The Impact of Playing a Musical Instrument on Obstructive Sleep Apnea: A Systematic Review

Abstract

Study Objectives: To conduct a systematic review of the medical literature evaluating the effects of playing a musical instrument on obstructive sleep apnea (OSA). Data Sources: Scopus, CINAHL, PubMed, and OVID. Review Methods: Searches were performed through October 22, 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. Results: After thorough investigation amidst specific exclusion criteria, four studies were included in the systematic review: one randomized controlled trial and three cross-sectional studies. Polysomnography was used to assess apnea-hypopnea index (AHI) related to obstructive sleep apnea (OSA) in the randomized controlled trial, while the Berlin questionnaire was used to assess high- and low risk OSA in the cross-sectional studies. Various instrument types were mentioned in these studies, largely focusing on wind instruments and subgroups within the wind instrument family. Conclusion: Current literature, although sparse, suggests that playing certain types of wind instruments are associated with either improving patients’ AHI or reducing the risk of developing OSA. Future studies with larger sample sizes utilizing validated diagnostic tools to measure the presence and severity of OSA are necessary to determine the true impact of such interventions. Although more research is needed, sustainable and minimally invasive interventions such as playing a specific type of musical instrument could serve as an accessible, inexpensive, and effective adjunctive treatment for OSA.

Beyond CPAP: modifying upper airway output for the treatment of OSA

“…This approach was viewed as easier than having participants practice with a "sham" didgeridoo. A clear role of didgeridoo playing in OSA treatment is not defined (48).…”

“…Subsequent studies have separated instruments into singlereed, double-reed, high-brass, and low-brass instruments (48). Single reed instruments (clarinet, saxophone) include a single piece of cane that vibrates when sound is introduced.…”

“…High brass includes trumpets and French horns. Of the instruments noted, the double reed appears to improve AHI and daytime symptoms consistently, with more hours spent playing corresponding to greater AHI reduction (48). Ward et al argued that the narrower aperture of double reed instruments and requisite air pressure were comparable to high-brass instruments (30-42 mmHg vs. 13-42 cmH 2 O) and thus did not explain the differences in efficacy across the woodwinds.…”

“…Ward et al argued that the narrower aperture of double reed instruments and requisite air pressure were comparable to high-brass instruments (30-42 mmHg vs. 13-42 cmH 2 O) and thus did not explain the differences in efficacy across the woodwinds. Additionally, benefit in OSA treatment was not seen in non-wind instrumentalists (48). Rather, they speculated that the differences in efficacy were attributable to the differences in muscle activation patterns across the instruments (48).…”

“…Additionally, benefit in OSA treatment was not seen in non-wind instrumentalists (48). Rather, they speculated that the differences in efficacy were attributable to the differences in muscle activation patterns across the instruments (48). Circular breathing does not have a clear and consistent role in improving the AHI (47).…”