On Thursday, May 12, 1999 the following Community newspapers carried this story about Sleep HealthCenters in the HealthyLiving Section.

Tired of not getting a good night's sleep?
Bedford center helps diagnose and treat clinical sleep disorders
By ROBIN ROBINSON  STAFF WRITER

David Governo just wanted a good night sleep. The Boston?based lawyer, 43, of Newton, said he was "really tired all the time," but figured it was because he worked a lot.

He talked to his doctor about his fatigue, and when the doctor found out Governo snored when he slept, he scheduled him for a sleep study.

 
STAFF PHOTOS BY TYSON TRISH

Above, David Governo is "wired" for a sleep study at the Sleep HealthCenter in Bedford. Governo suffers from a disorder called sleep apnea. Below, clinical devices keep his airways clear for a good night's sleep.

His doctor suspected Governo might suffer from sleep apnea, a disorder caused by obstructions in the airway that cut off breathing during sleep. Those obstructions also cause snoring, alerting Governo's doctor there might be a connection.

"It was a combination of being tired and the snoring," said Governo, "I don't meet all the criteria, I'm not overweight."

Other symptoms include morning headaches, difficulty concentrating, being grumpy, high blood pressure and depression.

Governo did suffer from sudden onset hypertension a few years ago, but the sleep study done at that time did not show a problem. As the condition persisted, Governo decided to try again.

After his second sleep study, which involves being hooked up by electrodes arid being watched while he spent the night in a sleep health center, he was diagnosed with sleep apnea.

The remedy for sleep apnea includes dental devices, surgery and equipment called a continuous positive airway pressure machine or C-PAP.

Governo did not want to use a C-PAP at first, so he tried every other alternative, including surgery and dental devices.

"I resisted it at first. The big thing was I tried a bunch of dental devices to change my jaw positions, because I had an obstruction at the base of my throat and I had a deviated septum fixed. I probably spent $1,500 to $2,000 because I wanted to get relief from those, but the physical anatomy of the back of my throat couldn't tolerate enough change."

So Governo tried the C-PAP and got one of his first good night's sleep in a long time. Governo said the C-PAP, which looks like a combination of an air mask and a muzzle, is not as hard to deal with as it looks.

"It takes some getting used to," he said. "But if you get a good night's sleep, it's worth It. '.

Governo said he started feeling better very soon after using the C-?PAP Other patients have seen results in just one night, according to information from the Sleep HealthCenter in Bedford.

"It does get better very quickly," he said. "Gradually, over the first week or two, I started to have more energy. "

According to sleep specialist Dr. David White, an untreated sleep apnea patient can wake up as often as 100 times a night, and not even know it. White, the director of Brigham and Women's Hospital sleep disorders program and director of Sleep HealthCenters in Newton and Bedford, said when there is a blockage of air, the person must wake up in order to open the airway again. People with sleep apnea feel exhausted because they are not getting good quality sleep.

Governo said he was waking up about 40 times a night. "I was waking up a lot but I could not tell my sleep was being disturbed," he said.

He can tell when he doesn't use the C-PAP, though.

"I'd be tired if I didn't use it," he said. "One night, it was annoying me, so I took it off, and I didn't sleep very well. I woke up and I felt terrible. "

Governo even travels with the CPAP, and said he would rather wear it every night and feel better, than to go without it.

"It's like a sleep machine for me, I put it on and just go to sleep with it," he said. According to White, some studies suggest one of the biggest risks of sleep apnea is a lowered amount of oxygen in the blood. The reduction can cause heart attacks, strokes, irregular heartbeat, impotence and high blood pressure.

On top of the physical ramifications, Governo said living with an untreated sleep disorder can he miserable, and people who suspect they may have a disorder should have a sleep study.
  
He said he had read that people with sleep apnea may be prone to more auto accidents from falling asleep and not being alert. Irritability from sleep deprivation can affect your personal life as well, he said.

"If you suspect you have a problem, do something about it," he said. "Don't ignore it, because you are just hurting yourself and your family."
 
Symptoms

Snoring, caused by vibrations in the throat when breathing during sleep, may be an indication of the serious sleeping condition, but not necessarily, according to SleepNet's Sleep Apnea website.

Primary, or normal, snoring is snoring without apnea, or cessation of breath. If a person doesn't have any other disorder symptoms, such as feeling tired after a night's rest, jerking or gasping during sleep, the likelihood of sleep apnea is low. The person may just be a snorer.

However, if a person snores loud enough to bother another person in the sane room, feels tired and groggy on waking, experiences sleepiness and fatigue during waking hours, the chances are higher that sleep apnea may occur. Other symptoms include being overweight and choking or gasping while sleeping.

The difference between snoring and apnea is in the flow of air into the throat.

When a person is awake, the muscles in the throat contract and keep the airway open. When one sleeps, the muscles relax, and if there are other factors like the airway is too small from increased weight, large tonsils, small jaw, etc., the airway may become partially obstructed, causing snoring. If the airway is really small, the blockage becomes complete, causing apnea.

"Obstructive sleep apnea is a potentially serious health risk that affects 10 million Americans," said White. "If snoring or fatigue is upsetting your life or the lives of those around you, a sleep study maybe helpful." Testing is now available through two Sleep HealthCenters affiliated with Brigham and Women's and McLean hospitals. The centers, located at 50 Tower Road, Newton and 41 North Road, Bedford, conduct studies on about four patients a night, up to seven nights a week. There is some daytime testing as well.

The Bedford Center, located in a business park near the intersection of routes 4 and 225, begins accepting patients around 9:30 p.m. The patients, pajamas in hand, are buzzed in by a sleep technician and shown to their private rooms. The sleep study rooms look more like hotel rooms than hospital rooms, and the patient relaxes by reading or watching TV, or a video on sleep apnea, while the sleep technicians prepare for the study.

The patients are wired with electrodes to the head, face and ankles that connect to a portable box. Patients are also fitted with straps that monitor breathing and a microphone that monitors snoring.

After the "wire-up," the patient returns to the room to wait until the final hook-up to the video and computer monitors.

After the night's rest, the results of the six-to-seven hour study are then tabulated and sent to the doctor. The technicians wake up the patient between 6 and 7 a.m. to unhook them from the tests and let them shower and go home.

"People worry about not being able to sleep during their sleep test." said sleep technician Elise Franko at the Bedford location. "But most people don't have a problem."

According to Governo, that first night of testing is a necessary step to a lifetime of good sleep.