"Blow into the didgeridoo" said the article in the February 4th issue of the BMJ (British Medical Journal) with a photograph of a middle aged man blowing into a strange wind instrument. Studies had proven that people who played this instrument for 25 minutes a day not only snored less, there was also a decrease in their sleep apnoea episodes.
Snoring is seldom heard by the perpetuator (who often vehemently denies the accusation). It is a complaint voiced by long suffering family members sharing the same living space.
A few years ago, snorers were not taken seriously and were the butt of unkind jokes. All that changed now, and snoring is considered a serious medical disorder. It has been found to be a forerunner to dangerous obstructive sleep apnoea. These are repeated episodes of cessation of breathing occurring during deep REM (rapid eye movement) sleep in the night. The diagnosis is confirmed if 15 or more episodes occur during the course of an hour. The person does not waken when this occurs. Instead the start and stop pattern of breathing leads to exacerbation of hypertension leading to heart attacks and sudden death, usually at night. `
Obstructive sleep apnoea is suspected if there is :
Loud snoring
Day time drowsiness
Choking at night
Morning headache
It is possible to distinguish between normal drowsiness, tiredness, simple snoring and dangerous sleep apnoea using an "Epworth" sleepiness scale.
Grade answers to pertinent questions with :
0 for never dozing
1 slight chances
2 moderate chances
3 high chances.
Add the score with answers to the questions:
Would you drop off to sleep
While watching TV
Sitting in a meeting
Riding in a car continuously for an hour
Lying down in the after noon
Sitting quietly after lunch
In a car at a traffic light
A score of 1-9 is normal
12-16 severe obstructive sleep apnoea
More and more Indians suffer from obstructive sleep apnoea, placing them in danger of sudden death. This is because our lifestyles have changed. India is moving up globally at a fast pace.
The boom in our economy has come at a price. MNCs employ our MBAs and other graduates at unimaginable salary scales. In private family owned businesses and in the public sector employees have to produce results. We have also acquired the diseases associated with this new lifestyle, Stressed out executives are unable to lead a regular life. They seldom have the time to exercise. Travel upsets their circadian rhythms and they do not to sleep well. Eventually, they tend to fall asleep in important meetings, or while driving. All this cuts into their productivity and the sharp cutting edge thinking process of their brains.
To cater to the requirements of this subset of patients "sleep labs" have sprung up in the major metros. For a fancy price, they will analyze your sleep patterns and diagnose either simple snoring or sleep apnoea.
A fortunate 30 % have correctable causes. Surgical removal of enlarged tonsils, adenoids, nasal polyps or correction of a nasal deformity removes mechanical obstructions to breathing. Others are in the habit of drinking alcohol or taking medications like sedatives and tranquillizers. All these depress the respiratory centre in the brain.
The remaining 70% will have some improvement if they loose weight. A BMI (Wt in kg / ht in m2) more than 30 needs regular dieting and exercise. Till the ideal weight is achieved CPAP(continuous positive pressure ventilation) through a nasal mask prevents the oxygen saturation from falling below danger levels.
Many anti snoring devices like a T-shirt with a tennis ball sewn in the back, especially designed pillows, neck braces and tongue depressors are advertised. Their efficiency is debateable and anecdotal.
Turning the snoring person to one side also helps.
Until the didgeridoo study sufferers were not really offered viable options. Now simply practising blowing into this instrument for 25-30 minutes a day has produced tremendous documented improvement. This can be done while travelling to and from work.
It is possible to substitute the didgeridoo with a football bladder available in sports shops, or an inexpensive bamboo flute sold on the streets. If the flute is used it makes sense to block the openings so that a loud irritating sound is not produced.
A simple solution to a complex dangerous and irritating problem!
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