Dyspnea Scale) 3 or 4). They will be randomly assigned to either the experimental group or the control group. Patients in the experimental group will participate in 5 sessions of medical hypnosis spaced 7 ± 2 days apart. The first hypnosis session will take place at the end of the enrollment visit. The final session will be held via teleconsultation. Four standardized telephone calls, spaced 7 ± 2 days apart, will replace the hypnosis sessions in the control group. The primary outcome of the study will be the evolution of quality of life, assessed 6 weeks after the start of the study as compared to baseline. Secondary outcomes will focus on changes in exercise capacity, dyspnea, anxiety, depression, dyspnea-related catastrophizing, self-efficacy, and pleasure in life.

Study Overview

• Status: Not yet recruiting
• Conditions: Chronic Obstructive Pulmonary Disease (COPD); Dyspnea
• Intervention / Treatment: Behavioral: Hypnosis; Other: standardized telephone calls

Detailed Description

The study aims at assessing the effect of medical hypnosis on the quality of life of dyspneic COPD outpatients. It plans to recruit 154 COPD outpatients with severe dyspnea (mMRC 3 or 4). They will have to be treated in accordance with the GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2024 guidelines, exept for pulmonary rehabilitation that is not required. Inclusion and non-inclusion criteria are provided below. Patients will be randomly assigned to either the experimental or the control group. Patients in the experimental group will participate in 5 sessions of medical hypnosis spaced 7 ± 2 days apart. The first hypnosis session will take place at the end of the enrollment visit. The final session will be held via teleconsultation. Four standardized telephone calls, spaced 7 ± 2 days apart, will replace the hypnosis sessions in the control group. The objectives of the study will be assessed 6 weeks after enrollment. The primary objective of this study will be to evaluate the benefit of hypnosis in improving the quality of life of outpatients with COPD and persistent dyspnea, compared to a control group that will receive support through standardized telephone calls but no hypnosis.

The primary outcome will be the change in the total score of the St George's Respiratory Questionnaire (SGRQ) which assesses respiratory related quality of life, measured 6 weeks after randomization.

The secondary objectives of the study will be to evaluate the benefit of hypnosis in patients with COPD and persistent dyspnea compared to the control group on the following outcomes:

1. The components of quality of life in COPD: symptoms, activity, and impact on daily life. Those components are part of the SGRQ.
2. The ability to engage in physical activity. It will will be assessed with the 6-min walk test.
3. Dyspnea and its affective, sensory, and emotional dimensions. They will be assessed using the multidimensional dypnea profile (MDP) questionnaire. d) Dyspnea in activities of daily living. It will be assessed using the London Chest Activity of Daily Living (LCADL) scale.

e) The level of anxiety. It will be assessed using the Hospital Anxiety and Depression Scale (HADS).

f) The level of depression. It will also be assessed using the Hospital Anxiety and Depression Scale (HADS).

g) The level of catastrophizing about dyspnea. It will be assessed using the breathlessness catastrophizing scale for chronic obstructive pulmonary disease.

h) The level of self-efficacy. It will be assessed using the COPD Self-Efficacy Scale.

i) The level of pleasure (or the level of anhedonia). It will be assessed using the Snaith-Hamilton Pleasure Scale.

• Study Type: Interventional
• Enrollment (Estimated): 154
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Christian STRAUS, MD, PHD; Phone Number: +331 42 17 85 78; Email: christian.straus@aphp.fr
• Study Contact Backup: Name: Marthe MAHI, Master; Phone Number: +331 42 16 16 99; Email: marthe.mahi@aphp.fr

Study Locations

• France
  • France
    • Paris, France, France, 75013
      • APHP, Hôpital Pitié-Salpêtrière
      • Contact: Christian STRAUS, MD, PHD; Phone Number: +331 42 17 85 78; Email: christian.straus@aphp.fr
      • Contact: Marthe MAHI, Master; Phone Number: +331 42 16 16 99; Email: marthe.mahi@aphp.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age >18 years
• COPD (any etiology), referred by a pulmonologist and managed according to GOLD 2024 guidelines except for pulmonary rehabilitation that is not required
• Outpatient follow-up
• Residing in Paris or the inner suburbs for centers located within the city limits, or within a 30-minute drive for centers located outside the city limits of Paris.
• Dyspnea rated as mMRC 3 or 4
• Having signed an informed consent form

Exclusion Criteria:

• Vulnerable individuals (under legal guardianship or curatorship) or deprived of liberty
• Pregnant or breastfeeding women
• Absolute or relative contraindication to the 6 minutes walk test, spirometry or body plethysmography
• Current COPD exacerbation or exacerbation resolved less than one week ago
• Psychosis or other psychiatric disorder likely to interfere with study participation
• Profound hearing impairment
• Cognitive impairment
• Use of psychedelic substances (ex: LSD (Lysergic acid diethylamide), psilocybin, etc.)
• Current participation in interventions that may be related to hypnosis: any kind of meditation, relaxation, sophrology, heart coherence training, yoga, Qi Gong, holotropic breathing, EMDR (Eye Movement Desensitization and Reprocessing) or any psychotherapies involving eye movements, as well as shamanic practices and brief psychotherapies or cognitive-behavioral therapies
• Previous management of dyspnea using hypnosis
• Ongoing pulmonary rehabilitation (physiotherapy outside a structured rehabilitation program initiated before study inclusion is not an exclusion criterion)
• Inability to be reached by phone or teleconsultation
• Lack of health insurance (French social security) coverage
• Participation in another clinical trial
• End of life

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hypnosis; Five medical hypnosis sessions, each scheduled 7 ± 2 days apart	Behavioral: Hypnosis; Five medical hypnosis sessions, each scheduled 7 ± 2 days apart
Other: control; Four standardized telephone calls, made at 7 ± 2 day intervals	Other: standardized telephone calls; Four standardized telephone calls, made at 7 ± 2 day intervals

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in quality of life assessed using the total score of the St George's Respiratory Questionnaire (SGRQ)	Change in the total score of the St. George's Respiratory Questionnaire (SGRQ), which assesses respiration-related quality of life, at 6 weeks after randomization and baseline. The SGRQ is a self-administered questionnaire that assesses three domains: symptoms, activity, and impact on daily life. It permits calculation of a total score from these three domains, reflecting respiration-related quality of life. Study participants will complete this questionnaire at the first visit, the randomization visit (V1), and the final visit (V6). The two visits will take place 6 weeks apart (with an extra week's buffer in case of unexpected delays regarding one of the visits or hypnosis sessions). (Total score ranges from 0 to 100, 0 = no impact of the disease on quality of life, 100 = maximum impact on quality of life.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the three component scores of the SGRQ that assess the quality of life in COPD in terms of symptoms, activity and impact on daily life	The SGRQ permits the calculation of 3 scores related to the quality of life in COPD patients : symptoms, activity and impact on daily life (Total score ranges from 0 to 100, 0 = no impact of the disease on quality of life, 100 = maximum impact on quality of life.).	6 weeks
Change in ability to engage in physical activity	Distance covered during the 6-minute walk test	6 weeks
Change in dyspnea and its affective, sensory, and emotional dimensions	Dyspnea will be assessed using the Multidimensional Dyspnea Profile (MDP) questionnaire (Scores range from 0 to 10-50 for each item with higher scores indicating more severe sensory or emotional dyspnea; 0 = no impact of breathlessness.).	6 weeks
Change in dyspnea in activities of daily living	Dyspnea will be assessed using the London Chest Activity of Daily Living (LCADL) scale (Scores range from 0 to 75, 0 = no limitation of daily activities due to breathlessness. 75 = maximum limitation of daily activities due to breathlessness.).	6 weeks
Changes in levels of anxiety and depression	The levels of anxiety and depression will be assessed using the Hospital Anxiety and Depression Scale (HADS) (Scores range from 0 to 21 for each subscale, with higher scores indicating more severe anxiety or depressive symptoms, 0-7 = Normal, 11-21 = Probable case of anxiety/depression).	6 weeks
Change in level of catastrophizing about dyspnea	The level of catastrophizing about dyspnea will be assessed using the breathlessness catastrophizing scale (Scores range from 0 to 52, A score of 0 indicates no catastrophizing, whereas a score of 52 indicates maximal catastrophizing) for chronic obstructive pulmonary disease	6 weeks
Change in level of self-efficacy in COPD	The level of self-efficacy will be assessed using the COPD Self-Efficacy Scale (Scores range from 34 to 170, 34= lowest perceived self-efficacy, 170= greatest perceived self-efficacy).	6 Weeks
Change in level of pleasure (or the level of anhedonia)	The level of pleasure will be assessed using the Snaith-Hamilton Pleasure Scale (Scores range from 0 to 14, 0 = no anhedonia, 14= greatest anhedonia or lowest experienced pleasure).	6 weeks

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: Christian STRAUS, MD,PHD, Assistance Publique - Hôpitaux de Paris

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): October 1, 2029
• Study Completion (Estimated): December 15, 2029

Study Registration Dates

• First Submitted: May 19, 2026
• First Submitted That Met QC Criteria: June 5, 2026
• First Posted (Actual): June 10, 2026

Study Record Updates

• Last Update Posted (Actual): June 10, 2026
• Last Update Submitted That Met QC Criteria: June 5, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Hypnosis; Chronic Obstructive Pulmonary Disease (COPD); Dyspnea,
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Respiration Disorders; Lung Diseases, Obstructive; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pulmonary Disease, Chronic Obstructive; Dyspnea; Therapeutics; Mind-Body Therapies; Complementary Therapies; Psychotherapy; Behavioral Disciplines and Activities; Hypnosis
• Other Study ID Numbers: APHP251231; N° IDRCB: 2025-A02601-48 (Other Identifier: ANSM)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Due to the procedures approved by the French data privacy authority (Commission nationale de l'informatique et des libertés - CNIL), and the content of the informed consent forms signed by participants, full database transmission is not authorized.

However, consultation of deidentified individual participant data may be considered for editorial boards or qualified researchers, upon reasonable request and under strict regulatory safeguards, subject to prior agreement on terms and conditions of access.

• IPD Sharing Time Frame: Beginning 3 months and ending 3 years following article publication. Requests outside of this time frame may also be considered by the sponsor
• IPD Sharing Access Criteria: Data will be shared with researchers who provide a methodologically sound proposal. The decision will be subject to the prior agreement of the sponsor and in compliance with applicable data protection regulations.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No