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floridafocusfloridafocusfloridafocusfloridafocusfloridafocusfloridafocusfloridafocusA good night’s sleeSLEEP CENTER SETS SLEEPLESS ON PATH TO SWEET SLUMBERIn May 2004, Floridian Robert Bartolotta packed up his motorcycle and cruised to the nation’scapital where he met his father, a veteran, and other relatives for the dedication of the NationalWorld War II Memorial. He could have fl own to this historic event with the rest of his family, butinstead jumped at the chance to tour the scenic Blue Ridge Parkway.I f the dedication had been five monthsearlier, Bartolotta would have passed on thisonce-in-a-lifetime experience. His then undiagnosedsleep apnea, which involves interruptionsin breathing throughout the night,deprived him of deep sleep and turned himinto a “walking zombie” by early afternoonevery day. He simply would not have felt safeon the nearly 3,000-mile roundtrip motorcycleexcursion. He didn’t even feel entirelysafe on his daily drive to work.“At least two times on my 24-mile commuteI can remember doing a quick nod behindthe wheel,” says Bartolotta. In February,this ongoing fatigue brought him to the SleepDisorders Program at Cleveland Clinic FloridaWeston, where he was diagnosed with severeobstructive sleep apnea. Through overnightobservation, it was determined that Bartolottaactually stopped breathing several hundredtimes a night, anywhere from a few secondsto a minute at a time.“I was shocked. I knew I had apnea, butI didn’t realize I was on the ‘top ten’ list,”he says.Surprise and denial are common reactionsto an obstructive sleep apnea diagnosis,says Laurence Smolley, M.D., SleepCenter Medical Director and Chairman ofthe Department of Pulmonology at Weston.These episodes of halted breathing, referredto individually as an “apnea,” cause a dropin blood oxygen levels and trigger the brainto try to wake the body, which is when anapnea sufferer gasps for air and rouses fromsleep. But because the individual awakensfor such a short period, he or she does notremember the apnea.The effects, however, can be serious.Each apnea occurrence disruptsthe body’s natural progressionto deep sleep. In aperpetually lighter sleep, theheart does not enter its normalresting stateand thebody’s blood pressure does not temporarilydrop as it would during deeper sleep. Whenbreathing stops during an apnea, additionalstress is placed on the heart. All this effortprevents both the mind and body from rejuvenatingand can lead to cardiovascularproblems such as a round-the-clock increasein blood pressure.“It’s like exercising all night,” explainsSleep Center chief polysomnographic technologistPatrick McMahon. “That’s why excessivenight sweating is a common sideeffect of sleep apnea.”The most drastic treatments for obstructivesleep apnea include surgery to removethe tonsils, uvula (the little piece of fl eshthat hangs down in the back of the throat)or other tissue, while mild to moderate casescan be addressed with dental appliances.Losing excess weight and avoiding alcoholand smoking can eliminate or improvethe severity of obstructive sleep apnea aswell. For his severe case, Bartolotta didn’twant to undergo surgery, which is notRobert Bartolotta38 cleveland clinic magazine