重症閉塞性睡眠時無呼吸（OSA）に対する持続陽圧呼吸（CPAP）療法中の、抗うつ薬高用量投与にもかかわらず3時間を超える極めて顕著な急速眼球運動（REM）睡眠リバウンド：症例報告

Rapid eye movement (REM) rebound following the initiation of continuous positive airway pressure (CPAP) is commonly observed, with episodes exceeding two hours being rare. We report a 38-year-old male with severe obstructive sleep apnea (OSA) (apnea-hypopnea index (AHI) = 74.2/hour) receiving fluoxetine 80 mg daily and trazodone 100 mg, who had a 206.5-minute continuous REM sleep episode during CPAP titration, followed by 66.5 minutes of stage N3 sleep. This duration exceeds previously reported continuous REM episodes during titration. This case demonstrates that severe OSA-related sleep fragmentation can overcome potent pharmacological REM suppression when effective treatment is initiated.