At first, no one noticed that Joe Borelli was losing his mind — no one, that is, but Borelli himself. The trim, dark-haired radiologist was 43 years old. He ran two practices, was an assistant professor at the Medical University of South Carolina and played a ferocious game of tennis. Yet he began to have trouble recalling friends’ names, forgot to run important errands and got lost driving in his own neighborhood. He’d doze off over paperwork and awaken with drool dampening his lab coat.
Borelli feared he had a neurodegenerative disease, perhaps early onset Alzheimer’s. But as a physician, he knew that memory loss coupled with fatigue could also indicate obstructive sleep apnea (OSA), a disorder in which sagging tissue periodically blocks the upper airway during slumber. The sufferer stops breathing for seconds or minutes, until the brain’s alarm centers rouse him enough to tighten throat muscles. Although the cycle may repeat hundreds of times a night, the patient is usually unaware of any disturbance.
Borelli checked in to a sleep clinic for tests, which came out negative. He went to a neurologist, who found nothing wrong. At another sleep clinic, Borelli was diagnosed with borderline OSA; the doctor prescribed a CPAP (continuous positive airway pressure) machine, designed to keep his airway open by gently inflating it. But he still awoke feeling exhausted, and he quit using the device after a couple of months.
Borelli’s fingers soon grew so clumsy that he couldn’t button his shirt cuffs. He was easily winded, and his heart raced whenever he rose from a chair. He developed chronic severe anxiety. He gave up tennis and his chairmanship of a national professional committee. His marriage fell apart. He contemplated suicide. “One day,” he recalls, “I collapsed in the shower, crying.” Then he went looking for the best sleep specialist in America.
