Ancient Conch Shell Blowing Eases Sleep Apnea Symptoms

Regularly blowing into a conch shell, an ancient Indian practice known as shankh blowing, could help ease symptoms of obstructive sleep apnea (OSA), according to a new randomized controlled trial published in ERJ Open Research.

The study found that patients who practiced the technique for six months reported better sleep, felt more alert during the day, and experienced fewer breathing interruptions at night. Researchers say the low-cost exercise could offer a non-invasive alternative for people unable or unwilling to use standard treatments like CPAP machines.

An Ancient Ritual Meets Modern Sleep Science

OSA affects millions worldwide, causing loud snoring, fragmented sleep, and daytime fatigue. The condition also increases the risk of high blood pressure, heart disease, and stroke. CPAP therapy remains the gold standard, but many patients find the facemask uncomfortable and difficult to use consistently.

Lead author Dr Krishna K Sharma, from the Eternal Heart Care Centre and Research Institute in Jaipur, India, explained: “In my clinical practice, several patients reported feeling more rested and experiencing fewer symptoms after regularly practising shankh blowing. 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 Six-Month Trial

The trial recruited 30 adults aged 19 to 65 with moderate OSA. Participants were randomly assigned to either a shankh blowing group (16 people) or a control group that performed deep breathing exercises (14 people). Each participant received training at the clinic, then practiced at home for at least 15 minutes a day, five days a week, over six months.

Before and after the intervention, patients underwent overnight sleep studies (polysomnography) and completed questionnaires on sleep quality and daytime alertness.

Key Findings

• Daytime sleepiness dropped by 34% in the shankh group compared to controls.
• On average, participants experienced four to five fewer apneas per hour during sleep.
• Nighttime blood oxygen levels were higher in the shankh group.
• Sleep quality scores improved more in the shankh group than in controls.

Dr Sharma believes the technique works by strengthening muscles in the throat and soft palate. “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,” he said.

“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.”

Expert Perspective

Professor Sophia Schiza, Head of the ERS group on sleep disordered breathing at the University of Crete, who was not involved in the study, called the results “intriguing” and suggested that shankh blowing could serve as an adjunct or alternative treatment for selected OSA patients, pending confirmation in larger trials.

Looking Ahead

The research team plans to compare shankh blowing directly with CPAP and explore its effects in patients with more severe OSA. They also hope to investigate the precise physiological mechanisms behind the practice, including how vibrations and resistance from the conch shell impact airway stability during sleep.

Journal: ERJ Open Research
DOI: 10.1183/23120541.00258-2025