A Personalized Approach Using an N-of-1 Trial of Virtual Reality Hypnosis for Persistent Dyspnea

Persistent dyspnea is associated with major suffering in chronic obstructive pulmonary disease (COPD) patients. Addressing this clinical challenge requires personalized approaches that account for individual variability in treatment response. N-of-1 trials offer a promising method to evaluate interventions tailored to individual patients. This study utilizes N-of-1 trials to assess the effect of virtual reality hypnosis (VRH) therapy on persistent dyspnea to inform personalized therapeutic decisions. Two COPD patients with persistent dyspnea participated in N-of-1 trials, each consisting of four counterbalanced periods of exposure to different virtual reality conditions (period A: VRH; period B: a distractive, pleasant drone ride) over 2 consecutive days. Through patient-generated problem-specific questionnaires, outcomes were evaluated on a 6-point Likert scale. Results showed significant reductions in dyspnea intensity and improved well-being during VRH for one patient, while the other reported improved well-being without significant changes in dyspnea. Our report illustrates the potential of N-of-1 trials in evaluating personalized treatment efficacy, highlighting the importance of customized approaches when conventional treatments have been exhausted. Incorporating N-of-1 trials of alternative treatments in the dyspnea clinic may enhance patient outcomes and satisfaction by tailoring interventions to individual patient needs.