Puhan · BMJ (Clinical research ed.) 2006 · randomized controlled trial · n=25

Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial.

Cited 238 times in the scientific literature.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 16377643 · doi:10.1136/bmj.38705.470590.55 · record verified 2026-08-29

What was done

A randomized controlled trial evaluated 25 adult patients (aged >18 years) with moderate obstructive sleep apnoea syndrome (apnoea-hypopnoea index [AHI] 15–30) and snoring complaints. Participants were randomized to either four months of didgeridoo lessons with daily home practice using standardized instruments or to a waiting list control group. Outcomes assessed were daytime sleepiness (Epworth scale), sleep quality (Pittsburgh quality of sleep index), partner-rated sleep disturbance (visual analogue scale), AHI, and health-related quality of life (SF-36).

What was found

Participants in the didgeridoo group practiced an average of 5.9 days per week (SD 0.86) for 25.3 minutes (SD 3.4). Compared with the control group, the didgeridoo group showed statistically significant improvements in daytime sleepiness (difference -3.0, 95% CI -5.7 to -0.3, P = 0.03), AHI (difference -6.2, 95% CI -12.3 to -0.1, P = 0.05), and partner-rated sleep disturbance (difference -2.8, 95% CI -4.7 to -0.9, P < 0.01). Sleep quality showed no significant difference (difference -0.7, 95% CI -2.1 to 0.6, P = 0.27), and changes in health-related quality of life did not differ between groups. A combined analysis of sleep-related outcomes showed a significant effect (difference in summary z scores -0.78 SD units, 95% CI -1.27 to -0.28, P < 0.01).

Why it matters

This study provides proof-of-concept that upper-airway training through regular wind instrument practice can reduce sleep apnoea severity and daytime symptoms in moderate cases.

Limits

The trial had a very small sample size (n = 25) recruited from a single sleep center and didgeridoo practice, limiting generalizability and statistical power. The control arm was a waiting list rather than a sham or active breathing control, leaving open the possibility of non-specific attention effects. Effects in severe sleep apnoea or long-term adherence beyond four months were not evaluated.

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