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

Posted on April 29, 2007 by Maurice Preter MD
See my comments on this in the full text version.
 
 
BMJ. 2006 Feb 4;332(7536):266-70. Epub 2005 Dec 23. Related Articles, Cited Articles, Free in PMC, LinkOut
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Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial.

Puhan MA, Suarez A, Lo Cascio C, Zahn A, Heitz M, Braendli O.

Horten Centre, University of Zurich, 8091 Zurich, Switzerland.

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.

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PMID: 16377643 [PubMed – indexed for MEDLINE]

Posted in Psychiatry/Neurology |

An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects

Posted on April 29, 2007 by Maurice Preter MD
An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects
Alternatives (or complements?) to Glucophage?

Indian J Physiol Pharmacol. 2005 Jul-Sep;49(3):319-24. Related Articles,Links

An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects.

Manjunatha S, Vempati RP, Ghosh D, Bijlani RL.

Department of Physiology, All India Institute of Medical Sciences, New Delhi.

The study was conducted to examine the hypothesis that yogasanas help in the treatment of diabetes mellitus by releasing insulin from the pancreas. Twenty healthy young voluntees (17 male, 3 female; age 19-31 years) participated in the study. Each volunteer performed four sets of asanas in random order for 5 consecutive days each with a 2-day gap between consecutive sets of asanas. The four sets of asanas were: (I) dhanurasana + matsyendrasana, (II) halasana + vajrasana, (III) naukasana + bhujangasana, and (IV) setubandhasana + pavanamuktasana. Blood samples were collected on days 4 and 5 of each set of asanas for measurement of glucose and insulin levels before the asanas, within 10 min after performing the asanas, and 30 min after ingestion of 75 g glucose, which in turn was ingested immediately after the second blood sample. A standard 75 g oral glucose tolerance test (OGTT) was also done before and after the study. On the days of the pre-study or post-study OGTT, no asanas were done. The serum insulin levels after the asanas were lower (P<0.05) than those before the asanas. However, the serum insulin level 0.5 h after the post-asana oral 75 g-glucose challenge was higher (P<0.05) in Set IV than the 0.5 h postprandial insulin level in the pre-study OGTT; the same trend was observed in other sets as well although statistically not significant. The observations suggest that the performance of asanas led to increased sensitivity of the B cells of pancreas to the glucose signal. The increased sensitivity seems to be a sustained change resulting from a progressive long-term effect of asanas. The study is significant in that it has for the first time attempted to probe the mechanism by which yogasanas help diabetes mellitus.

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PMID: 16440850 [PubMed – indexed for MEDLINE]

Posted in Health, Psychiatry/Neurology |

An exploration of associations between separation anxiety in childhood and complicated grief in later life

Posted on April 28, 2007 by Maurice Preter MD
Early vulnerability, many years later.
J Nerv Ment Dis. 2006 Feb;194(2):121-3. Related Articles,Links

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An exploration of associations between separation anxiety in childhood and complicated grief in later life.

Vanderwerker LC, Jacobs SC, Parkes CM, Prigerson HG.

Center for Psycho-oncology and Palliative Care Research, Dana Farber Cancer Institute, and Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 022115, USA.

Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder in bereaved individuals. The Structured Clinical Interview for the DSM-IV, Inventory of Complicated Grief-Revised, and CSA items from the Panic Agoraphobic Spectrum Questionnaire were administered to 283 recently bereaved community-dwelling residents at an average of 10.6 months postloss. CSA was significantly associated with CG (OR = 3.2; 95% CI, 1.2-8.9), adjusting for sex, level of education, kinship relationship to the deceased, prior history of psychiatric disorder, and history of childhood abuse. CSA was not significantly associated with major depressive disorder, posttraumatic stress disorder, or generalized anxiety disorder.

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PMID: 16477190 [PubMed – indexed for MEDLINE]

Posted in Aging |

Panic and fear induced by deep brain stimulation

Posted on April 28, 2007 by Maurice Preter MD
 Panic and fear induced by deep brain stimulation

J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):410-2. Related Articles,Links

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Panic and fear induced by deep brain stimulation.

Shapira NA, Okun MS, Wint D, Foote KD, Byars JA, Bowers D, Springer US, Lang PJ, Greenberg BD, Haber SN, Goodman WK.

Department of Psychiatry, University of Florida, Gainesville, FL, USA.

BACKGROUND: Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. OBJECTIVE: To investigate panic and fear resulting from DBS. METHODS: Intraoperative DBS in the region of the right and then left anterior limb of the internal capsule and nucleus accumbens region was undertaken to treat a 52 year old man with treatment refractory obsessive-compulsive disorder (OCD). Mood, anxiety, OCD, alertness, heart rate, and subjective feelings were recorded during intraoperative test stimulation and at follow up programming sessions. RESULTS: DBS at the distal (0) contact (cathode 0-, anode 2+, pulse width 210 ms, rate 135 Hz, at 6 volts) elicited a panic attack (only seen at the (0) contact). The patient felt flushed, hot, fearful, and described himself as having a “panic attack.” His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediately after turning the device on, and abruptly ceased in the off condition CONCLUSIONS: DBS of the anterior limb of the internal capsule and nucleus accumbens region caused severe “panic.” This response may result from activation of limbic and autonomic networks.

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Antidepressant-like effect of magnetic resonance imaging-based stimulation in mice

Posted on April 28, 2007 by Maurice Preter MD

Antidepressant-like effect of magnetic resonance imaging-based stimulation in mice.

Prog Neuropsychopharmacol Biol Psychiatry. 2007 Mar 30;31(2):503-9. Epub 2007 Jan 10. Related Articles,Links

Rokni-Yazdi H, Sotoudeh H, Akhondzadeh S, Sotoudeh E, Asadi H, Shakiba M.

Department of Radiology and Imaging, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Keshavarz Blvd., Tehran 14197-33141, Iran. rokniyaz@sina.tums.ac.ir

INTRODUCTION: It has been reported that a novel type of magnetic resonance imaging (MRI) scan called echo planar magnetic resonance spectroscopic imaging (EP-MRSI) may show antidepressant effects. We examined whether the two routine diagnostic protocols of MRI [T1 and echo planar diffusion weighted imaging (EPI-DWI)], have antidepressant-like effects in an animal model of depression. METHODS: The effects of standard EPI-DWI and T1 MRI on immobility, swimming and climbing times in the modified forced swimming test (FST) in mice were examined. After exposure to the first session of modified forced swimming test, we randomly divided the mice into four groups. The first group (T1 MRI group, n=21) received a 15-minute stimulation of T1 sequence. The second group (EPI-DWI MRI group, n=21) received a 15-minute stimulation of EPI-DWI protocol. The third group (sham group, n=21) spent 15 min in a tunnel similar to the MRI gantry in terms of size, temperature and light intensity and received recorded sounds from a normal session of EPI-DWI with similar duration and intensity. The fourth group acted as controls (n=21).The second session of the modified FST was conducted twelve hours later. The mean of immobility, swimming and climbing times in this session were compared to the control group. RESULTS: T1 weighted and EPI-DWI MRI groups showed a reduction in immobility time compared to the control group (P value<0.002, P value<0.017 respectively). This effect is comparable to that seen in the FST after the administration of antidepressant agents. The climbing time in the group subjected to EPI-DWI MRI was longer than the control group (P value<0.035). Previous studies showed similar effects after the administration of antidepressant drugs affecting the catecholamine systems. The swimming time in the T1 MRI group was significantly longer than the control group (P value<0.037). Previous studies showed qualitatively similar effect to that of anti-depressant drugs affecting the serotoninergic systems. The swimming, climbing and immobility times in the sham and control groups showed no significant difference. CONCLUSIONS: Our findings raise the possibility that MRI-based stimulation may have antidepressant-like effects in mice. This is likely to be through different mechanisms in T1 weighted and EPI-DWI protocols. However the possible biological basis of this effect is not yet understood and we would advocate further studies of MRI-based stimulation effects on transmitters in the different organs in the body specially the brain.

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