If there has been any suggestion that the young musician has suffered from asthma, or any other cause of wheezing from respiratory obstruction, it is likely that elderly relatives will applaud loudly. They will remember learning in their childhood of the benefit to children who wheeze of learning to play a wind instrument.

Before such drugs as Symbicort, which keep wheezing at bay, became available to treat children of 6 or older, it was difficult to think of helpful advice for sufferers. Learning a wind instrument didn’t have the same dramatic effect as modern drugs, but it seemed to improve their chance of a good night’s sleep.

Long before British primary schools discovered the recorder, Australian Aborigines had developed a more haunting and musically sophisticated instrument. They played the didgeridoo, which, like the clarinet or flute, helps people to overcome both upper and lower respiratory tract problems and encourages better sleep.

The didgeridoo is the oldest musical instrument known to mankind, and would have been around in Australia 40,000 years ago. It can produce a surprisingly wide range of sounds. Doctors visiting the World Conference of Neurology in Sydney two months ago were fascinated by a duet being played by two Aborigine street musicians. The older man drummed with sticks to accompany the younger man, who was a master of the didgeridoo. Apart from their loincloths they were naked, with a white-painted pattern on their abdomens.

As they played to the crowd, the paint pattern on the younger man was distorted, by the movements of his tummy every time he drew breath and blew into the didgeridoo. His playing clearly demonstrated the value of the abdominal muscles as an accessory in respiration once breathing becomes laboured. These are the same muscles that come into play when an asthmatic child is having to fight for every breath.

When a child has trouble breathing, what betrays their level of distress is their reliance on these abdominal muscles. Didgeridoo players likewise use them to supplement the role of the chest muscles when struggling for breath.

Research published in the online BMJ by Otto Braendli, a Swiss respiratory physician who has made sleep medicine his speciality, on the benefits of didgeridoo-playing serves as a link between the old wisdom about wind instruments and modern medicine. When Dr Braendli’s patients were persuaded to learn the didgeridoo their respiratory problems eased, the nature of their snoring changed and the prevalence of sleep apnoea, with consequent daytime sleepiness, lessened.

Crescendo snoring is the noisy type that becomes louder and louder until there is an ominous silence for a few moments, denoting that someone has stopped breathing. This pause is known as apnoea. The patient then wakes, sometimes with a shudder, before falling asleep again almost instantly. The cycle is repeated throughout the night.

Although the sleeper cannot next morning remember these momentary awakenings, they disturb the sleep pattern enough to dull the sufferer’s performance the next day, and may have other long-term ill effects.

One of the most important of these effects is otherwise unexplained depression that lifts once the snoring and sleep apnoea are alleviated. Very occasionally lack of oxygen in the blood during a period of apnoea fails to trigger the respiratory centre and respiration is not resumed.

Furthermore, the long-term effect of repeated apnoea and resultant low levels of oxygen in the blood predisposes crescendo snorers to cardiovascular disease, including strokes and heart attacks.

Better breathing is in the didge

A CIRCULAR breathing technique required to play the didgeridoo could help asthma sufferers manage their condition, research into the health benefits of learning the instrument shows.

Boys who learned to play the didgeridoo once a week for six months showed improved peak expiratory flow and reported better overall health, a pilot study of about 30 asthma suffers from Aboriginal communities around Toowoomba in Queensland shows.

Asthma affects 14 to 16 per cent of Australian children aged up to 14. Rates of hospital admission are higher among the indigenous population and those living in more remote or socio-economically disadvantaged areas, the Australian Institute of Health and Welfare says.

Dr Robert Eley, the study's lead researcher and a senior research fellow at the Centre for Rural and Remote Area Health at the University of Southern Queensland, said the "deep and circular breathing" required to play the didgeridoo helped to increase respiratory function.

Circular breathing requires inhaling through the nose while expelling air from the mouth using the tongue and cheeks.

Girls also took part in the study, published in the Aboriginal And Islander Health Worker Journal.

However, they did singing and breathing exercises, as it is not culturally acceptable for most Aboriginal females to play the didgeridoo.

Preliminary results showed that the girls' breathing capacity also improved, but the improvement was not as significant as among the boys. This could have been because of the different breathing requirements of singing, or the fact that the girls were quite shy and reluctant to sing, even in front of their close friends, Dr Eley said.

"The boys were completely uninhibited and had no reservations about playing their didgeridoos."

Dr Eley hopes the program will be reproduced in other indigenous communities across the country once the final data has been assessed.

Singing, breathing exercises and playing wind instruments has been widely advocated for asthma management, as has swimming and other sports that improve lung capacity through controlled breathing.

Charada Thompson, a teaching assistant at the Carbal Medical Centre, who was also involved in the study, said the patients had enjoyed the group interaction of the singing and didgeridoo classes and had reported an increase in confidence as a result of their participation.

A 2004 review by the Cochrane Collaboration of breathing training to treat asthma patients showed the technique led to significant improvement in quality of life.