The effect of playing a wind instrument or singing on risk of sleep apnea: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review composed predominantly of observational studies (5 cross-sectional, 1 RCT)
PubMed 32536365 · doi:10.5664/jcsm.8628
What was done
Authors searched PubMed, EMBASE, and Cochrane through December 2019 for observational studies and randomized or non-randomized controlled trials investigating the effect of playing wind instruments or singing on sleep, snoring, or obstructive sleep apnea. Outcomes were assessed via clinical tests or questionnaires. Risk of bias was graded, and both descriptive analysis and meta-analysis were conducted.
What was found
Six studies were included (5 cross-sectional, 1 randomized controlled trial; sample sizes ranged from 25 to 1,105). Descriptive analyses suggested double-reed instrument players had lower obstructive sleep apnea risk, singers snored less, and didgeridoo playing improved the apnea-hypopnea index, daytime sleepiness, and partner sleep disturbance ratings. However, meta-analysis failed to substantiate these effects, yielding an effect size of zero to small. Specific numerical effect sizes were not reported in the abstract.
Why it matters
This review demonstrates that despite popular interest in musical upper-airway training (such as didgeridoo or singing) for sleep-disordered breathing, quantitative evidence for meaningful clinical benefit remains unsubstantiated.
Limits
The total evidence base is limited to six studies, five of which are cross-sectional and cannot establish causality. Potential risk of bias ranged up to high, several studies had small sample sizes, and required rehearsal durations from professional musicians limit generalizability.
Cited by
- supports Playing the didgeridoo strengthens upper airway muscles through circular breathing and helps reduce mild sleep apnea.