Playing the digeridoo: can it really cure sleep apnea?

You’d be forgiven for not spotting the link between an ancient tribal wind instrument from indigenous Australia and a common 21st century sleep disorder.

However, in one of the most unlikely sounding studies in sleep medicine, researchers in Switzerland discovered that the digeridoo, an aAustralian aboriginal musical instrument much loved by dreadlocked festival goers, proved to be an “effective alternative treatment” for patients with moderate sleep apnea.

The study, published in the British Medical Journal in in 2006 set out to test the hypothesis that learning to play the digeridoo would strengthen the throat muscles of snorers and sleep apnea patients, preventing the breathing airway from collapsing during sleep.

After four months of digeridoo lessons, the patients showed an reduction in both daytime sleepiness and night-time apnea events. The study concluded that:

“Regular didgeridoo playing is an effective treatment alternative well accepted by patients with moderate obstructive sleep apnoea syndrome.“

Could other wind instruments help to treat sleep apnea?

The Swiss study didn’t exactly send digeridoo sales rocketing but the results were encouraging enough to prompt further research. Could there be other wind instruments with therapeutic benefits for snorers and sleep apnea sufferers?

So in 2009 a team of researchers at University of Michigan Medical School conducted a survey  to quiz over 1100 professional orchestra members. They gathered data including age, gender and body mass index in order to calculate the risk factor of every musician for sleep apnea.

But when they crunched the numbers they found that wind instrument players were more often male, and more often overweight than non-wind players. This meant that those playing wind instruments were actually associated with a slightly higher risk of obstructive sleep apnea.

Crucially, however, the researchers didn’t take into account the different types of wind instruments. Which leads on to the next part of the story.

Double reed instruments are most effective

Undeterred by these discouraging results, Dr Christopher P. Ward of University of Houston-Clear Lake and his colleagues conducted another poll of orchestral musicians, but this time with some additional questions about general health and musical experience.

Again, they found no connection between playing a wind instrument and a reduced risk of sleep apnea. But digging a little deeper the found that one particular sub-section of the woodwind section, did in fact exhibit the correlation they were looking for.

The results, published in 2012 revealed that of all the orchestra members, it was the double reed players who had the lowest risk of OSA. The double reed family of instruments, which includes the bassoon, oboe and English horn are what you could call ‘high resistance’ wind instruments.

The mouth aperture is relatively small, which means you need to blow quote hard to get a sound.

The exact mechanisms that protect double reed players are still a mystery, but the study authors suggested that playing these types of instruments on a regular basis may strengthen the muscles of the upper airway, leading to a lower risk of OSA. The report said:

“professional wind instrument musicians spend years engaging in training of the respiratory muscles and upper airway, which may suggest that a lower incidence of OSA might be found among wind players.”

Learning to play the bassoon is unlikely to become a popular OSA treatment any time soon. But the research carried out so far on musical instruments may lead to more discoveries about the physiology of the muscles in the throat and breathing airway and how they affect the millions of people who suffer from obstructive sleep apnea.