Breathing retraining in sleep apnoea: a review of approaches and potential mechanisms
- 24 Downloads
Anatomically based treatments for obstructive sleep apnoea (OSA) may not completely resolve OSA. This has led to interest in exploring ways of addressing physiological risk factors. This review examines the literature for research reporting on the effects of various types of breathing training and breathing activities on sleep apnoea. It also reviews and discusses proposed therapeutic mechanisms.
A search of electronic databases was performed using the search terms related to various breathing therapies or to activities requiring high levels of breath control such as singing and the playing of musical instruments and sleep apnoea.
A total of 14 suitable studies were reviewed. A diverse variety of breathing retraining approaches are reported to improve sleep apnoea, e.g., Buteyko method, inspiratory resistance training, and diaphragmatic breathing. There is also a reduced incidence of sleep apnoea with intensive and regular participation in activities that require high levels of breath control, e.g., singing and playing wind instruments. Improvements in sleep-disordered breathing are thought to be related to improvements in (1) muscle tone of the upper airway; (2) respiratory muscle strength; (3) neuroplasticity of breathing control; (4) oxygen levels; (5) hyperventilation/dysfunctional breathing; and (6) autonomic nervous system, metabolic, and inflammatory status.
Breathing retraining and regular practice of breath control activities such as singing and playing wind instruments are potentially helpful for sleep apnoea, particularly for individuals with minimal anatomical deficit and daytime breathing dysfunction. Research is needed to elucidate mechanisms, to inform patient selection, and to refine clinical protocols.
KeywordsSleep apnoea Breathing retraining Dysfunctional breathing
Compliance with ethical standards
Conflict of interest
The author declares that she has no conflict of interest.
Human and animal rights and informed consent
This article does not contain any studies with human participants or animals performed by any of the authors.
- 5.Eckert DJ (2016) Phenotypic approaches to obstructive sleep apnoea–new pathways for targeted therapy. Sleep Med RevGoogle Scholar
- 7.Lowe S et al. (2001) Idiopathic hyperventilation (IHV) during wakefulness and sleep Am Rev Respir Crit Care MedGoogle Scholar
- 9.Jack S et al (1998) Breath hold time in idiopathic hyperventilators. Eur Respir J 12(28):412SGoogle Scholar
- 13.Wardrop PJC et al (2011) Do wind and brass players snore less? A cross-sectional study of snoring and daytime fatigue in professional orchestral musicians. Clin Otolaryngol: Official Journal Of ENT-UK ; Official Journal Of Netherlands Society For Oto-Rhino-Laryngology & Cervico-Facial Surgery 36(2):134–138CrossRefGoogle Scholar
- 28.Ward CP, York KM, McCoy JG (2012) Risk of obstructive sleep apnea lower in double reed wind musicians. J Clin Sleep Med: JCSM: official publication of the American Academy of Sleep Medicine 8(3):251Google Scholar
- 31.Lequeux T et al (2005) Physiotherapy in obstructive sleep apnea syndrome: preliminary results. Eur Arch Oto-Rhino-Laryngol: Official Journal Of The European Federation Of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated With The German Society For Oto-Rhino-Laryngology - Head And Neck Surgery 262(6):501–503Google Scholar
- 43.Courtney R (2017) Breathing training for dysfunctional breathing in asthma: taking a multidimensional approach. Eur Respir J Open Res 3(4):00065–02017Google Scholar
- 47.Folgering H, Colla P (1978) Some anomalies in the control of PACO2 in patients with a hyperventilation syndrome. Bull Europ Physiopath Resp 14:503–512Google Scholar
- 62.Edwards BA, Andara C, Landry S, Sands SA, Joosten SA, Owens RL, White DP, Hamilton GS, Wellman A (2016) Upper-airway collapsibility and loop gain predict the response to oral appliance therapy in patients with obstructive sleep apnea. Am J Respir Crit Care Med 194(11):1413–1422PubMedPubMedCentralCrossRefGoogle Scholar
- 65.Trimer R, Cabidu R, Sampaio LL, Stirbulov R, Poiares D, Guizilini S, Bianchi AM, Costa FS, Mendes RG, Delfino A Jr, Arena R, Borghi-Silva A (2014) Heart rate variability and cardiorespiratory coupling in obstructive sleep apnea: elderly compared with young. Sleep Med 15(11):1324–1331PubMedCrossRefGoogle Scholar