Didgeridoo playing as alternative treatment for obstructive sleep apnoea (2006)
pmc.ncbi.nlm.nih.gov258 points by kelseyfrog 3 days ago
258 points by kelseyfrog 3 days ago
I think my favourite part of the study is that the control group is just the class wait list.
Unfortunately this study doesn’t control for luck.
Unfortunately, digeridoo playing is just as disruptive to partner's sleep as snoring is. Perhaps they should try bagpipes?
Funny.
The didge forces you to learn circular breathing, it's cheaper, it is easier to learn, and is easier to play well. Plus I think it sounds better. Everyone should learn to play the didgeridoo. Bagpipes are a whole another level, and feel more like a practical joke gone horribly wrong (Sorry Gran.)
I suspect bagpipes may be the worst wind instrument to learn in this regard, at least if the goal is to train circular breathing?
I don't think circular breathing is the goal. It's just a means to an end. The goal is strengthening the muscles that keep the airway open. The resistance from blowing into the didgeridoo seems to be what does that. I have no idea how that compares to bagpipes, however.
I would imagine some basic breathing techniques may help, wonder what the research in anuloma viloma pranayama shows, but beware there's a lot written by random people on the internet about it without scientific evidence.
If you're talking about the great highland bagpipes, circular breathing can be really helpful while learning. Because of the "practice chanter," every piper have one or two and use it to learn new tunes or just practice technique.
Several varieties of bagpipe I'm aware of don't even require breathing, since they're powered by bellows. The pipes are surprisingly hard to learn by the way. One normally starts on the chanter, which is more like a recorder and is not bag assisted.
Both can practice in the other room.
Didge isn't that loud unless you're really going for it. Nothing compared to bagpipes.
A friend of mine started "blowing air into water with an straw" (making bubbles) very seriously. I was very skeptical to say the least; but after a couple of months the effects have been very eye opening. Not only it has helped sleep apnea and snoring but also helped with reducing their weight. They had an online group and most participants reported the same. The wight loss was reverted when they stopped for some personal reasons. I wonder if making bubbles in the water has the same effect.
I don’t mean to be rude, but what kind of personal reasons might stop a person from breathing into a straw at night
They objected to the Paper Straw Mandate
A very good reason. I refuse to use paper straws. They are disgusting (it feels like sucking on a piece of printer paper).
Don't get me wrong. I try to remove plastics in all areas of my life as well (because of microplastics), but can't they coat the surface in some biodegradable polymer like PHA/PBS?
Or if this is too expensive coat it with some beeswax at the very least...
My didgeridoo teacher had the class practice at home continuously blowing air through a straw - it still took me almost half a year to reliably be able to do circular breathing.
I have read a few references that humming or ‘ohming’ help sinus health and breathing so I guess it makes sense playing the didgeridoo would help also. Blowing bubbles through a straw won’t cause vibration, so probably in itself won’t help.
Reminds me of that guy who started drinking water upside down to train his swallow muscles and cure his chronic heartburn.
There's some science on training those muscles, even without upside down drinking. "Dry swallowing" while on an incline seems to do the trick just fine.
Is the weight loss just from sleeping better and therefore making better food choices?
Underrated question
Personally, when I have not slept well and need to be productive in a day, I’m much more likely to want to load up on sugar and unhealthy food
I’m the same way. Getting good sleep is my best predictor of whether I’ll blow a weight loss attempt or skip exercise.
Almost certainly plays a role. Also increased activity levels due to better less fatigue.
Certainly is not defeating thermodynamics, assuming calorie absorption is not disrupted somehow it's likely the above.
I saw a documentary where a vocal coach used a similar technique to help metal singers sing in a way that didn't destroy their throat and vocal chords
I do death metal growling at karaoke sometimes. It makes a nice change after the umpteenth Abba or Pink Pony Club rendition.
There is a technique to it. You have to sing from the chest not the throat.
Would you happen to have more information about this online group? Would love to join it!
Sounds like a semi-occluded vocal tract exercise, something that singers will do to strengthen the vocal folds and reduce tension.
Just learned from comments here it's called "circular breathing"!
Just read how this works and tried it. A bit tricky at first but actually quite easy once you get the hang of it. And it's kind of a fun exercise. Now I'm wondering if I should get a Didgeridoo too.
circular breathing is useful for other instruments as well, though it's not typically a technique that's necessary until you get to fairly high levels.
Yes. Someone who masters circular breathing in a weekend should start playing a wind instrument.
50mm/2” PVC pipe with a bit of beeswax on the end to protect your lips is a quick way to test out whether you want to spend the time to track down a proper didgeridoo.
Someone really needs to properly do the science on this
I (presumably like the majority) assumed that sleep apnea was at least partially caused by weight gain, but if there is weight gain caused by sleep apnea it’s going to give doctors some new tools
There is plenty of proper science on this. Weight gain does not cause obstructive sleep apnea until you get into extremes (e.g. huge necked bodybuilders or people with so much fat on their chest that they physically struggle to move it to breathe). Sleep apnea makes it harder to lose weight and easier to gain weight. Having sleep apnea and being heavier can make sleep apnea worse. Losing weight quickly can make sleep apnea worse when you lose muscle mass along side fat (e.g. on ozempic).
There are plenty of tools for doctors to treat sleep apnea. The problem is that they refuse to use them. Many people on CPAP would benefit greatly from being on BiPAP instead, but doctors commonly refuse to prescribe it. Some cases of sleep apnea can be treated using positional therapy (typically side sleeping), but there's no prescription for that. Some cases can be solved by exercising throat muscles (with or without a didgeridoo), but there's no prescription for that either, and there are virtually zero speech/physical therapists who focus on that. There are some surgeries that can really benefit some patients, but most sleep labs and ENTs refuse to even to even perform a proper sleep endoscopy.
The idea people aren't doing 'proper science' on this is a spectacular level of oblivious. There's nothing in here that I haven't at some point had a discussion about with my sleep doc in the last 20 years (well, not specifically a didgeridoo, but circular breathing and other types of breath exercises, including 'straw breathing'). Yes, some people do loose weight when they get their apnea under control, among other health benefits. That also is not new, and it's not some sort of miracle insight that noone has considered.
I had textbook symptoms of sleep apnea with a BMI of 19, before I was diagnosed. The sleep tech told me bluntly that plenty of slim people, even children, develop sleep apnea.
Obesity increases the chance of developing sleep apnea, yes. But sleep apnea also increases the chance of becoming obese. It is not just a simple unidirectional cause and effect.
Can you please expand on that? How many times and minutes a day? Full power?
Got a link?
same, my fat ass is ultra curious
I just made a test with one of the AI: It seems there is some evidence in there, sounds like mainly you are strengthening the muscles around your throat with that technique and this then can reduce sleap apnea a little bit.
CPAP machines are essentially a hose that has you breathe into water.
this is incorrect lol. the water is just to help with humidity, to prevent a dry mouth and sinuses. all resumed cpap machines for example can be used without the water tank as long as you have the backplate.
the water in the tank is heated to increase the humidity of the air circulating.
cpap machines work by increasing the air pressure on breath-ins and help open your airways by keeping your genioglossus tensor veli palatini muscles engaged.
Kind of, yeah. When I first got onto CPAP I was worried that it would cause my muscles to atrophy over time because it makes the inhale so much easier. But the pressure is still there on the exhale, which is exactly like breathing out through a straw into water (with 5-20cm water on top of the straw, depending on the CPAP pressure).
I once took a didgeridoo course and played for quite a while after that. One weekend of 2×3 hours of didgeridoo playing, and my nose was incredibly clear. Like never before and never again since.
By the way, you can practice circular breathing very well in the shower. Take water in your mouth and breathe in through your nose while simultaneously spraying the water out through your lips.
I started playing didgeridoo 10 years ago for precisely this reason. Sleep apnea already cured by weight loss, but I knew by air pathways were prone to it, and I never wanted it to come back.
It worked
It took me 1-2 years to learn circular breathing, but even just learning to play for 15 seconds on one breath can give the "oxygen high" from breathing so much.
You can't get "oxygen high" from breathing normal air. The O2 levels will always stay the same unless you stop breathing for a while. What will make you feel weird in the head when breathing too fast is the reduction of CO2 in your blood.
So, if you breathe in an intensive manner for a few minutes, oxygen percentage in the blood won't change?
One a friend and I hooked ourselves up to continuous pulse oximetry and had a contest to get the lowest recorded oxygen level. We tried everything we could think of, from just holding our breath to end-expiratory breath holding to hyperventilating to clear O2 (I used to do some recreational free-diving) beforehand to exercising (jumping jacks)...
Neither of us could get it below 98%, and this was at a mile of elevation (UNMH in Albuquerque).
It is pretty easy if you use the Wim Hof method. Breathe deep and fast for a few minutes, to the point where you get dizzy or feel weird sensations. Then exhale and stop breathing while being fully relaxed. I've done this while hooked to a pulse oximeter and it takes quite a while before O2 actually starts dropping (especially because the effect can be delayed in your limbs), but once it starts you'll pretty quickly run into the regime where a normal oxi will start an alarm because O2 is too low. You can even go below 85% without losing consciousness, because your limbs will desaturate faster than your brain. It's also not uncomfortable, because rising CO2 is what causes breathing reflex, but you dropped its levels far below the threshold by hyperventilating first.
I got a pulse oximeter during COVID and was able to get my O2 levels to spike down to 64% using Wim Hof breathing (for less than a second, ofc).
If you've ever done the wim hof breathing method, it is a very intense experience.
Basically hyperventilation + long breath holds. Probably similar to what free divers do without the mammalian dive reflex due to the cold water. Or like a dangerous game kids used to do when I was in school where you hyperventilate and then have someone press on your chest until you pass out.
But anyway, I'm not sure if the science would back it up, but Wim Hof describes it as over oxygenating the blood and then stopping and letting CO2 ramp up or something. Whether it is significantly dropping the CO2 or increasing oxygen during the hyperventilation phase, isn't it kind of the same thing? Adjusting the ratio.
Anecdotally, when I was doing it regularly I seemed to not get sick at all.
No it would stay at pretty much 100% (as is normal). But co2 goes down, which lessens the ability of oxygen to come out of the blood. That's why you get dizzy when hyperventilating
Blood oxygen saturation is always near 100% in a healthy person. 95% is the low end of normal. Dropping to 90% is considered hypoxemia, and 80% is a medical emergency. So there really shouldn’t be any room to increase it significantly.
In many people a momentary drop to the 80s or even below is not an emergency or anything close to it. Not saying that it is good. Someone that is awake, sitting up, and struggling to breathe should be considered an emergency regardless of oxygen levels (and in this situation 80% would be very concerning).
EDIT: your comment is otherwise entirely correct, particularly at sea level.
90% you should really be traveling to see someone. At least an urgent care, if not an ER.
Nope. The blood is already fully saturated with oxygen (in a healthy-ish person) at rest. Even intensely breathing pure o2 can't give you a saturation higher than 100%.
Double Reed instruments have also been shown to have a positive effect for those suffering from sleep apnoea. It seems due to the higher air pressure needed to play: https://en.wikipedia.org/wiki/Double_reed
Presumably quadruple reed instruments (that require even more air pressure to play) would be even better: https://en.wikipedia.org/wiki/Quadruple_reed
Unrelated to the health aspects, but if you like electronic music and the Didgeridoo check out Aphex Twin's album "Digeridoo". It's so good.
And also the mandatory "Treaty, Yeah!":
?Yothi Yindi? I listened to this song a bit back in the early nineties but it sounds a bit dated now. (Ironically the traditional instruments sound a lot better than the synths.)
Didgeridoo (when played properly) can sound great. Like the bagpipes there are a lot of people who can barely play, but go out busking.
The carnyx is the nearest traditional western European equivalent. There is a guy who plays it called John Kenny who I don't rate. Abraham Cupeiro, on the other hand, is amazing. See here:
There seems to be a typing mistake. The embouchure should have diameter of 2.8-3.2 centimeters, not millimeters. Perhaps that can be done DIY from an PVC pipe with an hot air gun or a gas burner to soften and shape the end.
"Participants received a standardised acrylic plastic didgeridoo that was developed by the instructor in collaboration with Creacryl GmbH (Ebmatingen, Zurich, Switzerland, and costs €80 (£43; $94), fig 1). The didgeridoo is 130 cm long with a diameter of 4 cm and an elliptical embouchure with a diameter of 2.8-3.2 mm. Acrylic didgeridoos are easier for beginners to learn on than conventional wooden didgeridoos."
"Perhaps that can be done DIY from an PVC pipe with an hot air gun or a gas burner to soften and shape the end."
When I used to make my own PVC didgeridoos, I would melt candle wax and then dip one end repeatedly into the wax to build up wax layers until it had the desired thickness and shape.
Twenty years ago my neighbor, a retired surgeon, made me a PVC didgeridoo and did the wax buildup thing - I still mostly play that didgeridoo. Years later my wife bought me a traditional heavy didgeridoo from Australia, but it doesn’t play as well; still, when I played at a friend’s wedding I used the Australian one because it looks better :-)
I had excellent results using a large section of black bamboo, though I forget the exact taxonomy (lako?). I meticulously beat out the segment walls, then with a rasp fastened to a long stick, filed down the ridges. After sanding, I finished it with oil based stain, which necessitated it living outdoors for a while. In the end it proved a fine primitive instrument. I gifted it to someone and miss it. I can attest to the therapeutic effects of mastering the didge.
PVC works, but the acoustics do seem superior with actual plant material. Certainly the feel.
Update: I used beeswax for the gob hole.
Yeah that should be 2.8-3.3cm for sure.
For added fun, two tubes of roughly that size that air seal fit one inside the other makes for a slide didgeribone.
Last thing I need for my sleep through my thin walls is a neighbor with a didgeridoo.
I don’t think they’re suggesting you do it like a sleeping pill and play some didgeridoo right before bed. Rather, it’s about regular practice like with any other instrument.
These two https://www.youtube.com/watch?v=oXBGZoBYaLY must be best dorm neighbours ever then.
That's fairly cool.
I probably couldn't listen to that on a regular, but I enjoyed it.
Thanks!
30% of Americans have reflux, which is associated with obstructive sleep apnea.
Check out the papers on Inspiratory Muscle Training (IMT) and bridge swallowing.
Unrelated to the content of this submission, but trying to visit this link in Firefox takes me into an endless recaptcha loop, whereas visiting in Chrome took me to the site without any captcha.
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Wondering what sort of plugins you've got on the Firefox side. If they're stripping out headers, for instance, it's a good way to make yourself look like a bot.
I've only got "Firefox Multi-Account Containers" and "Privacy Badger". I tried reloading with Privacy Badger disabled, still the same behaviour. Works in Safari and Chrome with no issues at all!
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Firefox on android with ublock origin didn't hit any captchas. I wonder what triggers them?
The captcha on this site is irritating.
Original paper: https://www.bmj.com/content/332/7536/266
Thank you, I was completely unable to access that page with my current browser settings.
Yeah I dunno if I believe this, I played trombone when I was a kid... I didn't get sleep apnea until like 10 years ago. Unless it somehow takes like 30 years to develop, it seems implausible.
What are you saying? That you expected your childhood trombone playing would somehow protect you from sleep apnea forever? "Use it or lose it." Sleep apnea can certainly take 30 years to develop. Old age increases the chances of getting it. Menopause does too. Muscles get weaker.
n=25, self report AND only players with partners. I think there’s merit to using muscular musculature to improve your sleep apnea but this doesn’t answer the question of why playing the instrument wasn’t preventative in the first place.
Because anatomy not consistently used declines in fitness?
And unused muscles start to significantly decline in your mid-forties. Maybe thirty years after playing trombone as a kid.
It sounds like an attention thing.
Attention is magic stuff. Putting it on part of your body can make it better. Withdrawing it can make it worse. I suspect that much disease stems from such neglect.
I used to have a chronically stuffed nose. Then I started doing a kind of meditation where I put my attention upon my nose. My nose opened up and I almost never get a stuffed nose anymore.
Didgeridoo specifically?, or any instrument that requires circular breathing https://en.wikipedia.org/wiki/Circular_breathing
Circular breathing is easiest to accomplish on the didgeridoo. This is because of several reasons: optimal back-pressure (hits the sweet spot between lack of resistance on a flute and too much of it on an oboe, for example), loose embouchure (relaxed lips make it easier to puff up the cheeks) and single drone focus (no distracting fingerings required).
I also suspect the intense vibrations have a similar effect (probably stronger) to humming, which is known to dramatically (15-20x) increase the release of beneficial nitrous oxide in the nasal passages.
> I also suspect the intense vibrations have a similar effect…
My gut says that there are some interesting discoveries waiting around the intersections of frequency of vibration, individual resonant frequency, and duration
the study was conducted using a didgeridoo but the circular breathing seems to be the important mechanism. No studies have been conducted on other instruments that require or benefit from it.
I doubt many of them actually figured out how to circular breathe after one lesson. Source: have been playing sax for 20 years, tried learning it many times, still no good.
CPAP user here, and "have you tried taking up the didgeridoo" is comfortably the best sentence I've ever read in a medical journal. The mask works fine — it's just that I go to bed every night looking like a minor Star Wars character, so I'm very open to alternatives. And from the other comments, the didgeridoo sounds like the boring tongue exercises in a trenchcoat: same throat muscles, except you might actually keep doing it. Which is the entire problem with the tongue exercises. Study was moderate apnea so I'm keeping the machine. But I am absolutely buying a didgeridoo and becoming insufferable about it. My household has been notified.
I played with my didgeridoo 3 times a day for ten years and it cured my snoring. But I went blind.
There are also various simple tongue and throat exercises that can improve your sleep apnea that would generally be better tolerated by your neighbors than playing a Didgeridoo, see for example...
https://www.youtube.com/watch?v=wNscQ3bGxNk
...along with various other videos on that person's youtube channel (he's an NHS Sleep and Ear Surgeon).
Of course, there are lots of underlying causes of sleep apnea that vary between people, so what helps one person may or may not be relevant for others. Seeing a doctor in the field should be your first step if you suspect you are suffering from sleep apnea.
If your neighbour plays the banjo, invite them over: https://www.youtube.com/watch?v=sr3iI8gg2fo
Two wrongs can make a right.
45 seconds of didge, and then be puts it down!
Hope he sleeps well tonight!
Blame the song structure.
You'll hear Charlie McMahon going at it with continuous circular breathing for five to eight minutes or so on the early Gondwanaland albums (along with sliding length didgeridoo effects and 'singing' down tube).
Not really related, but worth repeating: there's an old saying, "A gentleman is one who knows how to play the accordion, but doesn't".
Looks like there was no placebo group? Don't know what that could be, something silly like otamatone lessons.
RTFA? "Participants in the control group remained on the waiting list for lessons"
That's not a placebo. A placebo would be learning to play some other instrument like a piano, that doesn't involve breath. I also RTFA and saw no mention of any meaningful control group. For all they know the effects would come from learning any instrument, or just going to regular classes, or...
Now I want to hear about the possible effects of ukulele playing on scoliosis.
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Anything except just losing weight.
You know who doesn’t have sleep apnea? Skinny people. I mean wafer thin. They only get it from actual constructive nasal obstruction.
Not true. I know very fit, very skinny triathletes who have sleep apnea.
Oh not this nonsense again. Plenty of "wafer thin" people have obstructive sleep apnea. There are lots of factors that contribute to sleep apnea, from big tonsils to hormones to muscle tone to tongue size. Weight is not the issue.
> The randomisation list was concealed from the recruiting physicians and the didgeridoo instructor in an administrative office otherwise not involved in the study. We used a central telephone service, which the didgeridoo instructor used to obtain group allocation.
Oh, did you make use of the central telephone service did you? You didn't send the list by carrier pigeons?