Nocturnal premature ventricular complexes in a young woman with respiratory effort-related arousals

We report a young female with snoring and daytime sleepiness who exhibited frequent premature ventricular complexes (PVCs) primarily during non-rapid eye movement sleep. She was underweight and suspected to have respiratory effort-related arousal (RERA) based on polysomnographic data. The presence of autonomic instability and alternating conducting system provoked by repetitive markedly negative intrathoracic pressure was assumed to be precipitating PVCs. Follow-up polysomnography after oral appliance therapy showed reduced PVCs. The results suggest that a careful evaluation of polysomonographic data is warranted when RERA is suspected as an underlying mechanism for nocturnal PVCs even in non-obese patients.