AS THEIR HUSBANDS STOP SNORING, WIVES REST EASIER

Scientists at the Mayo Clinic have documented what many Americans have long suspected: Women who sleep with a man who snores loudly enough to be heard in the next room lose sleep--an average of an hour of sleep per night.

The study was conducted with 10 married couples in which the husband was being evaluated for obstructive sleep apnea--a breathing disorder that occurs when the muscles in the back of the throat relax during sleep, causing the airway to close momentarily and breathing to resume with a loud snort. It found that the quality and quantity of the wives' sleep was significantly affected by snoring.

Normal, restorative sleep for the wives was impossible because of repeated awakenings, reported John Shepard, lead author of the study published yesterday in the Mayo Clinic Proceedings.

Shepard, medical director of the Mayo Clinic Sleep Disorders Center, measured the effects of apnea on both bed partners through the use of simultaneous polysomnography, a sophisticated measurement of breathing patterns, oxygen levels, and arm and leg movements as well as heart, lung and brain activity during sleep.

Midway through the night-long study, Shepard and his team had the snorers don devices that resemble an oxygen mask. The devices greatly reduced the snoring and stopped the apnea. Researchers then compared the quality and quantity of wives' sleep before and after the devices were used.

Guess what? Once the husbands wore masks that stopped their snoring and snorting, their wives slept much better.

Most people who snore do not have sleep apnea. Habitual snoring is believed to affect about 44 percent of men and 28 percent of women. Obstructive sleep apnea is a potentially serious condition that affects an estimated 4 percent of women and 9 percent of men between the ages of 30 and 60.

--Sandra G. Boodman

HIGHLIGHTS OF CENTURY INCLUDE MORTALITY DECLINE

Infant and maternal mortality rates have dropped by more than 90 percent since 1900, according to federal officials, who called this change one of the century's most significant advances in public health.

The rate of infants who die before age 1 went from 100 per 1,000 live births in 1915 to fewer than 7.2 per 1,000 in 1997. The Centers for Disease Control and Prevention (CDC) said the decline was unparalleled by other mortality reductions.

"When you look at the number of babies that have been saved during the 20th century, it's enormous," said Solomon Iyasu of the CDC's Division of Reproductive Health.

In addition, at the turn of the 20th century, more than six of every 1,000 women died of pregnancy-related complications. The rate was less than 0.1 per 1,000 in 1997.

Early efforts to combat infant mortality focused on improving living conditions in urban areas, such as establishing safe drinking water and sewage and trash disposal. Rising standards of living, educational levels and access to health care also contributed to the decline. In addition, women started having fewer children.

But there wasn't much decline in maternal mortality rates until health care providers shifted their focus from infant health problems to a more holistic approach that included the mother, Iyasu said. The death rate began decreasing during the 1930s and 1940s with the introduction of penicillin and other antibiotics, along with the availability of safer blood supplies.

--Associated Press

STUDY QUESTIONS THE VALUE OF ISOLATION IN HOSPITALS

Anti-infection policies requiring isolation of patients and wearing of gowns and gloves by hospital personnel may hinder patient care, a Duke University study suggests.

"Our study raises concerns that contact isolation may have negative consequences for patients," researchers concluded.

While the effectiveness of wearing gowns and gloves against the spread of hospital infections remains unproven, Duke researchers said, their costs are real--in dollars and lost time with patients. During the average hospital stay for a patient in isolation--46 days--health care workers use more than 2,000 disposable gowns and 4,000 disposable gloves, at a cost of more than $1,600, they estimated.

In addition, health care workers are much less likely to visit patients in isolation rooms, where they have to don gloves and gowns upon entering. "Particularly in an intensive care unit . . . less frequent hands-on contact could have a negative impact on disease outcome," researchers said.

The study was conducted in the intensive care unit at Duke University Medical Center. Researchers observed how often nurses, doctors and other health care workers entered the room, whether they had direct contact with the patient, whether they washed their hands and whether they wore a protective gown and gloves. The results were compared for patients in isolation rooms and those in regular rooms.

Kathryn B. Kirkland and Jill M. Weinstein, of Duke University Medical Center, reported their findings Saturday in a research letter to The Lancet, a British medical journal. Use of gowns and gloves "should not be accepted as a substitute for hand washing," they said.

Health care workers in the Duke study washed their hands before and after seeing a patient, as recommended, only 9 percent of the time--during one out of every 11 visits. Physicians were less likely than other health care workers to wash their hands.

Almost all the hand washing by health care workers came after they saw a patient, not before. The tendency of doctors and nurses to wash their hands only after seeing patients, Kirkland and Weinstein said, "suggests that they may perceive hand washing more as an act of personal protection than as a way to prevent spread of [hospital infections] to patients."

--Don Colburn