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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.
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.
Views: 665
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Since there hasn't been any further progress with this line of reasoning, I'm assuming that this idea never panned out. It's been over 10 years since the study was published. Here's the link to the full paper: http://ajrccm.atsjournals.org/cgi/reprint/157/5/1522
This is probably how the throat lubricant sprays for snoring were developed.
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Permalink Reply by Judy on
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Doggone it! In one of the discussions regarding banana smoothies and OSA if someone didn't say "The phospholipids provide a 4 to 6 hour lubricant that prevents the throat tissues from making an air tight seal and thus prevent apnea." Say what? So, of course, I had to go looking .... so much for searching for more didgeridoo and OSA. Evidently the researchers weren't ready to give up on this theory after all!!!
Relationship between surface tension of upper airway lining liquid and upper airway collapsibility during sleep in obstructive sleep apnea hypopnea syndrome
Jason P. Kirkness, Melanie Madronio, Rosie Stavrinou, John R. Wheatley, and Terence C. Amis
Ludwig Engel Centre for Respiratory Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia 2145
Submitted 9 May 2003 ; accepted in final form 8 July 2003
http://jap.physiology.org/cgi/content/abstract/95/5/1761
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J Physiol Volume 574, Number 3, 859-866, August 1, 2006 DOI: 10.1113/jphysiol.2005.102129
RESPIRATORY
Influence of breathing route on upper airway lining liquid surface tension in humans
Manisha Verma1,3, Margaret Seto-Poon1,3, John R. Wheatley1,2, Terence C. Amis1,2 and Jason P. Kirkness1,2,3
1 Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Westmead, NSW 2145, Australia
2 The University of Sydney, Camperdown, NSW 2006, Australia
3 University of Western Sydney, Penrith, NSW 1797, Australia
http://jp.physoc.org/cgi/content/abstract/574/3/859
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J Physiol Volume 586, Number 22, 5537-5547, November 15, 2008 DOI: 10.1113/jphysiol.2008.159822
RESPIRATORY
Saliva production and surface tension: influences on patency of the passive upper airway
J. C. M. Lam1, K. Kairaitis2,3, M. Verma2, J. R. Wheatley2,3 and T. C. Amis2,3
1 Division of Respiratory and Critical Care Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China
2 Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute
3 University of Sydney at Westmead Hospital, Westmead, NSW, Australia
http://jp.physoc.org/cgi/content/abstract/586/22/5537
You are probably very right abut the origin of the throat lubricant sprays, Dr Park. But - I don't care!! I am still NOT gonna drink a banana smoothie or banana anything before bed or any time. Yech! I'm with you. I'Il GLADLY stick w/my faithful Resmed VPAP Auto and Simplicity nasal cushion mask, thank you!!
And now to the didgeridoo .....
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Permalink Reply by Mike on
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judy, you left us with a cliff hanger there. what's your take on the didgeridoo?
Judy said:Doggone it! In one of the discussions regarding banana smoothies and OSA if someone didn't say "The phospholipids provide a 4 to 6 hour lubricant that prevents the throat tissues from making an air tight seal and thus prevent apnea." Say what? So, of course, I had to go looking .... so much for searching for more didgeridoo and OSA. Evidently the researchers weren't ready to give up on this theory after all!!!
Relationship between surface tension of upper airway lining liquid and upper airway collapsibility during sleep in obstructive sleep apnea hypopnea syndrome
Jason P. Kirkness, Melanie Madronio, Rosie Stavrinou, John R. Wheatley, and Terence C. Amis
Ludwig Engel Centre for Respiratory Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia 2145
Submitted 9 May 2003 ; accepted in final form 8 July 2003
http://jap.physiology.org/cgi/content/abstract/95/5/1761
-----------------------------------------------------------------------------------------------
J Physiol Volume 574, Number 3, 859-866, August 1, 2006 DOI: 10.1113/jphysiol.2005.102129
RESPIRATORY
Influence of breathing route on upper airway lining liquid surface tension in humans
Manisha Verma1,3, Margaret Seto-Poon1,3, John R. Wheatley1,2, Terence C. Amis1,2 and Jason P. Kirkness1,2,3
1 Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Westmead, NSW 2145, Australia
2 The University of Sydney, Camperdown, NSW 2006, Australia
3 University of Western Sydney, Penrith, NSW 1797, Australia
http://jp.physoc.org/cgi/content/abstract/574/3/859
--------------------------------------------------------------------------------------------
J Physiol Volume 586, Number 22, 5537-5547, November 15, 2008 DOI: 10.1113/jphysiol.2008.159822
RESPIRATORY
Saliva production and surface tension: influences on patency of the passive upper airway
J. C. M. Lam1, K. Kairaitis2,3, M. Verma2, J. R. Wheatley2,3 and T. C. Amis2,3
1 Division of Respiratory and Critical Care Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China
2 Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute
3 University of Sydney at Westmead Hospital, Westmead, NSW, Australia
http://jp.physoc.org/cgi/content/abstract/586/22/5537
You are probably very right abut the origin of the throat lubricant sprays, Dr Park. But - I don't care!! I am still NOT gonna drink a banana smoothie or banana anything before bed or any time. Yech! I'm with you. I'Il GLADLY stick w/my faithful Resmed VPAP Auto and Simplicity nasal cushion mask, thank you!!
And now to the didgeridoo .....
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Am sidetracked w/family, horse show coming up for grandkids, etc. I WILL bring us up to date on the didgeridoo. Just give me time.
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Permalink Reply by Dave on
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I am a little confused - are we saying throat lubricants do not help lower one's AHI for OSA if you have a typical tongue obstruction?
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Here is a history of the didgeridoo:
http://www.aboriginalarts.co.uk/historyofthedidgeridoo.html
http://en.wikipedia.org/wiki/Didgeridoo
The didgeridoo and "circular breathing""
http://www.geocities.com/Area51/4708/didgeridoo.html
And "Breathing Techniques for Playing the Didgeridoo":
http://www.ehow.com
And the article you have all been waiting breathlessly for: News in SCIENCE
"Didgeridoo Helps Stop Snoring"
http://www.abc.net.au/science/news/stories/s1537183.htm
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thanks for these. long live the didgeridoo. it's just kind of fun to write it and say it. imagine what playing it must be like. and heck, if it improves my breathing, all the better.
Judy said:Here is a history of the didgeridoo:
http://www.aboriginalarts.co.uk/historyofthedidgeridoo.html
http://en.wikipedia.org/wiki/Didgeridoo
The didgeridoo and "circular breathing""
http://www.geocities.com/Area51/4708/didgeridoo.html
And "Breathing Techniques for Playing the Didgeridoo":
http://www.ehow.com
And the article you have all been waiting breathlessly for: News in SCIENCE
"Didgeridoo Helps Stop Snoring"
http://www.abc.net.au/science/news/stories/s1537183.htm
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I would think that the REASON for our OSA would determine if the didgeridoo would or wouldn't help reduce our OSA events.
I mean if our OSA is just a matter of loss of muscle tone due to a sedentary life style or aging ... I could see where it would help.
BUT if our cause is weight or anatomy of the thraot or tongue or jaw ... I doubt it would have any influence at all other than the enjoyment of mastering the instrument and technique. Something new and different and likely unique in our neighborhood or circle of friends.
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Permalink Reply by RockRpsgt on
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Found this on another site. Apparently singing can also help with snoring.
http://www.arthritis.org/how-singing-eases-snoring.php
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Singing, and whistling, can also help w/COPD by the longer exhales cleaning out the lungs as COPDers tend to breathe quite shallow.
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so nobody is suggesting that singing, playing the didgeridoo, throat exercises, etc. are a substitute for CPAP machines, right? just supplemental therapy... or does anyone know of someone who was able to turn to one of these alternative treatments exclusively and have data showing that it worked effectively?
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