Results
Twenty-four patients were recruited (16 males; figure 1). From them, one patient did not complete the evaluation and was excluded. The OSAS features of patients were described in Table 1. The mean patient age was 50.8 yo. The mean body mass index was 26.6. The hypnosis was ineffective in one patient because important septal deviation and pain during the third hypnosis session (4.3%). Another patient adhered to hypnosis after the second session. Most patients had moderate OSAS at the PSG (Table 1). The patient satisfaction outcomes were reported in Table 1. The nasofibroscopic examination was well-tolerated, while the level of stress during the HISE was low. Otolaryngologist adequately completed the VOTE scoring in 23 patients (95.7%; Table 2). The most common anatomical region of obstruction were velum and oropharynx. The satisfaction of otolaryngologist was high. Otolaryngologist reported patient reaction during the hypnosis process when the fiberscope touched the soft palate in 45% of cases (N=11), but that was not associated with wake-up or an inability to continue the examination. The hypnosis practitioner reported adequate satisfaction outcomes, with better results for trance compliance (Table 1). There were no adverse effects or complications throughout the process of study.
The multivariate analysis reported a negative association between the percentage of snoring and the consciousness state of hypnosis (rs=-0.527; p=0.012). The level of patient pain during the first nasofibroscopic examination was positively associated with the following outcomes: level of stress during the HISE (rs=0.581; p=0.004), the VOTE scoring (rs=0.421; p=0.046), the adherence of the first hypnosis session (rs=0.517; p=0.012) and the overall satisfaction of hypnosis practitioner (rs=0.675; p=0.001). There were significant positive associations between the level of difficulty to perform nasofibroscopy and related VOTE scoring and the following outcomes: level of patient stress during HISE (rs=0.492; p=0.017), and during trance (rs=0.691; p=0.001). At most the nasofibroscopic examination was difficult to perform, at most the muscle relaxation (rs=0.440; p=0.036) and the consciousness (rs=0.604; p=0.002) steps were difficult.