An ancient ritual which involves blowing into a large shell could tackle the symptoms of a common sleep disorder, a study suggests.
The practice of conch blowing, also known as shankh blowing, could improve sleep for patients with obstructive sleep apnoea (OSA) without the need for uncomfortable machinery, according to researchers.
Shankh blowing involves breathing in deeply before exhaling forcefully into a conch, the spiral-shaped shell from a species of sea snail.
The small trial, led by researchers in India, involved 30 people aged with 19 and 65 with OSA.
OSA happens with the walls of the throat relax and narrow or close, with symptoms including choking noises, loud snoring and waking up a lot.
The condition is thought to impact about eight million people in the UK.
For the trial, 16 people were provided with a traditional shankh used in yogic practices and trained in how to use it properly before taking it home, while the remaining 14 people were asked to carry out deep breathing exercises.
Both groups were encouraged to practice for a minimum of 15 minutes five days a week.
They were monitored during sleep and asked questions about sleep quality and how tired they felt during the day.
After six months, the study found those who practised shankh blowing reported sleeping better and were 34% less sleepy during the day.
They also had higher levels of oxygen in the blood during the night and had four to five fewer apnoeas, where breathing stops during sleep, per hour on average.
They also had higher levels of oxygen in their blood during the night.
Dr Krishna K Sharma, of the Eternal Heart Care Centre and Research Institute in Jaipur, India, said: “The way the shankh is blown is quite distinctive.
“It involves a deep inhalation followed by a forceful, sustained exhalation through tightly pursed lips.
“This action creates strong vibrations and airflow resistance, which likely strengthens the muscles of the upper airway, including the throat and soft palate, areas that often collapse during sleep in people with OSA.
“The shankh’s unique spiralling structure may also contribute to specific acoustic and mechanical effects that further stimulate and tone these muscles.”
Continuous positive airway pressure (Cpap) machines are the first line of treatment for OSA.
They involve patients wearing a mask that blows pressurised air into the nose and throat while they sleep.
However, they can be uncomfortable.
Speaking of Cpap, Dr Sharma said: “While effective, many patients find it uncomfortable and struggle to use it consistently.”
He suggests shankh blowing could be a “promising alternative”.
“Shankh blowing is a simple low-cost, breathing technique that could help improve sleep and reduce symptoms without the need for machines or medication,” Dr Sharma said.
Researchers are now planning a larger trial involving several hospitals.
Dr Sharma added: “This next phase will allow us to validate and expand on our findings in a broader, more diverse population and assess how shankh blowing performs over longer periods.
“We also want to study how this practice affects airway muscle tone, oxygen levels and sleep in greater detail.
“We’re particularly interested in comparing shankh blowing with standard treatments like Cpap, and in examining its potential help in more severe forms of OSA.”
Reacting to the findings, Professor Sophia Schiza, head of the ERS group on sleep disordered breathing, based at the University of Crete, Greece, said: “We know that OSA patients have poor quality of sleep, and higher risks of high blood pressure, strokes and heart disease.
“A proportion of patients experience sleepiness during the day.
“While Cpap and other treatments are available based on careful diagnosis of disease severity, there is still need for new treatments.
“This is an intriguing study that shows the ancient practice of shankh blowing could potentially offer an OSA treatment for selected patients by targeting muscles training.
“A larger study will help provide more evidence for this intervention which could be of benefit as a treatment option or in combination with other treatments in selected OSA patients.”
