• Vincent Delord, Sonia Khirani, Adriana Ramirez, Erick Louis Joseph, Clotilde Gambier, Maryse Belson, Francis Gajan, and Brigitte Fauroux.
• Pediatric Pulmonary Department, AP-HP, Hôpital Armand Trousseau, Paris, France.
• Chest. 2013 Jul 1;144(1):87-91.

BackgroundPatient cooperation is crucial for the success of noninvasive positive pressure ventilation (NPPV). This study evaluated the efficacy of medical hypnosis to reduce anticipatory anxiety and acclimatization time in children who are candidates for long-term NPPV.MethodsMedical hypnosis was performed by a trained nurse. The acclimatization time and long-term compliance with NPPV were evaluated.ResultsHypnosis was performed in nine children aged 2 to 15 years. Seven children had a high level of anticipatory anxiety because of a tracheotomy since birth (n=2), a history of maxillofacial surgery (n=2), severe dyspnea because of lung disease (n=2), and morbid obesity and depression (n=1), and two children with obstructive sleep apnea failed standard NPPV initiation. The hypnosis techniques were based on distraction in the youngest patient and indirect or direct hypnotic suggestions in the older children to obtain a progressive psychocorporal relaxation. All patients accepted the interface and the NPPV after the first hypnosis session. A median of three sessions was needed for overnight (>6 h) NPPV acceptance. The 6-month compliance with NPPV was excellent, with a median use of 7.5 h per night.ConclusionMedical hypnosis is an effective, safe, noninvasive, and inexpensive tool for reducing the anticipatory distress and acclimatization time for NPPV. This therapy is particularly useful in children with traumatic experiences, such as a tracheotomy or facial surgical procedures.

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