Each time you breath in, muscles in your throat, chest and
diaphragm help you inhale; air flows from your nose and mouth into your
lungs - the breath of life. During your waking hours your breathing
is usually regular and automatic, unless you suffer from asthma or other lung
diseases. Throat muscles are
important, although we are generally not aware of their action, by keeping
the airway open and stiff so inhalation
is easy. When you sleep, these throat muscles may relax, narrowing your
airway. Normally, this narrowing
doesn’t prevent air flow in and out of your lungs. But if you have sleep apnea, your airway can become
partially or fully blocked because of factors like these:
*Your throat muscles and tongue relax more than normal. Aging may play a role here.
*Your tongue and tonsils may be large compared to the
opening into your windpipe.
*Overweight may cause extra fat tissue to thicken the wall
of the windpipe, narrowing it and making it harder to keep open.
*The shape of your head and neck may result in a smaller
airway size.
Apnea is a word that means the suspension of breathing. During sleep apnea, when the opening to
the windpipe is narrowed or closed, people snore loudly and/or stop breathing
for a time. Breathing may stop for up to a minute. Blood oxygen levels drop,
triggering the brain to disturb sleep.
This helps to tighten airway muscles and open the windpipe. Normal breathing starts again, often
with a snorting sound. When this
happens repeatedly during the night, drops in oxygen levels and constant waking
can result in the release of stress hormones. A risk of high blood pressure, heart attack, stroke and
irregular heartbeat is increased.
People with this condition often have excessive daytime fatigue because
of sleep disturbance. They often
do not experience REM sleep and do not have dreams.
Sleep apnea can be greatly helped by a device called CPAP – continuous
positive airway pressure, as well as by certain dental devices. Many people with sleep apnea have used
these treatments, which are important and helpful. However, it is not easy for everyone to get used to these
treatments and use them regularly. Weight loss is also helpful for some people with sleep apnea.
Since the human mind is infinitely inventive, new treatments
that involve breathing techniques were bound to emerge. Instructors teaching
the didgeridoo noted that their students reported reduced daytime sleepiness
and less snoring after practicing the instrument for several months. In Zurich, a group of doctors,
respiratory therapists and sleep therapists decided to test the proposition
that training the upper airway by digeridoo playing would reduce daytime
sleepiness, due to training the muscles of the upper airways that control
airway dilation and wall stiffening. The recruited 25 patients, average age 50, who had moderate sleep
apnea and were willing to learn the didgeridoo. Half the patients became a control group, who had to wait
for 4 months before taking the didg training. The patients had weekly lessons, and were told to practice
for 20 minutes 5 times a week.
They were instructed in circular breathing. Apparently the practice was enjoyable, as compliance was excellent
– the subjects practiced 6 days a week, and there were no dropouts. The same was true of the control group,
who started didg playing 4 months later.
The study found that patients had reduced daytime sleepiness and snoring
– the effectiveness of didg playing was slightly less than that of regular CPAP
use, but still notable. The study
was published in the British Medical Journal in 2006.
A study in Australia looked at the effectiveness of
didgeridoo playing on boys with asthma.
The comparison group was singing lessons for girls. Asthma is a problem for 15% of Austrian
Aborigines, probably because of poverty and poor living conditions. Girls are not supposed to play the
didgeridoo in public for cultural reasons. Asthma relief was more pronounced for the didg players than
the singers. Playing the didg has a pronounced effect on lung capacity, relaxation
and the ease of controlled breathing.
The study was published in Music and Medicine in 2013.
I have been taking classes in didgeridoo playing in
Petaluma, and have found playing the instrument to be calming, mesmerizing, and
helpful for my lungs. I love the sound of the low vibrations. Other people in
the classes have found improvement with their sleep apnea. The teacher, Elise Peeples, will be
giving an introductory class in January as well as continuing lessons. The classes will take place on Saturday
morning in Petaluma. I plan to
post fliers about the classes and also give them to local doctors who may want
to refer their patients. Feel free
to contact me if you are interested.
Full disclosure – I am crazy about wind instruments.
Sadja Greenwood, MD,
MPH Back issues on this blog!
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