A Case of Rapid Eye Movement Sleep-Related Bradyarrhythmia Syndrome with Severe Obstructive Sleep Apnea Syndrome

A close relationship has emerged between obstructive sleep apnea (OSA) and cardiac arrhythmia. However, transient sinus arrest or atrioventricular (AV) conduction disturbance during rapid eye movement (REM) sleep was rarely reported. This sleep stage specific arrhythmia has been referred to as REM sleep-related bradyarrhythmia syndrome. The differential diagnosis between OSA-related arrhythmia and REM sleep-related bradyarrhythmia syndrome is important in determining the treatment strategy for the underlying disease and its complication, especially in patient with a history of OSA. Here, we report a case with both REM sleep-related AV block and severe OSA, whose REM sleep-related AV block was not improved with continuous positive airway pressure treatment.