The strange habit that may be a cure for sleep apnea

Daily Mail​

2 days ago

For the 25million Americans who suffer from sleep apnea, an odd habit may be the solution to problem.
Blowing into a conch shell before bed was shown to have measurable benefits for people suffering from obstructive sleep apnea (OSA).
An estimated 25 to 30 million Americans have OSA, a condition that causes a person to snore, stop breathing, and choke dozens of times throughout the night, making it impossible to have an uninterrupted night of sleep.
The gold-standard treatment for OSA is to wear a CPAP machine, which gently pumps air into a mask over their mouth or nose while sleeping. It prevents muscles in the back of the throat from narrowing, which constricts the airway and causes the snoring and choking.
Between eight and 10 million Americans use a CPAP machine at night, though many people with OSA find the machines uncomfortable and difficult to get used to. Some research suggests that at least a third of people with the dangerous condition quit their CPAP for a variety of reasons, including discomfort.
But recently, Indian researchers recruited more than a dozen people with sleep apnea to either complete deep breathing exercises or blow into a conch shell called a shankh, several times during the week.
Those who blew into the shankh had improved levels of oxygen in their blood as they slept at night, experienced fewer times waking up in their sleep from choking, and were markedly less sleepy during the day.
Researchers believe that exhaling through a conch shell strengthens upper airway muscles, which has been shown in other studies to improve OSA symptoms, to keep the airway open during sleep.
The effects of untreated OSA can be serious, leading to anxiety, daytime tiredness that increases the risk of accidents, and low productivity.
OSA has also been tied to an increased likelihood of heart attack, high blood pressure and stroke.
Sleep apnea also puts a person at risk of entering a state of hypoxia, the result of insufficient oxygen levels in the blood, sometimes to dangerously low levels.
The brain wakes the sleeping person up when it happens, but repeated bouts of hypoxia can reduce focus while awake, kill brain cells, cause dizziness and headaches, impaired judgement and memory problems.
For the study, 16 patients were asked to forcefully exhale through the shankh, while 14 people were told to do deep breathing exercises, five times a day for at least 15 minutes for six months.
Before starting home practice, all participants received in-person training at the clinic from a study team member. Those in the conch-blowing group were given a shankh used in traditional yoga practice.
Scientists surveyed each person before and after the trial on their daytime sleepiness, using an eight-item questionnaire, measured their sleep quality using a more objective test as well as the frequency of breathing disruptions lasting at least 10 seconds.
They also conducted overnight sleep studies that recorded a wide array of physiological signals such as breathing patterns and drops in oxygen.
The shankh-blowing group saw a 34 percent lower sleepiness score on average, from 14.6, meaning significant daytime sleepiness, down to 9.6, which is within the normal sleepiness range.
The shankh group also saw a 19 percent decline on average in the number of times they stopped breathing in the night. The control group, meanwhile, saw an increase in the number of times their breathing paused.
And the shankh-blowing group saw a seven percent improvement in oxygen delivery throughout the body.
According to researchers, reductions surpassed the minimal clinically important difference (MCID) of approximately 20 percent reduction in breathing disturbance reported in literature, 'suggesting that the intervention has a meaningful impact on disease severity.'
That group also lost some weight by the end of the study, while the control group had a larger BMI on average.
Researchers said: 'The improvement in these outcomes by shankh blowing may be attributed to the training of upper airway muscles, indicating decreased collapsibility of the upper airways.
'Notable reduction in neck circumference was observed within the intervention group, implying that blowing shankh might induce upper airway remodeling.'
Doctors often recommend that patients with OSA try to lose weight. Excess neck fat narrows the airway, making it more prone to collapsing while a person sleeps.
Abdominal fat also restricts lung expansion, leading to a lower oxygen reserve in the lungs, which results in worse drops in blood oxygen levels.
A 10 percent rise in body fat is associated with 32 percent more oxygen saturation drops and breathing disruptions, according to a 2024 report in The Journal of Clinical Endocrinology & Metabolism.
The scientists behind the latest research, published in ERJ Open Research, suggested that, with more research, their shankh idea could become a validated, low-cost tool to support sleep apnea care, especially in areas where people have less access to sleep specialists and CPAP machines.
They said: 'In conclusion, upper airway muscle training by blowing shankh improves subjective measurements of daytime sleepiness and sleep quality with improvement in objective measures of severity of obstructive sleep apnea.
'Our research provides novel insights into the potential benefits of blowing shankh as an alternative intervention for individuals with moderate OSA.'