Effects of hypnosis on sleep and insomnia symptoms (2026)
Björn Rasch
Department of Psychology, University of Fribourg, Switzerland
Correspondence: Bjoern.rasch@unifr.ch
Keywords: EEG; sleep; sleeping difficulties, insomnia, slow-wave sleep
Sleep is critical for our health, and sleep disturbances are common in our society. Insomnia (difficulty with sleep onset and maintenance, early awakening) is characterized by hyperarousal, worry, and rumination, and the standard treatment is cognitive behavioral therapy for insomnia (CBT-I). However, CBT-I is not always available, and response rates vary. Thus, there is a need for the development of alternative interventions.
Hypnosis has been successfully used to treat sleep disturbances, with promising, albeit heterogeneous, results (see Wofford et al. 2023 for a review). For example, in a randomized controlled trial, Elkins and colleagues (2024) found that a self-administered hypnosis intervention over five weeks (relative to a sham hypnosis intervention) improved subjective sleep quality, increased sleep duration (measured by actigraphy) and reduced daytime sleepiness in 21 participants with mild cognitive impairment. The intervention included suggestions for relaxation and mental imagery for deeper sleep. Similar high-quality research is needed in the future to evaluate the effectiveness of hypnotherapy to improve sleep.
In healthy participants, we examined whether hypnotic suggestions could deepen sleep. Deep sleep or slow-wave sleep (SWS) is considered important for recovery, cognition and our immune system, and its duration decreases in older adults. In a series of studies, we observed that listening to a hypnosis recording before sleep (compared to a control recording) significantly increased the length of SWS by approximately 10-15 minutes in students and older adults during a nap and nighttime sleep (Cordi et al. 2020; Cordi et al. 2014; Cordi et al. 2015). Deeper sleep after hypnotic suggestions was accompanied by an increased secretion of growth hormones, which are involved in recovery processes during sleep (Besedovsky et al. 2022). During the hypnosis intervention, participants were invited to follow a dolphin and dive deeper into the sea. The mental imagery of deeper sleep was accompanied by suggestions of safety, relaxation, letting go, etc. Importantly, a separate control study showed that a hypnosis recording including mental imagery of a boat floating on the surface of the water without sleep or safety suggestions was not effective in extending SWS. Furthermore, simply wanting to sleep better without hypnosis is insufficient to improve sleep and can even worsen sleep (Combertaldi & Rasch 2020). Thus, the sleep-deepening effects of hypnotic suggestions cannot be explained by demand characteristics or nonspecific relaxation from listening to hypnosis. Importantly, the beneficial effect of hypnotic suggestions on deep sleep appears to be restricted to medium-to-high hypnotizable participants (Cordi & Rasch, 2021), whereas low hypnotizable participants appear to profit more from non-verbal relaxation techniques like music (Cordi et al., 2019). Interestingly, we do not find general differences in sleep architecture between high and low hypnotizable participants, even on control nights (Cordi & Rasch 2022).
In sum, hypnotic suggestions appear to be effective in improving sleep and are promising for developing interventions to treat sleep disorders. Mechanistically, one could speculate that the positive effects of pre-sleep hypnotic suggestions on sleep rely on specific mental activity that remains active (or is reactivated) during the sleeping state.
References
Besedovsky, L., Cordi, M., Wißlicen, L., Martínez-Albert, E., Born, J., & Rasch, B. (2022). Hypnotic enhancement of slow-wave sleep increases sleep-associated hormone secretion and reduces sympathetic predominance in healthy humans. Communications Biology, 5(1). https://doi.org/10.1038/s42003-022-03643-y
Combertaldi, S. L., & Rasch, B. (2020). Healthy sleepers can worsen their sleep by wanting to do so: The effects of intention on objective and subjective sleep parameters. Nature and Science of Sleep, 12, 981–997. https://doi.org/10.2147/NSS.S270376
Cordi, M. J., Schlarb, A. A., & Rasch, B. (2014). Deepening sleep by hypnotic suggestion. Sleep, 37(6), 1143–1152. https://doi.org/10.5665/sleep.3778
Cordi, M. J., Ackermann, S., & Rasch, B. (2019). Effects of relaxing music on healthy sleep. Scientific Reports, 9(1), Article 9079. https://doi.org/10.1038/s41598-019-45608-y
Cordi, M. J., Hirsiger, S., Mérillat, S., & Rasch, B. (2015). Improving sleep and cognition by hypnotic suggestion in the elderly. Neuropsychologia, 69, 176–182. https://doi.org/10.1016/j.neuropsychologia.2015.02.001
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