One man’s quest for better sleep

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Continuous Positive Airway Pressure, known as ‘CPAP’ machines, are cumbersome devices.

By Gordon Allison, Jr. | Technical Engineer

Editor’s note: Mr. Allison is a regular contributor to this newspaper. Many readers may remember his fascinating multi-installment series on the mystery surrounding the disappearance of pilot Amelia Earhart. Here, he offers first hand experience that whatever a doctor initially recommends is not always to the best option.

DENVER, COLORADO – We lived outside of Denver  (the “mile-high city”) when I had my first cancer surgery. While recuperating I slept in a recliner to avoid post-surgical pain. I noticed I kept waking up – apparently from NOT BREATHING!

My wife Patty was also concerned about my heavy snoring. A referral from my doctor for a sleep study launched me on my journey with oxygen. National Jewish Hospital in Denver has a reputation for handling all things regarding breathing, lungs, and diseases of the lungs so it was THE place to have my sleep study performed.


The appointment was made and I was called with my arrival time for the preparation –  based on my normal midnight bedtime. I am definitely a “night owl.”

The sleep study indicated I had a rather bad case of sleep apnea. There were periods of time during the night when I went for several minutes without breathing! My oxygen saturation level dropped as low as 78 percent.  Normal oxygen saturation levels vary from around 94 percent to 98 percent. Most doctors use a pulse oximeter as part of your check-in process (along with blood pressure) to get your vitals. The way the body responds to the deadly problem of low oxygen saturation is to have the heart increase its beating rate in an attempt to get more oxygen to the tissues.

This fit my case perfectly. My heart rate rose from 56 beats per minute (Bpm) to 143 Bpm.  his may give you a clue as to why many people die in their sleep!  In Colorado, some 10 years before we moved to North Carolina, my oxygen saturation varied between 89 percent to 93 percent.  Medicare parameters state that a saturation level of 88 percent or lower is cause for use of oxygen.

During the sleep study, I was wakened and fitted for a CPAP (Continuous Positive Airway Pressure) machine.  The first device they used on me was a small “mask” that only covered my nose.  I felt like I was drowning!  Then they tried various full face masks until there was one that fit properly. The next morning, I sprang out of bed – raring to go! That was the first time in my memory that I awoke in the morning and felt great. The feeling lasted about three days.

I was not keen to get a CPAP machine.  About a half of my friends in Colorado used CPAPs and around a half of those also had a unit called ‘constant flow oxygen concentrator’ feeding into the CPAP.  I got to thinking that if the CPAP required supplemental oxygen for half the people with sleep apnea in Colorado then why not cut out the “middle man” and go with just oxygen instead of the CPAP?  I went in to discuss the results of the sleep study and learned my primary care doctor couldn’t answer the 20-plus questions I had after reading the study report.  He suggested that I call the doctor at National Jewish and make an appointment to have him answer my questions.  The doctor at National Jewish said: “I can’t speak with you since you didn’t contract for the study!!!!”  A call to my doctor and his subsequent call to National Jewish resulted in an appointment for me to speak to the National Jewish doctor – one on one –  for a solid hour.

I returned to my own physician and asked him if he would allow me to do a home study with a recording pulse oximeter and an oxygen concentrator.  He said he would be tempted to let me do the study except for the fact that I am a mouth breather.  I countered that the oxygen flow would create a “bubble” of enriched air over my face and when I breathed in that air, it could enter my lungs via the mouth or my nose.  He acquiesced and the equipment was delivered to my home.

On the first night I used the recording pulse ox, but no supplemental oxygen. The study report showed many apnea events, some lasting several minutes and my oxygen saturation dropped to 78 percent – the exact same number as National Jewish recorded.  My best oxygen level was 89 percent — again, the same as the sleep study recorded. My heart rate hit 142 Bpm – the same number as National Jewish recorded within instrumentation error.

The next night, I used the recording pulse ox, but I also had oxygen piped to my nose with a nasal cannula.  Apnea events were considerably fewer and they lasted for much shorter times. My oxygen concentration was in the 92 percent to 96 percent range.  Needless to say, my doctor was very pleased!  Several years later he referred me to a sleep apnea specialist who treated sleep apnea with oxygen. That specialist’s treatment philosophy mirrored mine.

Why was I interested in using strictly oxygen instead of a CPAP?  Let me enumerate some of the most important reasons:

1) The pressure in the CPAP mask would leak out as I rolled over in bed and the air blew into my eyes, waking me up.

2) Use of the CPAP didn’t help my sleep apnea so I used the oxygen concentrator as a supplement for the CPAP in order to achieve medical efficacy – a tedious situation.

3) We sailed on Lake Granby, about 100 miles west of Denver with an elevation at some 8,000 feet above mean sea level. Unfortunately, the sailboat battery was not sufficient to run the CPAP for eight hours per night.

A so-called “E-cylinder” of oxygen is about 5 inches in diameter and around 30 inches high. Using two liters of oxygen per minute and a demand regulator, I could get 16 hours of use from one tank/cylinder with no battery or electricity required.

(4) When we traveled, I could pre-arrange to have oxygen cylinders delivered to the hotel so that with my demand regulator, I was set for sleeping.  Also I didn’t have to use valuable space in the suitcase for the CPAP machine and all its accessories.

Next week, in Part Two of this series, we’ll discuss use of oxygen concentrators, my first-hand experience with them, and airline requirements for bringing your oxygen concentrator on-board.