Reactions 1680, p274 - 2 Dec 2017 REM sleep rebound: case report An adult man [exact age at reaction onset not stated] developed REM sleep rebound following the withdrawal of paroxetine [route and time to reaction onset not stated]. The 34-year-old man visited the sleep laboratory for heavy snoring, tendency to fall asleep in non-demanding situations and non-restorative sleep. Subsequently, he was diagnosed with moderate obstructive sleep apnoea. He was recommended for nasal surgery, diet and positional therapy. After 16 years, he came back. He had undergone nasal surgery 12 years ago. He was diagnosed as a hypertensive 10 years ago and currently treated with telmisartan, carvedilol and hydrochlorothiazide. Five months before, he was initiated on paroxetine 20 mg/day for the treatment of depressive symptoms. He reported severe worsening of daytime sleepiness and sleep quality, which introduced to a fragmented and restless sleep. Nocturnal polysomnography was performed and automated continuous positive airway pressure (CPAP) was applied during the polysomnography. He immediately fell asleep and showed a very short REM latency. Later, most of his sleep was described by 71.6% REM of total sleep time, while just few awakening and arousals occurred. The CPAP use satisfactorily corrected respiratory disorders during both REM and NREM sleep. Apnoea/hypopnea index was 1.9, and lowest SaO2 was 84%. However, mean SaO2 during effective CPAP was 94%. The next day, when asked, he mentioned that he had suddenly discontinued paroxetine three days before. A new polysomnography was planned to evaluate if the CPAP treatment and paroxetine withdrawal could revert sleep structure to normal. He came back four months later. He had no residual daytime sleepiness. He used CPAP regularly, but he had to initiate paroxetine again. Polysomnographic study with fixed CPAP at 12cm H2O demonstrated a decrease in REM duration to 57.5 minutes with a REM latency of 38.5 minutes. Apnoea/hypopnea index was 0.2, and lowest SaO2 was 89%. Author comment: "We enquired about possible additional factors contributing to that abnormal REM rebound and concluded that withdrawal of paroxetine could be involved." Lo Bue A, et al. Extreme REM rebound during continuous positive airway pressure titration for obstructive sleep apnea in a depressed patient. Case Reports in Medicine 2014: 292181, Jan 2014. Available from: URL: http:// doi.org/10.1155/2014/292181 - Italy 803285231 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera