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May 1977

Bigeminy Related to REM Sleep

Author Affiliations

Dept of Medicine Div of Neurology Univ of Texas Health Science Center at San Antonio
CMET EEG Laboratory Neurology Section Medical Service
VA Hospital San Antonio, TX 78284

Arch Neurol. 1977;34(5):319-320. doi:10.1001/archneur.1977.00500170073018

To the Editor.—  A variety of autonomic changes occur during rapid eye movememt (REM) sleep. Of these, changes in the cardiovascular functions are perhaps of the greatest clinical interest dating from MacWilliam's1 pioneering observation of cardiovascular disorders associated with "disturbed" sleep. The statement is commonly made that cardiac arrhythmias are frequently found in REM. The work of Nowlin et al2 is usually cited. These authors described ST-T wave changes and angina in four patients during REM sleep, but no actual arrhythmias. Similar changes and changes in heart rate have been frequently reported.However, reports of REM-related arrhythmias are quite rare. Fahrion3 described a patient with paroxysmal atrial tachycardia with "heart rate variability" during dreams. Rosen-blatt et al4 reported an increase in premature ventricular contractions in 11 subjects in all stages of sleep, but more so in REM. However, this phenomenon appeared to be related more to

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