Wind Instrument Training and Sound-Based Interventions for Sleep Quality and Obstructive Sleep Apnoea: A Narrative...

Tolerability issues with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) have spurred interest in nonpharmacological alternatives like sound-based interventions (wind instrument training, singing and music therapy) for improving upper airway function and sleep quality.

A systematic search of PubMed, Embase, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (through March 2024) identified studies evaluating the effects of wind instrument training, vocal interventions (singing or speech therapy) or music therapy on OSA-related outcomes and sleep quality. Eight studies, specifically, four randomised controlled trials, one before-after quasi-experimental study and three cross-sectional observational studies, were included.

Wind instrument training, particularly that with high-resistance instruments, showed moderate effectiveness in reducing OSA severity and improving sleep outcomes, although no significant improvements in pulmonary function were reported. Music-based interventions (e.g., passive bedtime listening) had mixed effects on sleep quality. Some evidence indicated that structured vocal exercises (singing or speech therapy) can reduce snoring and enhance outcomes when combined with CPAP, but results varied across studies. Overall, sound-based interventions demonstrated potential benefits for OSA, although heterogeneity amongst studies was high.

This review highlights sound-based interventions as a unique and promising nonpharmacological treatment for OSA. In contrast to CPAP, which has a mechanical approach, these strategies aim to improve airway patency via upper airway muscle training and may serve as alternatives or adjuncts for patients intolerant of CPAP. Although moderate evidence supports their ability to improve sleep quality and OSA symptoms, outcomes remain inconsistent. The noninvasive, low-cost nature of sound-based interventions underscores substantial clinical potential. Large multicentre trials with long follow-ups and direct comparisons with CPAP are warranted to validate efficacy and clarify underlying mechanisms.