WHO KNEW?! The DIGERIDOO!

By K. Hogan Pesaniello, MD Psychiatrist, Snow Hill, MD

 

     Dr. Nancy Klimas, a neuro-immunology expert was our second –and delightful -- presenter at a recent webinar offered by MABS (Her website is worth exploring and sharing with patients). She reviewed the necessarily integrative approach to COVID long-haulers. Her approach –also necessarily– is based on existing evidence from her accumulated and distinguished experience with Myalgic Enecephalomyelitis Syndrome / Chronic Fatigue Syndrome (ME/CFS). Her research group has received a large grant for study of COVID neuro-immune complications. Here is a website for clinical considerations in recognition and management of ME/CFS. Note Dr. Klimas is one of the authors of this clinical resource.
https://mecfscliniciancoalition.org/clinical-management/

On to the fun part!             The Didgeridoo for mild-moderate sleep apnea:

     Dr. Klimas engaged my question about whether she sees increased sleep apnea in these patients. (I shared my observation of a high incidence of sleep apnea in my patients who have suffered concussion and whiplash, which AS YOU KNOW, increases inflammation in the brain.) She reported that, indeed, her group screens ALL these patients for sleep apnea both for research and treatment purposes. AND she noted that she has come to re-test patients, finding that often even when they initially did not have it, they DO demonstrate sleep apnea after years pass. She notes addressing sleep is key to treatment here.
Acknowledging the disappointment of any clinician who feels they must resort to treatments that do not address the underlying issue -- and the intolerance or self-rejection of many patients with our attempts to help with C-pap or oral devices—she shared the existence of research on the use of playing the didgeridoo in reducing the airway collapse associated with sleep apnea! How delighted I was to find the below article from the British Medical Journal!

     Addressing mild sleep apnea with a musical device? THREE LESSONS PLUS PRACTICE?
https://www.bmj.com/content/332/7536/266

     I also noted this product: Medical Product and teaching for sleep apnea: a Medical Digeridoo! Sleep without sleep apnea - Silent Sleep Training

     I had previously noticed reports on Oral exercises to address sleep apnea, but had not seen anything approaching this! Now I’m envisioning offering a didgeridoo class/lessons for my patients for whom I know without a doubt – this will appeal much more. And it is notable how quickly it works.
NOTE: to those who want a larger study…consider the risk-benefit. Is a larger study REALLY warranted?
This article is not intended as treatment recommendations. I strongly recommend any sleep or sleepiness issues be reviewed with your primary care provider for accurate intervention. Remember, most of medicine, particularly polypharmacy is practiced at the LOWEST level of evidence, such as hunches, discussion, reading articles, peer opinions, even when the risk factors (fall risks, side effects particularly) are significant. The requirement for evidence must consider the urgency (great), the risks (low) and standard treatment non-response

 

Didgeridoo playing as alternative treatment for obstructive sleep apnea syndrome: randomised controlled trial    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/



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