Intended for healthcare professionals


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

BMJ 2006; 332 doi: (Published 02 February 2006) Cite this as: BMJ 2006;332:266
  1. Milo A Puhan, research fellow1,
  2. Alex Suarez, didgeridoo instructor2,
  3. Christian Lo Cascio, resident in internal medicine3,
  4. Alfred Zahn, sleep laboratory technician3,
  5. Markus Heitz, specialist in respiratory and sleep medicine4,
  6. Otto Braendli, specialist in respiratory and sleep medicine (otto.braendli{at}
  1. 1 Horten Centre, University of Zurich, 8091 Zurich, Switzerland
  2. 2 Asate Alex Suarez, 9630 Wattwil, Switzerland
  3. 3 Zuercher Hoehenklinik Wald, CH-8639 Faltigberg-Wald, Switzerland
  4. 4 Lungenpraxis Morgental, Zurich, Switzerland
  1. Correspondence to: O Braendli
  • Accepted 24 November 2005


Objective To assess the effects of didgeridoo playing on daytime sleepiness and other outcomes related to sleep by reducing collapsibility of the upper airways in patients with moderate obstructive sleep apnoea syndrome and snoring.

Design Randomised controlled trial.

Setting Private practice of a didgeridoo instructor and a single centre for sleep medicine.

Participants 25 patients aged > 18 years with an apnoea-hypopnoea index between 15 and 30 and who complained about snoring.

Interventions Didgeridoo lessons and daily practice at home with standardised instruments for four months. Participants in the control group remained on the waiting list for lessons.

Main outcome measure Daytime sleepiness (Epworth scale from 0 (no daytime sleepiness) to 24), sleep quality (Pittsburgh quality of sleep index from 0 (excellent sleep quality) to 21), partner rating of sleep disturbance (visual analogue scale from 0 (not disturbed) to 10), apnoea-hypopnoea index, and health related quality of life (SF-36).

Results Participants in the didgeridoo group practised an average of 5.9 days a week (SD 0.86) for 25.3 minutes (SD 3.4). Compared with the control group in the didgeridoo group daytime sleepiness (difference −3.0, 95% confidence interval −5.7 to −0.3, P = 0.03) and apnoea-hypopnoea index (difference −6.2, −12.3 to −0.1, P = 0.05) improved significantly and partners reported less sleep disturbance (difference −2.8, −4.7 to −0.9, P < 0.01). There was no effect on the quality of sleep (difference −0.7, −2.1 to 0.6, P = 0.27). The combined analysis of sleep related outcomes showed a moderate to large effect of didgeridoo playing (difference between summary z scores −0.78 SD units, −1.27 to −0.28, P < 0.01). Changes in health related quality of life did not differ between groups.

Conclusion Regular didgeridoo playing is an effective treatment alternative well accepted by patients with moderate obstructive sleep apnoea syndrome.

Trial registration ISRCTN: 31571714.


  • Contributors MAP, AS, and OB designed and organised the study. AS assigned the intervention. CLC, OB, MH, and AZ collected the data. MAP supervised data collection, analysed data, and wrote the first draft. AS, CLC, AZ, MH, and OB critically reviewed the manuscript, and MAP and OB prepared the final version. OB is guarantor.

  • Funding Zurich Lung Association, Zuercher Hoehenklinik Wald.

  • Competing interests AS is a professional didgeridoo instructor and teaches t'ai chi and qi gong.

  • Ethical approval Ethics committee of the University Hospital of Zurich.

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