Conch shell blowing could help treat common snoring disease

By Stephen Beech

Blowing through a conch shell could help to treat a potentially deadly snoring condition, according to new research.

Patients who took part in the ancient practice regularly for six months experienced a reduction in their symptoms of obstructive sleep apnoea (OSA), say scientists.

OSA is a common sleep disorder where breathing repeatedly stops during the night due to a blocked airway.

It leads to loud snoring, restless sleep and daytime sleepiness.

OSA can also increase the risk of high blood pressure, heart disease, and stroke.

Blowing the conch shell - or shankh blowing - has been part of Indian culture for thousands of years.

The new study, published in ERJ Open Research, showed that people with moderate OSA who practised shankh blowing slept better, felt more alert during the day and had fewer breathing interruptions at night.

The research team says conch blowing is a simple, low-cost intervention that could help reduce symptoms without the need for medication or machines.

Study leader Dr. Krishna K Sharma says the standard treatment for OSA is a continuous positive airway pressure machine, or CPAP, which keeps the patient’s airway open by blowing air through a facemask throughout the night.

Dr. Sharma, of the Eternal Heart Care Centre and Research Institute in Jaipur, India, said: "While effective, many patients find it uncomfortable and struggle to use it consistently.

“In my clinical practice, several patients reported feeling more rested and experiencing fewer symptoms after regularly practising shankh blowing – a traditional yogic breathing exercise involving exhaling through a conch shell.

"These observations led us to design a scientific study to rigorously test whether this simple, ancient practice could serve as a meaningful therapy for people with OSA.”

The study involved 30 participants with moderate OSA, aged between 19 and 65, who were assessed at the Eternal Heart Care Centre and Research Institute between May 2022 and January 2024.

They were tested with polysomnography, meaning they were monitored throughout a night’s sleep, and asked questions about the quality of their sleep and how sleepy they feel during the day.

They were randomly assigned to either be trained to practise blowing through a conch shell or to practise a deep breathing exercise.

Participants were provided with a traditional shankh used in yogic practices.

They were trained in person at the clinic by a study team member before beginning home-based practice.

Participants were encouraged to practise at home for a minimum of 15 minutes, five days per week. The patients were reassessed after six months.

Compared to the people who practised deep breathing, the people who practised shankh blowing were 34% less sleepy during the daytime.

They also reported sleeping better, and polysomnography revealed that they 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. Sharma 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.

“For people living with OSA, especially those who find CPAP uncomfortable, unaffordable, or inaccessible, our findings offer 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."

He added, “This is a small study, but we are now planning a larger trial involving several hospitals.

"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.”

Professor Sophia Schiza, head of the European Respiratory Society (ERS) group on sleep disordered breathing, welcomed the findings.

Professor Schiza, of the University of Crete, Greece, said: "Obstructive sleep apnoea is a common disease around the world.

"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."

Schiza, who was not involved in the research, added: "This is an intriguing study that shows the ancient practice of shankh blowing could potentially offer an OSA treatment for selected patients by targeting muscle 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."