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Bananas, Didgeridoos and now Surface Lubricants and OSA

Am. J. Respir. Crit. Care Med., Volume 157, Number 5, May 1998, 1522-1525

Surface Tension Forces in Sleep Apnea: The Role of a Soft Tissue Lubricant
A Randomized Double-blind, Placebo-controlled Trial
RUZICA JOKIC, ARTUR KLIMASZEWSKI, JOSEPH MINK, and MICHAEL F. FITZPATRICK

Division of Respiratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Upper airway obstruction in patients with sleep apnea may occur in the absence of a negative intraluminal upper airway pressure. We hypothesized that surface tension forces may play a role in the pathogenesis of obstructive sleep apnea (OSA), and that a topical soft tissue lubricant might reduce the severity of OSA. Ten male patients (age 49 ± 10 yr [mean ± SD]; body mass index [BMI] 31 ± 5 kg/m2) with OSA (apnea-hypopnea index [AHI] 17 ± 9) were studied. The arousal index was lower with the lubricant treatment than with placebo (mean difference 8; 95% CI 4 to 11 arousals/h; p = 0.001). The AHI was lower, in each of the 10 patients, on the lubricant treatment than the placebo (mean change 10, 95% CI 6 to 13; p = 0.0003). The lower AHI with lubricant as compared with placebo was present in both supine (mean difference 13; 95% CI 5 to 20; p = 0.006) and nonsupine (mean difference 6; 95% CI 0 to 12; p = 0.05) positions. There was no significant difference in sleep architecture between the lubricant and placebo treatments. Application of a topical lubricant consistently reduced the severity of OSA. This implies a pathogenetic role for surface tension forces in OSA, and a potential role for surface tension-reducing agents in the treatment of OSA.

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I've been asked to watch posting links. That's why I deleted links from my post above. So if anyone wants didgeridoo recommendations, please contact me directly.

Hah, sounds like you have it all figured out, Mike!  ;-)

Cheapest usable option: those black tubes golfers stick in their bags to keep their clubs from clanging. $2-3 bucks at a sporting goods store. 

I thought Steve's link was very interesting and informative, whether he sells anything or not. It's totally unique to the SA community so it's important. I know there are reasons for not allowing links that I just have no clue about, but I'm glad that his got through. :)

Even as a musician I worry that I won't ever learn circular breathing. It could be that my vocal cord problem *is* the circular breathing deterrent.

Thanks, Mike and Marcia. Marcia, if you call me I can easily describe an exercise that will let you try circular breathing.

Mary, I think there's much more to instrument selection than sales details. There are poor choices: If a beginner gets a didg with a poor, uncomfortable mouthpiece, or too low a key, or one with low backpressure that makes it difficult if not impossible to breathe correctly, one will likely assume that they lack the ability to play, or just not like it. Either way, they will fail to get any benefits that they might otherwise enjoy. I've seen that too many times. And it's not always the cheapo instruments; they may have a formerly nice instrument from Australia or elsewhere that's riddled with air leaks and is unusable, too.

These problems can be avoided by getting good advice/having a teacher, which is the whole point of the Sleep Apnea-Didgeridoo Network. 

I'm betting there are similar issues to purchasing CPAPS and other apnea products, no? I suppose some have made their own with a fan, funnel, garden hose, beeswax...  ;-)

Well, a few things: The network website only went live a couple months ago. LA Outback is a didg dealer in LA, nice guys. But we're not competitors. I'm not a vendor, I only stock some sticks for my students and friends. And the ones we carry are not from LAO, but from the Didgeridoo Store in Oakhurst, CA. They're old friends of ours, and we just like certain models they have.

Also, thus far there are NO sales pitches at the Sleep Apnea-Didgeridoo Network website. So I'm not sure where anyone is getting that impression. The only monetary links at all are for donating to charities. That might change, but that's where it's at right now.

Pablo is a great, kind friend, a good player, and if you meet him you MUST ask him to "do the baby." You'll thank me later. 

Well, I do know the didge may be helpful in treating sleep apnea and I guess there is a difference in selling and giving information.  So, all in all, Steve, I appreciate this information aimed at making didge beginners successful.  I'll delete the post and accept the help.

I may just call you one of these days, Steve. I've been trying to loosen my lips up and have found that the middle of my lower lip can't buzz or even flap so I think I may not be able to do the didg. Sigh.

Cool: 612-521-4308.

What does your lip do when you try? 

It feels like it's doing nothing. The upper lip vibrates some. I think my lips muscles have fallen apart since I quit playing. It takes great effort to just flap the lips, not buzz them.

FWIW, I also have lip leaks when I sleep and can't use a nasal mask or pillows for that reason. Chin straps keep the mouth closed but not the lips unless I use an Ultimate Chin Strap (the mummy kind).

Wow, Mike, enjoy that new stick. What changed your mind?

A few thoughts:

"Circular breathing"  is fun, and when you get it you'll feel like you're "in the club." Which is cool, and I don't doubt that CB can be a helpful part of the technique as far as OSA is concerned. But, the other techniques likely help a lot, too, and I suspect that CB is overstressed. Nice, but you may benefit before or besides it. If you want to call me sometime, I can walk you through my preferred method easily and quickly.

Gamble: Well, of course you can look at it like that. But hey, CPAPS and all the other OSA gear and accessories are gambles too: they are expensive, and don't work for everyone. And folks are told that they'll need to use that stuff for the rest of their lives. On the other hand, they are all considerably less fun and lack the other benefits of playing the didg.

So, choose to approach this with high expectations, exuberance, and a sense of play. Remember, we don't call it "working" an instrument, we call it "playing" an instrument.  ;-)

Mike, you need to learn a bit of technique, it sounds like to me. No way that didge is going to play/feel like a big-bore C# molded plastic unit. Relax and call Pablo, man!   ;-)

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