{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:25:43Z","timestamp":1775057143551,"version":"3.50.1"},"reference-count":0,"publisher":"Vilnius University Press","issue":"1","license":[{"start":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T00:00:00Z","timestamp":1526256000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AML"],"abstract":"<jats:p>Introduction. Rapid eye movement (REM) sleep-related bradyarrhythmia syndrome is characterized by pathological asystoles during the REM sleep phase. It is a rare rhythm disorder, being reported only few times in the literature. Due to non-specific symptoms, REM sleep-related bradyarrhythmia might be often underdiagnosed. Other cardiac diseases associated with pathological sinus arrests must be excluded to establish the correct diagnosis of and appropriate therapy for REM sleep-related bradyarrhythmia. We report a case of this syndrome followed by hypertension and diastolic heart failure.\n The case. A 49-year-old male with severe hypertension presented for a cardiologist\u2019s consultation. His main complaints were palpitations, fatigue, dyspnoea, and snoring. Polysomnography test revealed a normal sleep structure with episodes of bradycardia and increased parasympathetic activity during phasic events of REM sleep. Heart rate variability Poincare plot analysis demonstrated similar results. REM sleep-related bradyarrhythmia syndrome was diagnosed and patient was treated with dual chamber heart pacemaker implantation.\n Discussion. Various components of the autonomic nervous system influence the development of REM sleep-related bradyarrhythmia syndrome. The main factor is likely an increased vagal tone during the phasic REM sleep with the absence of normal compensatory sympathetic activity. Concomitant hypertension in REM sleep-related bradyarrhythmia syndrome is caused by a paradoxically abnormal control of the autonomic nervous system and can be explained through the acetylcholine metabolism pathway. Best suited diagnostic and treatment options for REM sleep-related bradyarrhythmia syndrome are discussed.\n Conclusions. Patients with REM sleep-related bradyarrhythmia syndrome often present with indistinct symptoms. Polysomnography is an essential diagnostic test for the differential diagnosis of various nocturnal arrhythmias and sleep disorders. Severe hypertension is a common complication of sleep disorders and requires appropriate treatment of the underlying condition. An implantation of a heart pacemaker is the first-choice treatment for patients with REM sleep-related bradyarrhythmia syndrome.<\/jats:p>","DOI":"10.6001\/actamedica.v25i1.3697","type":"journal-article","created":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T21:30:02Z","timestamp":1526333402000},"page":"1-6","source":"Crossref","is-referenced-by-count":4,"title":["A rare case of REM sleep-related bradyarrhythmia syndrome with concomitant severe hypertension: a\u00a0case report and a\u00a0review of literature"],"prefix":"10.15388","volume":"25","author":[{"given":"Gabrielius","family":"Jakutis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vytautas","family":"Juknevi\u010dius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurat\u0117","family":"Barysien\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia","family":"Mata\u010di\u016bnien\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birut\u0117","family":"Petrauskien\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u017daneta","family":"Petrulionien\u0117","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandras","family":"Laucevi\u010dius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6097","published-online":{"date-parts":[[2018,5,14]]},"container-title":["Acta medica Lituanica"],"original-title":[],"link":[{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/download\/21308\/20420","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/download\/21308\/20420","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T06:11:26Z","timestamp":1609999886000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/view\/21308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,14]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,5,14]]}},"URL":"https:\/\/doi.org\/10.6001\/actamedica.v25i1.3697","relation":{},"ISSN":["2029-4174","1392-0138"],"issn-type":[{"value":"2029-4174","type":"electronic"},{"value":"1392-0138","type":"print"}],"subject":[],"published":{"date-parts":[[2018,5,14]]}}}