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Comments (7)| (1)|Flag ThisAlternative Treatment for Sleep Apnea: Playing DidgeridooNewsby The Doctor Weighs In
(3 Days Ago)inHealth /Conditions

by Patricia Salber

Ok, so it is official.  I am a CPAP failure.  I gave it my best effort, but I just couldn’t do it. The first night I used the machine, I got in 4 hours before the noise woke me up and I couldn’t fall asleep again.  Despite that, I felt great the next day…this sent a message to me that my sleep has been seriously disrupted by the apnea.

The next night, the CPAP nasal pillows rubbed my nostrils and drove me crazy….crazy…crazy.  My sleep was fitful.  The final night of my failed trial, it was both the noise and the nostrils that took be from a beautiful pre-CPAP drowsiness to an angry, wide-awakefulness due to trying to sleep with this “therapy” on my face.  After two hours, I ripped the nasal pillows off of my face and threw them to the ground.  I promptly fell asleep and awoke the next day feeling pretty darn good.

Now I am a doctor and I know that “silent” conditions, like sleep apnea, can shorten your life.  And, of course, I plan on living forever.  OMG, in considering my options I decided that CPAP is so unpalatable to me that I would rather lose 20 pounds and give up wine with dinner. I am highly committed to making these behavioral changes so that I can “cure” my sleep apnea.  So there!  That is what I am going to do.

Resolute on implementing my plan, I went to return the medieval torture device to the lovely people at the Kaiser San Rafael sleep center.  The nurse who took care of me was explaining CPAP alternatives and, in the course of the explanation, laughingly said, “You could take up the didgeridoo.”

This caught my ear.  Since I got the diagnosis of sleep apnea, I have been reading the sleep apnea literature.  I remember reading that the British Medical Journal published a paper, entitled, “Didgeridoo playing as alternative treatment for obstructive sleep apneoa syndrome:  randomized controlled trial” in February 2006.

So, the nurses’ remark about the didgeridoo made me think:  “What is what is worse – the dreaded CPAP machine or learning to play an Australian aboriginal wind instrument?”

So I tracked down the BMJ didgeridoo study on the Internet.   Here is what the researchers did.  They recruited 25 people, aged >18 years old, and an apnea-hypopnea index of 15-30 (moderate sleep apnea).  The participants in the study could not be using CPAP, drugs that act on the NS, drink no more than 14 drinks/week, be obese, or have an active weight loss plan.

The patients were randomized into an intervention group – the didgeridoo trainees – or a control group.  The didgeridoo group got individual lessons on how to play the instrument from a didgeridoo instructor.  Over time they were taught circular breathing (a technique that enables the instrument player to maintain a sound for long periods by inhaling through the nose while maintaining airflow through the instrument, using the cheeks as bellows.  In later lessons, they learned to “optimize the complex interation between the lips, the vocal tract, and circular breathing so that vibrations in the upper airway are more readily transmitted to the lower airways.  The didgeridoo trainees practiced 5.9 days a week for 25.3 minutes a day.  The control group was told they were on a waiting list to start their didgeridoo training.  They were not allowed to start playing the instrument during the four month training period.

Daytime sleepiness (as measured by the Epworth index), the primary outcome of the study, improved significantly (- 3 units) in the didgeridoo group compared with the control group.   The apnea-hypopnea index also improved significantly (-6.2) as did the partner rating of sleep disturbance (-2.8).  Despite these positive findings, there was no effect on the quality of sleep as measured by the Pittsburgh quality of sleep index.    There was no significant effect on the SGF 36 and adjusting for severity of the condition and weight change during the study did not alter the results.

The conclusion of the study was that didgeridoo playing improved daytime sleepiness in patients with moderate snoring and obstructive sleep apnea.  It also reduced sleep disturbance in their partners.

Limitations of the study are the small number of participants and the exclusion of folks with predisposing behaviors (alcohol and drug consumption).  That being said, it seems like a pretty benign treatment, and if nothing else, for someone like me, there may be a placebo effect that is additive to known behavioral interventions, such as alcohol abstinence and weight loss.

So for now I have expanded my Sleep Apnea Self-Directed Treatment list:

Lose 20 poundsDC wineBuy a didgeridooFind a didgeridoo trainerPractice at least 5.9 days per week for 25 minutes a day

Wish me luck!

Comments (7)| (1)|Flag ThisDiscussionFollow Ups Regarding News Alternative Treatment for Sleep Apnea: Playing Didgeridoo Thank You for your Comment

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Didgeridoo therapy for Sleep Apnea

Works for me, and I forget that it's treating my symptoms because I have so much fun playing. I just googled "sleep apnea didgeridoo" and found a place in Los Angeles that had the most info about this, along with a package deal that had a training DVD with my didge. It's a blast.

Baz

- Bazza April 7, 2011 12:09PM

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another study...

Performed in Brazil shows that doing specific exercises to the mouth and neck produce similar results as the Didgeridoo Swiss study. Can you take a look at that and report back? You medical summary, like the one you did above, would be very interesting to hear.

I will add. The biggest indicator of reduction of Apnea is neck circumference or NC. Both studies indicate the NC measurements were reduced. Something to think about.

- Headapple April 7, 2011 12:33PM

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Screening Obese Musical 'air instrument' players

Interesting ! Thanks for sharing. May I ask what type of Doctor you are (M.D. – O.D. -Ph.D.?
Maybe you start a study on obese tuba players or players of wind instruments. An EZ screening using a portable in-home sleep testing company.
Good luck and thanks again.
Al

- Bigal April 8, 2011 8:28AM

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Tough Love is called for here

and that's what this is.

Doctors are often bad patients.
Especially when they treat themselves.

And doctors are not immune to denial. That's you right now.

You won't persist with CPAP more than 3 days. But you plan to:

a. lose 20 pounds
b. abstain from alcohol
c. carve 5 hours a week out of your schedule to play didgeridoo

FOR THE REST OF YOUR LIFE

hoping to reduce, but not eliminate, sleep apnea and its complications. Get serious.

Here's what to do:

a. If your sleep specialist and DME can't help you over the hump, get different ones.
b. Every problem you had has been experienced and overcome by thousands of people. Go online and find out how they did it.

You might start at CPAPtalk.com

It's YOUR life.

- MDHosehaed April 8, 2011 11:49AM

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There Are None So Blind As Those Who Will Not See

The road to h*ll is paved w/good intentions. You won't put forth any REAL effort to acclimate to the "gold standard" for 0SA therapy but you will supposedly make all your listed adjustments to your lifestyle. Yeah, right.

It often seems the more educated are the ones who INSIST on a "pill" for everything rather than take the time to put forth any effort to do things the "right" way.

You would do well to put forth some effort to EDUCATE yourself regarding OSA and CPAP treatment and if your sleep professionals (as is so often the case) aren't up to providing you w/the support and advice needed as is their responsibility then it would behoove you to bypass them and learn on your own.

It will require less effort and have better chance of success than your stated objectives.

- COPD2 April 8, 2011 2:21PM

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Love the feedback

Everyone living with chronic illness, including those who happen to be health professionals, have to make very personal decisions. What are they willing to do and what is way too much given their personal preferences.

I believe that as long as a person is provided with full information (thank you Internet) and understands the consequences of their choices, they should fully engage in making choices that work for them.

I chose lifestyle interventions instead of cpap. I understand my choice is not the gold standard, but I am willing to invest fully and am also willing to live with the whatever benefits I gain from my investment in time and energy .

- The Doctor Weighs In April 8, 2011 9:03PM

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treatments for osa

CPAP is efficacious in the lab but often not effective at home. You may still wish to pursue it under the care of an experienced sleep medicine doctor and a good DME company that will work through your problem.
Having said that, CPAP is not for everyone and treatment of OSA requires a personalized approach. Oral appliance therapy could be a good option for some. Reconstructive surgery, performed by a sleep apnea expert surgeon could also have a good success rate. You need to seek out an expert and not just any ENT surgeon.
Provent may be tried, but whether it will help or not is unpredictable.
If you have positional OSA, a positional device such as pillow, belt, or special shirts with cushions (or the old tennis ball) in back may reduce your OSA.
Good luck!

- sleepspec April 9, 2011 8:36PM

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