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This study examines the efficacy of hypnotherapeutic audiotapes on 21 subjects suffering from chronic insomnia. Both group and single-case analyses are preformed. A consecutive sample
was enrolled in a prospective two-period treatment protocol. Following a 7-day conventional baseline phase, a supplemental tape-based hypnotherapeutic treatment was administered for the following three weeks. Tapes included metaphoric suggestions with regard to several typical symptoms of sleep disorders. Subjects kept a sleep diary that recorded several sleeping parameters for the whole period of 28 days. Results from group comparisons showed a significant improvement of the five diary variables for all subjects, as compared to their baseline levels. Findings from timeseries analysis and subsequent pooling through meta-analysis also revealed a reduction of sleeping problems. Nevertheless, the single-case analysis demonstrates that group comparison might slightly overestimate effects as it neglects autocorrelative processes. The discussion focuses on the application of this form of autohypnosis as a supplementary therapeutic tool for chronic insomnia and on the advantages of single-case time-series analysis in clinical settings.
About one-third of subjects seen in a primary care setting experience occasional insomnia and approximately 10 percent may suffer from chronic sleep problems (National Institute of Health, 1998). Insomnia is defined as inadequate or poor sleep with one or more of the following symptoms: difficulty falling asleep, difficulty maintaining sleep, waking up too early in the morning, feeling unrefreshed after sleep. Symptoms of insomnia cannot be ascribed to one specific disease or disorder. They appear in depressive disorders, posttraumatic stress syndrome and somatoform pain disorders. Chronic insomnia refers to difficulty sleeping on at least three nights a week for a total time period of one month or more.
Two general treatment approaches are currently used - behavioural and pharmacological (see Morin, 1993 for an overview). Typical pharmocological treatment may provide rapid symptom relief, but unwanted side effects are well documented and long-term effects have not yet been studied. Behavioural approaches such as relaxation, stimulus control or purposely prohibiting sleep take a few weeks to improve sleep but continue to provide relief after training sessions have been completed (Morin, Culbert & Schwartz, 1994). Relaxation therapy is based on the observations that subjects suffering from insomnia often display high levels of physiological, cognitive, emotional and behavioural arousal. Cognitive...