title: A case of central sleep apnea strictly dependent upon REM-sleep.
abstract: Central sleep apnea (CSA) is characterized by the inability to generate regular breathing patterns as a result of the loss of metabolic drive and failure of respiratory muscle control. We present the case of a 54-year-old woman with a severe CSA strictly dependent upon REM-sleep. Extensive diagnostic workup excluded typical underlying causes and serological analysis revealed acute borreliosis infection. The severity of sleep apnea decreased after repeated polysomnographic studies without a specific therapy. CSA is usually associated with non-REM stages of slow-wave-sleep. This report illustrates the clinical presentation and diagnostic implications of an unusual case of a CSA strictly associated with REM-sleep. Anecdotally reports of severe respiratory failure in borreliosis indicate the potential of this infection to destabilize breathing control but the precise impact of the infection remains controversial. In our case, a relevant neuroborreliosis was not proven, since there were no other neurologic impairments and the patient refused studies of liquor fluid.
authors.forename: Armin
authors.initials: A
authors.lastname: Steffen
authors.forename: Johann
authors.initials: J
authors.lastname: Hagenah
authors.forename: Barbara
authors.initials: B
authors.lastname: Wollenberg
authors.forename: Norbert
authors.initials: N
authors.lastname: Brüggemann
mesh_terms: D001899:Borrelia Infections / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009460:Neurologic Examination; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology*