Apnea

Falling asleep almost killed Irving Lewis and his wife, Beatrice. While driving to visit their son on a rainy night about 10 years ago, Irving Lewis fell asleep at the wheel. The car careened off the road. The Lewises were lucky to walk away. This crash was not the only instance when falling asleep at an inappropriate time played havoc with the Lewises' lives. During the past 10 years, there have been countless other incidents that embarrassed, humiliated and endangered the couple.

"To sleep, perchance to dream . . . " to wake up screaming or gasping for air, or maybe walking into a wall. Albert Wagmen and B. Franklin Diamond have seen several variations on the sleep theme at the Sleep Disorder Center at Abington Memorial Hospital. Since the center opened four months ago, the two neurologists have been trying to help their patients unravel the mysteries of sleep and find that golden slumber so touted by Shakespeare. Recently the two doctors were trying to discover if one of their colleagues has chronic apnea, a condition in which the patient has trouble breathing when in deep sleep.

She watches through the screen door on Hoyt Terrace as friends she has made over 29 years pack up, preparing to move. Just two years ago, the Philadelphia Housing Authority moved Anna D. Powell-White and some other residents of Passyunk Homes from dilapidated units into refurbished townhouses in the South Philadelphia project. She loves the new place. It has become more than a home to her. It is, she says, the only place she can appreciate nature and talk with God. But today, Powell-White and 41 of her neighbors are angry.

Cephalon Inc. received the backing yesterday of a Food and Drug Administration advisory panel to sell its narcolepsy drug, Provigil, to treat a broader range of sleep disorders, including one suffered by night-shift workers. Eight members of the committee voted to recommend to the FDA that use of Provigil be expanded to treat fatigued shift workers and to treat obstructive sleep apnea, a condition in which nighttime sleep is interrupted by irregular breathing. The FDA, which usually follows its advisory panels' recommendations, is expected to give the West Chester biopharmaceutical company a preliminary approval letter by Oct. 20 and final approval by the end of the year.

Late-night snoring got the family down? Sew a tennis ball into the back pockets of the pajamas of your chronic snorer to force him to sleep on his side. Or, with a doctor's permission, have him take a mild over-the-counter diet pill containing a mild stimulant. Those were two of the suggestions made yesterday by medical researchers attending a meeting of the American Association for the Advancement of Science in Philadelphia. Snoring, invariably the subject of humor, complaints and ridicule, was the topic of discussion during a symposium on "Snoring and Sleepiness.

A poke in the ribs. A tennis ball sewn into a pocket on the back of the pajamas. Laser surgery. Separate bedrooms. People try almost anything to stop themselves or somebody else from snoring. In Holland, Bucks County, in March, a 15-year-old boy pummeled his foster brother with a baseball bat because the brother's snores kept him awake. A month earlier, a 30-year-old Davis, Calif., woman was fined $50 for snoring so loudly she violated the city's noise ordinance. In the snoring olympics, Robert D. Nance, of Upper Gwynedd, considered himself a gold-medal contender.

NFL great Reggie White might have died because of a respiratory disease combined with other health problems, a preliminary autopsy report said yesterday. The Mecklenburg (N.C.) County Office of the Medical Examiner said White's death likely was caused by pulmonary and cardiac sarcoidosis, a disease of inflamed cells that can occur in various organs such as lungs, kidneys or eyes. The disease likely contributed to White's fatal cardiac arrhythmia, an irregular heart rhythm, the office said in a prepared statement.

As an NFL player, Reggie White was familiar with inflammation, the pain and swelling that are the body's healing response to any injury. But a different, harmful kind of inflammation may have been the cause of the football great's death, according to a preliminary autopsy. Called sarcoidosis, it is a mysterious disease that inflames cells, triggering the formation of lumps no bigger than grains of sand. It usually develops in the lungs, where White was affected, but can occur in almost any organ.

Tonsillectomy, a once-ubiquitous operation that was later branded almost completely unnecessary, may be making a slow comeback, some doctors say. But though tonsils were taken out routinely because of infections in the preantibiotic age, most children today have the operation for a reason almost unheard of when baby boomers were babies: sleep apnea. Large tonsils and adenoids can block children's airways, leading some to stop breathing temporarily many times each night or to have difficulty eating during the day. The consequences can be serious: heart and lung problems, low weight and slow growth, frequent choking, school and behavior problems, and even orthodontic difficulties.

An inmate in the Federal Correctional Institution at Fort Dix has sued the prison, contending that its staff ignored a medical condition that causes him to snore loudly and uncontrollably, which in turn draws the ire of other inmates. George Davis, 58, who is serving a five-year sentence for possession of cocaine with intent to distribute, wrote in his lawsuit that he suffered from sleep apnea, a condition marked by irregular breathing and snorting that often halts breathing for brief periods.