xt72z31nkh91 https://exploreuk.uky.edu/dips/xt72z31nkh91/data/mets.xml University of Kentucky. Office of the Vice President for Research and Graduate Studies Kentucky University of Kentucky. Office of the Vice President for Research and Graduate Studies 1990 volumes. Call Number: LD2762.9 .K38c. Accession Number: 2018ua049 journals LD2762.9 .K38c English Office of the Vice President for Research and Graduate Studies Contact the Special Collections Research Center for information regarding rights and use of this collection University of Kentucky Odyssey Magazine Research -- Kentucky -- Periodicals Education -- Research -- Periodicals Research -- Kentucky Odyssey: The Magazine of University of Kentucky Research, Winter/Spring 1990 text images Odyssey: The Magazine of University of Kentucky Research, Winter/Spring 1990 1990 1990 2026 true xt72z31nkh91 section xt72z31nkh91

/l;/

TURNING COAL INTO OIL:
LIQUID ASSETS
FOR KENTUCKY’S FUTURE

ODYSSEY

his issue of ODYSSEY is dedi—

cated to Wimberly C. Royster,
retiring vice president for Research
and Graduate Studies at the Univer—
sity of Kentucky.

Dr. Royster is a mathematician by
trainingand has always viewed him—
selfas a math faculty member tempo—
rarily assigned to other activities.
Those "temporary ” assignments have
lasted 27 years and have included
such positions as chair of the Depart—
ment of Mathematics, dean of the
College ofArts and Sciences, dean of
the Graduate School and vice president for Research and Graduate Studies.

The career ofRoyster and the emergence of the University of Kentucky as one ofthe
top 45 public research universities in the nation occupy the same space in time. In about
a 12—month period in the mid—[940$ Royster arrived on campus as a new graduate
student, the Kentucky Research Foundation (hzter the University of Ken tucky Research
Foundation) was established, and the Keenehznd Foundation gave UK what was most
likely its ﬁrst electron microscope. In a similar 12—month period some 40 years later,
UK received almost $60 million in external grants and contracts through UKRH the
university negotiated the simultaneous purchase of nine electron microscopes, and
Royster was named the university’s ﬁrst vice president for Research and Graduate
Studies.

Historians have long debated whether “individuals create events ” or “events make
individuals.” In the case of W/imberly Royster and the emergence of research and
graduate education at the University of Kentucky, the two are inextricably inter—
twined. It is with recognition and appreciation of his distinguished career at the

University of Kentucky that we dedicate this issue of ODYSSEY to Dr. Royster.

he Iy'nit'ersityo/Keiitucky, theconv
monwea/ths graduate education
and research institution, exists to provide
opportutitties/or the education. personal
growth and develo/mtent (t/‘I‘tlllil’i/lIt/Ih‘

and to contribute to the improvement of

society.

With this mission as its premise, one
goal o/‘the university is to conduct pro
grams ofbasu'andtipp/iedresearch which
support graduate and /n‘ofe.~'stonal edw

cation, provide/or the advancement of

knowledge. and seek solutions for the
acute problems o/society.

Ihe university s research mission also
acts as a magnet/or.tttracting top gradw
ate students who u rant to participate in
nationally competitive research projects.
This research e.\perience can offer them a
significant advantage in their education
while laying the foundation for ﬁat/re
research and development. ()IJYSSIf),
through articles about various research
pro/'ects and graduate education prrr
grams. reflects the breadth ofthe univer»
sity s searchfor new knowledge and the
myriad o/research endeavors underway
The progress that the university has made
toward achieving its research mission
and securing the extramuralfunds re»
quired to support these types of endeavors
would have been impossible without the
talents and dedication ofour researchers.

The goal of( )I ) YSSIS Y is to offer the

reader the opportunity to share in some of

the excitement, curiosity and creativity
evident in the research underway at the
University oflx'entucky.

u» v

(/3

.1»- ..
L/‘l.
1/ ’

ODYS 8 BY

Volume VII], No. 1

CONTENTS

Turning Coal into Oil: Liquid Assets for Kentucky’s Future 2

No More Restless Nights:
UK Researchers Combating the Dangers of Sleep Apnea 6

Making Babies:
Would—Be Parents Aided by New Medical Techniques 11

Moving Mountains:
The Star Fire Project in Eastern Kentucky 16

Rock Fences of the Bluegrass 18

The Cross-Fertilization of Knowledge:
UK‘s University Studies Program 25

Research Briefs 28

Research Results:
Research Briefs, [2. 28 Data Bank Accruing Worldwide Interest 56

Linis'ersf'z‘y ﬁtchivex

Magnet

yam”,

Lat-‘1: {sir “'L "‘,

OD YSSEYis published by the Office orthe Vice President for Research and Graduate Studies. Each issue or ()D YSSEY
describes only a few ofthe many University of Kentucky research projects underway in a variety of areas.

Requests For permission to reprint material and readers‘ comments regarding OD YSSEYare welcome and should be
sent to the Editor, Research Communications, University ot‘Kentucky, Lexington 40506-0037 (phone (706/237-8297).

The publication of OD YSSEYis not financed by state—appropriated funds.

Editor: Susan H. Hodgerts. Asst. Editor: jeff‘Worley. Designer: Shear & Shear. Publications Asst.: Sharon 1. Turner.
Graduate Asst.: Melinda Higgins. Contributing Writers: Elizabeth Hansen, 1.eigh Gaines, Claudia Haller. Printing:
Merrick Printing. Inc.

Credits: photos on cover and pp. 6, 1 1, 12, and 15 by Lee Thomas; photo on inside cover by Tim \X'alden; photos on
pp. 3, 4, 5, 7, 8, 9, 13, 14. 17, 18, 19, 25, 27, 50, 34, and 36 by Ken Goad; photo on p. 26 by Bill \Wells; photo on pp.2(),
22 and back cover by James Rebmann; photo on p. 2‘) courtesy oprpalshop.

Issued-1 _ra.°7'(§n.c/i 37?:

by jg]? Worley

It's not quite the trans

mutational miracle?

changing metal to
gold—that the alchemists
in the Middle .Ages had in
mind. but it may prove to
be the scientific break—
through that keeps the
21st century in motion.

\V'iththenevvmillenium
will come the reality that
the world‘s natural oil
supplies will gradually
d\vindle. But modern
researchers in liquefacti( >n
science are preparing for
that eventuality At the
l'niversity of Kentucky.
researchers are novv at
work to discover ways to
change coal into liquid
fuels.

"\V'e've been doing this
vvork for four years novv
as part ofa five—university
consortium." says Gerald
Huffman. director of the
Consortium for Fossil Fuel
Liquefaction Science
(CFELS) and a professor
of chemical engineering
at ['K. Other members of
the CEELS group are
Auburn ['niversity. the
[‘niversity of Pittsburgh.
the I‘niversity of l‘tah. and \V'est Virginia ['niversity. Also
included is the ['K Center for Applied Energy Research.

The idea for the consortium came from Lyle Sendlein.
currently the director ofI‘K‘s Institute for Mining & Minerals
Research. "l was interested in doing something to increase
the research activity in the coal liquefaction area." says
Sendlein. also a professor ofgeological science. “and in the
early ’80s the federal government iust \vasnt sponsoring
anything new—the Department of Energy budget for
synthetic fuels work had plummeted." So Sendlein began
talking with DoE Energy officials. who were very encour—
aging. He then went to \V'ashington. Where he met with
Senator \V'. I), IIuddleston. \vho convinced the Senate
Appropriations Committee to initiate the funding for liquid

ODYSSEY 2

Liquid Assets for

Kentucky’s Future

fuel research. “This was

TURNING in 1983." Sendlein ref

calls. I contacted sev

eral universities then
where I knew other

scientists who were
interested in liquefac-
tion. The consortium
was formed. and with
the S1 million appror
priatit )n we were offand
running."

The term "liquelao
tion." Huffman explains.
means changing a sub—
stance to a liquid form.
In the direct liquefacr
tion process. coal is
finely ground. mixed
with a solvent and
hydrogen. and then
heated under pressure
in hydrogen in metal
vats to a high temperw
ture. The hydrogen is
assimilated into the
molecular structure of
the coal. producing a
product that can be
upgraded for use as a

liquid fuel.

Largerscale coal con—
\ ersion into liquid fuels
is not a nevv idea. (ierr
many used coalrderiv ed
liquid fuels regularly
during \V‘orld \V'ar ll.
\\"hen cut off from petroleum supplies by the surrounding
Allied forces. the Germans used coal liquids exclusively
during the closing months of the \var. l’resentrday South
Africa has an extensive coalrto-liquid fuel conversion
industry.

"Though both ofthese processes are different from the
conversion techniques we are novv exploring.” Huffman
says. “they proved that coal liquefaction is a viable
technology when political and economic conditions
warrant it." Long—term commercial development ofthese
fuels will depend on the price of petroleum. Huffman
predicted. “\V'hen the price of crude reaches 55% to Sit)
a barrel. you will see competitive coal—derived liquid fuels
entering the market, I wouldn't be surprised to see this

happen by the year 2010 as petroleum prices
rise and our conyersion technologies im—
proye."

;\t the I'niyersity of Kentucky. Huffman.
\aresh Shah. assistant professor of chemical
engineering. and Frank Huggins. professor of
geological sciences. haye been focusing their
efforts on the role of catalysts. materials that
accelerate chemical reactions. in the liquefac—
tion process. He explains that because the
molecules that make up coal are cross—linked.
it is necessary to break these links or bonds for
the process to work. A catalyst added to the
mixture can help to break these bonds. Re—
cently. the researchers haye been experiment—
ing with iron—based catalysts.

"The reaction between hydrogen and coal
happens because hydrogen reacts with the
iron catalyst and is transferred to the bond you
want to break." Huffman says. “\V’e‘re explor‘
ing all sorts of ways of adding the iron, The
finer the catalyst is. the greater its surface area.
ofcourse. which makes for a greater reaction."

C‘ When the price of

crude reaches $35 to $40 a
barrel, you will see competitive
coal-derived liquid fuels

entering the market. ’ ’

Huffman mentions that at the L'niyersity of
Pittsburgh. Trying \V'ender has been working
with liquid compounds called iron carbonyl
catalysts. \Vhen added to the system. they
produce a highly dispersed catalytic reaction,
"\V'ender's results so far." Huffman says. “look
to be may promising."

Huffman says that iron may be the ultimate
catalyst because it is relatively inexpensiye.
"You‘re dealing with large quantities of coal.
so you need something cheap enough that

you can essentially throw it away. If you're
using nickel or cobalt or molybdenum. some
other popular catalysts. you cant just throw
them away with the solid residue from the
reactionvyou haye to recoyer them."

Although none ofthe liquefaction processes
is now economically feasible. Huffman be-
lieyes that eyentually it will be. "The latest
estimates I'ye seen indicate that with current
technology you can conyert and produce a
barrel of oil from coal for about 538. On the
world market right now. oil is going for about
$1118 a barrel. The objectiye of course is to
keep pushing the liquefaction cost down
while the price of oil keeps going up."
Huffman's best guess is that "in perhaps 30 to
"0 years" it will be economically feasible to
sell huge amounts of liquified coal."

Huffman is anything but reticent when he
talks about the research capabilities of the
consortium, "I think we have the best basic
coal research group in the country." he says.
“\V'e haye outstanding scientists at all fiye
uniyersitites. and it‘s a Very integrated pro—
gram," The consortium members are currently
working in four principal research areas re
lated to liquefaction and each member is
supplying data for different phases of the
research. "This way the works not dupli—
cated." Huffman says.

In the fiye uniyersitites about 30 faculty and
an equal number of graduate students and
post—doctoral students participate in the pro
gram. "\V'ithin the fiye uniyersities we haye
just about eyer sort of capability you could
think ofin coal science." Huffman says, “There
isn‘t anything one could think of to do in coal
liquefaction that we couldnt do somewhere
in the consortium."

In addition to experiments with ironibased
catalysts. a Variety of other types of catalysts
are being used throughout the consortium.
"One that looks pretty promising at the ini—
yeisity of Pittsburgh.” Huffman says. "is gals
lium. a metal that becomes a liquid at coal
liquefaction temperatures" MOO—300 C). Be—
cause the metal is a liquid at these tempera
tures. it is highly dispersed and coats all the

t (III/[HUM] (HI page *I

Gerald Huﬁmm

5 ()l)\ SSliY

Lyle Sendlein

ODYSSEY 4

“ The objective of course is to

keep pushing the liquefaction cost down
while the price of oil keeps going up.

iron particles. Cobalt and nickel are being
used by other research teams in the consor>
tium, and at Auburn University Christine Curtis
and her colleagues have made advances in the
use ofmolylxlenum, a metal traditionally trsed
to strengthen and harden steel. as a catalyst in
the liquefaction process.

Huffman refers to the third area as “novel
liquefaction methods." "These vary signifi—
cantly from the traditional liquefaction ap—
proach and are being carried out at all five

universities." he explains. At the I‘niversity of

Kentucky. chemical engineers Dibakar Bhati
tacharyya and Richard Kermode are collabo-
rating with biologist Hussain Aleem to study
the biological process of converting coal into
liquids. Their efforts are focused on trying to
identify bacteria or microbes that at room
temperature will attack the coal structure and
break its molecular bonds. “The result."

Huffman says. "might not be a liquid itselfbut
would be a derivative that might be more
easily liquefied. a pretreatment of sorts."

A fourth area of research in the consortium
focuses on understanding the basic structure
of coal and relating this structure to the
liquefaction process. Different types of coals
have different types of structures. so they may
behave differently when being processed.
Iqufman cites as an example the difference in
structure between the “lignites.” also called
“brown coals." which are found in the western
I'nited States. and bituminous coal. softer
coal, mined in the east. "In breaking these
coals down. we need to know. for example.
how porous they are and what their molecular
structure is. Maybe iron will be a better
catalyst. or maybe something like molybde—
num will be." he adds.

In the area ofbasic coal structure characteri—

AVERAGE ANNUAL WELLHEAD PRICE OF UNITED STATES CRUDE OIL

IN CURRENT AND CONSTANT 1967 DOLLARS
(US. DOLLARS PER U.S. BARREL OF 42 GALLONS)

II Illl Illl Illl llll

Source:

(irrrrcnr Dollars I’rrtcil \ l'ncrgw Information \Lllllllll\ll.llillll
I’rodtrcer I‘rrtc lndc\rl \ llrrrtxrtr of labor \ratrsrrts

constant Dollar l’r‘rtc computed In \rrrcirran l’etrolctarr Irrsrrlrrtc

ration. Huffman says. researchers Ronald
I’ugmire and Henk :\Ieurelaar at the l'niyer»
sity of I 'tah haye made tremendous adyances.
"I think they have some of the best structural
characterization capabilities in the world. and
they‘ye made significant progress in under—
standing the basic molecular structure of coal
and the liquids produced from coal.” At IVK.
Rumble Subbaswamy. professor of physics.
has been successful in deyeloping quantum
mechanical models of coal‘s‘ molecular struc—
ture. His models. cleyeloped on the 1K super-
computer. are being used to interpret data
obtained at the I'niyersity of [itah and elsei
where in the consortium,

Another goal of the consortium is to collect
this structural information and create a data
bank. At I'Ix' Erank Huggins is in charge ofthis
particular operation, "Slowly but surely."
Huffman says. "we‘ye created a pretty solid
data base.

"()ne of the most exciting things for me is
just seeing this program come together as it
has." Huffman says. "seeing top scientists and
professors from fiye uniyersities working

‘C There isn’t anything

one could think of to do in coal
liquefaction that we couldn’t

do somewhere in
the consortium.

together on the same problems." The the
uniyersity coal consortium. he belieyes. is the
first of its kind. “It‘s \‘ery fulfilling." adds
Sendlein. who has seen his idea blossom. “I
feel yeiy good about it."

Last fall the 128. Department of Energy
entered into a $2.8 million agreement for
continuation of the coal liquefaction research
program. The consortium members receiyed
$1.4 million. which was matched by the fiye

member uniyersities. In 1991). I)oE requested
that the consortium prepare a threcuyear
proposal. a "sole—source solicitation” by the
agency. “\V'hat DoE is saying. basically. is that
this is the only group in the country they‘ll
fund to carry out this research." Huffman
explains. "It's a nice bit of recognition."

In April of 1990. the I’)epartment of Energy
awarded the consortium a $1.48 million grant
to continue liquefaction research The one
year grant. part of a new three~year agreement
between the consortium and the DoE to spend
$9 million on coal liquefaction. began .\Iay 1.
The new agreement augments the federal
funds already granted to 1K and the other
consortium members,

In addition to this funding. the consortium
is attracting a reasonable amount of interest
from industry, "\V'e haye a lot of industrial
representation at our meetings." Huffman says.
Most of the major oil ct)mpanies—Am<)co.
Exxon. Ashland. and others—haye sent repre~
sentatiyes to all the consortium meetings, The
Electric Power Research Institute and Amoco
haye contributed funds to the program. money
which Huffman says will be used to support
trayel by faculty and graduate students—
"things that aren‘t coyered in the I’)oE contract.

"By the end of this three-year program."
Huffman says. "I‘m hopeful we will haye
reached some conclusions on the best way to
turn coal into oil." 0

David Lazar, senior editor/technical writer for
IMMR, contributed to this article.

students
Sudipa Mitra, M.
Me/Jdi Tagbiei and
Anup Ska/J are working
wit/9 UK geologistFran/e
Huggins to catalogue
data resulting from
[iqueﬁlction experiments
at the University of
Kentucky. Tag/Jiei is
from Iran; Mitra and
Shah areﬁom India.

Graduate

3 ODYSSEY

No More
Restless Nights:

UK Researchers

Combating
the Dangers
of Sleep Apnea

by Elizabeth Hansen

rank Anderson snored so loudly his

family couldn‘t sleep. As he slept.

Anderson. who was in his early -’i()s and
weighed more than 500 pounds. sometimes
stopped breathing. After se\ eral seconds. the
lack of oxygen aroused Anderson enough so
that he began breathing again. l ie drifted back
to sleep only to begin the cycle again. His
restless nights left Anderson. who was also
hypertensive. so sleepy in the daytime that he
worried about driving.

Sleep apnea is a pause in breathing that
occurs during sleep. The cause ofthis disease.
its effects. and lt()\\' it is treated are the subjects
of several past and ongoing research projects
at the l‘niversity of Kentucky.

Frank Anderson is typical of persons who
deyelr >p obstructive sleep apn *a syndrome. a
condition that most often affects overweight.
middleatged males who snore. Excessive tis—
sue or some other physical abnormality blocks
or obstructs the airway. This structural abnor—
mality, coupled with an impaired drive to
breathe. causes apnea. About four years ago
Anderson lost 36 pounds but quickly gained
the weight back and more. "That's when I
started snoring." says Anderson. a photogra—
pher for the l.e.\‘1'ng1‘tm Herr[Id—leader.

"I didn't use to snore. My wife started
complaining that I was snoring a Whole lot
more and it was becoming very loud. very
disruptive. I didn‘t believe her. She taped the

ODYSSEY ()

one night and she played it back to me and I
said. '\\"ell. you ought to take me out and
shoot me.“ Anderson recalls. The noise kept
both his wife and children awake at night.
"Then my wife said one night I woke her up

because I jttst quit breathing. That sort of

alarmed me and alarmed her."

Anderson also noticed that in the afternoons
he became so sleepy "I just hardly could hold
my head up." His drowsiness made him afraid
to drive. He also deyeloped high blood pres-
sttre for the first time in his life.

Then one day Anderson heard a radio
program about obstructive sleep apnea syn-
drome. The symptoms described matched his.
so he called the l‘niyersity of Kentucky Sleep
Disorders (Ilinic for help. lie was eyaluated in
the sleep lab in the summer of 1988 and
became part of a research project conducted

by Barbara A. Phillips. associate professor of

medicine. that compared two treatments for
the syndrome.

like all adults participating in apnea re—
search projects. Anderson first underwent a
nighttime sleep study. He arrived at ['K‘s
(Ihandler Medical (Ienter about 9 pm, and got
ready for bed. The laboratory is two small
rooms. one furnished with a hospital bed.
television. lamp. a small oriental rug and
tables holding medical equipment, An orien—
tal screen hides boxes stored along one wall.
A teleyision camera suspended from the ceil—
ing focuses on the bed and sends images to a
\"ide< )tape recorder in an adjacent room where
a technician monitors the test subject all night.

Fight to 1() sensors were pasted to Ander—
son‘s scalp to measure brainwayes. The wires
\\ ere laced behind his head into a wire pony—
tail and then connected to a machine. ()ther
sensors were placed near his eyes to measure
eye movement and still others measured muscle
actiyity. A probe he wore near his nose and
mouth measured breathing and a clip on an
earlobe measured oxygen saturation in the
blood. ()ther sensors monitored heart rate and
effort to breathe. All of the wires were con
nected to a machine that recorded the reade
ings on paper all night. After almost two hours
of preparation (none of which is painful or

t onlimrez/ on page 8

‘ ‘ My wife started
complaining that I

was snoring a whole lot more
and it was becoming very

loud, very disruptive. I didn’t

believe her. ’ ’

Barbara Phillips helps Fran/e Anderson adjust the
mas/e of a nasal CPAP anit. Aﬁer sleeping most
nightsfor almost two years with a face mas/e hoo/eea'
to the machine, he says he no longer gets tirea' during

the day.

_ ODYSSEY

Ir! 1

Barbara Phillips

ODYSSEY 8

—

Apnea in middle—aged people is
considered to be signiﬁcant if
there are more than ﬁve episodes
per sleep hour.

ha'/.ardous). Anderson was ready to go to
sleep.

A full day of testing followed the sleep test.
including a physical exam. a medical history.
questionnaires about health. psychological
and cognitiye abilities tests. pulmonary funce
tion tests. motorskills tests and “multiple sleep
latency testing." The latter measures how
sleepy people are during the daytime by
haying them lie down for 2()»minute naps four
times during the day and measuring how
quickly they fall asleep. according to l)a\‘id
Berry. an assistant professor of psychology
who studies sleep apnea. Those who score
below a certain thresholdrwho fall asleep
quickly——are considered to be "pathologically
sleepy." Subjects also rate how sleepy they
feel and describe their sleep habits,

Those tests found that Anderson did indeed
suffer from obstructiye sleep apnea syndrt >me.

Apnea in middlealged people is considered
to be significant if there are more than fiye
episodes per sleep hour. according to ertte
R. Cook. assistant professor of neurology.
who collaborates with Berry and Phillips on
sleep apnea research.

According to Berry. automatic detection
devices in the body monitor blood oxygen
leyels. When an apnea occurs and the oxygen
saturation in the bloodstream falls below a set
point. the person wakes up or is aroused to a
lighter leyel of sleep and starts breathing
again. Carbon dioxide detectors monitora rise
in carbon dioxide and those. too. can stimuA
late the person to wake tip and start breathing
again.

People with sleep apnea syndrome haye
multiple espisodes each night. “l‘m talking
about hundreds of apneas in the worst cases."
Berry says. Apneas last from It) seconds to as
long as two minutes. and repeated episodes
throughout the night “can be yeiy destructiye
of the night's sleep." Berry says.

Like Anderson. most people who suffer
from sleep apnea haye hypersomnt)lence. or
excessiye sleepiness. during the day. HyperA
somnolence leads to what Phillips terms the
most dangerous effect of untreated sleep
apnea: car wrecks. Sufferers haye three times

as many car wrecks as people who don't haye
apnea. she says.

()ther effects of obstructiye sleep apnea in
middle-aged people. according to Berry. Phil—
lips and Cook. include cardiac arrhythmias.
hypertension. depression. impaired intelleo
tual ability such as reduced attention spans
and difficulty in concentrating. irritability. and
poor job performance because of drow siness.
Researchers don't know whether impaired
intellectual ability in persons with seyere
obstructiye sleep apnea is due to the excessiye
daytime sleepiness or from damage done by
reduced oxygen leyels in the brain with each
episode.

A multidisciplinary approach is used in
treating obstructiye sleep apnea. "There is no
one treatment that all patients like and benefit
from. so therapy has to be indiyidualixed.”
Phillips says. "In l‘)‘)() the first line oftreatment
is nasal (IPAP ((Iontinuous Positiye Airway
Pressure) and lifestyle changes." ()ther treat—
ments include medication. surgery and use of
a stillsexperimental intraoral deyice.

Anderson became part ofa research study to
compare the effectiyeness of nasal (PAP and
oxygen in treating apnea. \asal (IPAP "w orks
by forcing air in through the nostrils and
keeping the back of the throat open." Phillips
explains. It effectiyely eliminates snoring and
apnea.

But the patient must wear a mask oyer his
nose while he sleeps. The mask is attached by
hoses to a machine about the size of a small
stereo speaker. "It is cumbersome. it is not
sexy and it makes noise (about as much as a
room air conditioner). But some patients with
seyere obstructiye sleep apnea think it‘s
wonderful because it does allow them It > sleep
restfully and peacefully for the first time in a
long time." Phillips says.

The treatment is effectiye and has no signifk
cant side effects. but M) to pt) percent of
patients won't Lise nasal CPAP on a longeterm

tollffllllt’tf on page III

: Not “Sleeping Like a Baby”

“Rebecca” was born too soon. B< >rn
5.’ weeks after conception. she was
taken to the \'e<>n;ttal Intensive (Zare
l'nit (\l(3[') in the (Ihandler Medical
Center. One of Rebecca's problems
was apnea of prematurity: during a
2 i-h< >ur peri< )d. she wouch quit breath—
ing 30 to it) times.

The younger the gestational age of

the newborn the more likely a baby
is to have apnea of prematurity. In—
fants born 20 to 3“ weeks after con-
ception (compared to the usual gesr
tation period of it) weeks) have only
a 5‘0 percent survival rate overall and
almost too percent of those who do
survi\ e have the disorder. according
to \irmala l)esai. a neonatalogist who
treats the babies in the \l()[‘. In
contrast. few babies born after 330
weeks develop apnea of prematurity.
(Apnea may also occur in premature
and fullrterm babies who have chronic
lung disease and disorders of the
central ner\ ous system.)

;\s with adults. apnea in preterm
babies occurs during sleep. but the
babies rarely snore. [f the baby is
aroused. the apnea goes away, The
disorder can be lifeAthreatening if it
goes on long enough. but the infants
susceptible to it are Usually closely
monitored in a neonatal intensive
care unit so “it rarely leads to any
terminal event." says Robin (iilmore.
associate professor of neurology and
apnea researcher at l'lx'.

Some preterm infants may have as
few as two to four apnea incidents in
a 31—hour period while others may
have tens to hundreds of episodes.
Repeated episodes can cause recui>
rent hypoxia (lack of oxygen) of the
brainstem. "()ne of the effects of
hypoxia in the newborn is to produce

Nirm/zlzz Des/1i

apnea. so it is a vicious cycle." (iilmore
says. (in contrast. in an adult lack of
oxygen due to apnea stimulates the
person to start breathing again.) The
baby‘s heart rate also slows down

If an infant is haying only a few
apnea incidents. an effective treat—
ment may he touching the baby to
stimulate breathing. \X'hen the baby
stops breathing in the VILII '. monitors
alert nurses who touch the baby to
arouse it. If the baby‘s breathing is
obstructed. a nurse may reposition
the baby to relieve pressure on the
trachea. which. because of the long
necks infants have. is easily folded.
l)esai says. If incidents are more fre—
quent. the baby may be placed on an
apnea mattress. a tiny t )scillating water
bed. The movement stimulates the
peripheral nerves. which send signals
along the same pathways to the brain
as those used in breathing.

Babies may be giyen oxygen but
the most frequent treatment. accord—
ing to l)esai. is a respiratory stimulant

such as theophylline or caffeine.
Caffeine is the more effective drug.
but because theophylline dosages can
be more easily regulated. that drug is
used most frequently at (K. \asal
(.Il’Al’ is occasionally used. if none of
these measures works. the baby may
be placed on a Ventilator to help it
breathe.

"The majority of babies outgrow
apnea ofprematurity by the time they
are ready to go home." l)esai says.
That's usually between $8 and to
weeks of gestational age. \V'hen a
baby reaches a weight of about four
pounds and a gestational age ofﬁS—ﬁb
weeks. ,\'I(Il' staff begin to make
plans for the baby to go home. At this
time. if the baby has no apneas for
five or six days while still being given
a respiratory stimulant drug. the drug
is stopped and the baby is monitored
for three or four days. If no apneas
occur. the baby is then sent home
without a monitor to signal ifthe baby
stops breathing. lfthe apneas re< >ccur
once the drug is stopped in the hos—
pital. the drug therapy is started again
and the baby is sent home with an
electronic monitor.

"Certain babies definitely need to
be monitored. but I. for one. do not
advocate the routine monitoring t >fall
babies (at hoinel." l)esai says. In
198‘). ()8 of the "()0 babies treated in
the neonatal intensive care unit were
sent home on monitors. l)esai be-
lieves the number will be lower in
1990. O

‘1 ()l )\ S\lf\

ODYSSEY 1t)

basis. according to Phillips. That‘s one reason
Phillips compared the effectiyeness of (PAP
and nasal oxygen in a study supported by the
Sanders—Brown (Ienter on Aging. Most of the
subjects in the study were older people who
sometimes haye more trouble using (IPAP
than younger people. \asal oxygen can be
deliyered by a small catheter under the nose
and is much less restrictiye than nasal (LPAP.
(iiying a patient oxygen continuously through—
out the night keeps the oxygen leyel in the
blood from dropping as it does in untreated
sleep apnea patients. Phillips found. The
study showed that both (IPAP and nasal
oxygen resulted in some improyements in the
subject‘s neurt)psychological function. par-
ticularly in reaction time and attention span.
But unlike (IPAP. nasal oxygen did not im~
proye daytime sleepiness.

()fthe eight patients in the study. four ch< )se
to continue using nasal (IPAP. two chose

Sufferers have three times as many car

wrecks as people who don’t have apnea.

oxygen treatment. one opted for surgery and
the eighth declined any further treatment

Anderson chose nasal (IPAP. and alter sleep-
ing with a face mask hooked to a machine
most nights for almost two years. he is pleased
with the results. lie doesn't snore when he
uses nasal (IPAP and he no longer gets tired
during the day. He gets eight hours of restful
sleep. When he occasionally takes a night off
from the machine or doesn‘t use it when he
travels. he can tell the difference in