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by Abigail Van Buren

Deadly Sleep Disorder Is Simple to Spot and Treat

DEAR ABBY: I am a physician who specializes in patients with sleep disorders. The dramatic letter you printed concerning a 32-year-old man who died in his sleep of morbid obesity should be very interesting to all of us.

The death, of course, is tragic. Your readers should know that even in the absence of weight loss, this death might have been avoided, or at least postponed. People with obesity die in their sleep because of a condition called "obstructive sleep apnea." This disorder causes asphyxiation because the airway is unstable and collapses during sleep, producing a drop in the oxygen level.

The symptoms of sleep apnea are easily recognized even by a layperson. Patients with this disorder snore loudly, appear to hold their breath during sleep, and awaken repeatedly through the night with gasps and snorts, which indicate a blockage of the airway.

Sleep apnea is easily treated with a mechanical device called "nasal continuous positive airway pressure." This treatment can be instituted even in the absence of weight loss and produces a significant improvement in the individual's well-being.

I hope that your readers will understand that obesity itself does not kill during sleep. It is sleep apnea that produces this terrible outcome. -- NEIL FELDMAN, M.D., ST. PETERSBURG (FLA.) SLEEP DISORDERS CENTER

DEAR DR. FELDMAN: I think you have stated it very clearly. If my readers learn something they did not know from your letter, they will not be alone -- I learn every day from the people who write to me. Thank you for an important letter.

DEAR ABBY: I read your quotes from the courts of law a few days ago and got a big laugh from them. But did you know that actions can speak louder than words, even in a courtroom?

My grandfather, John M. Killits, was a district federal court judge in the 1930s, and a local judge before that. In one of his cases an injured man was suing someone for his injuries, and the defending lawyer became suspicious about the case. He appeared very friendly and sympathetic.

First he said: "I see that one of your serious injuries was damage to your left arm. Is that right? How high can you raise it?" The man grunted and groaned and managed to raise his arm about a foot.

The lawyer clucked sympathetically, "My goodness, that IS terrible. How high could you raise it before it was injured?"

"Oh, about like this," the man replied, and he lifted the arm high above his head.

Needless to say, the whole courtroom burst out laughing and Grandpa threw the case out of the court. -- RICHARD N. GARDNER, HUNTINGTON BEACH, CALIF.

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