Sleep apnea syndrome and arrhythmias Sleep apnea syndrome (SAS) is a respiratory disease that can seriously affect patients’ sleep and cause damage to multiple organs of the body, with a prevalence of 2% to 4% in the population. Some studies have shown [1] that the mortality rate of cardiovascular diseases occurring in patients with respiratory sleep apnea is significantly higher than in the normal population, and nocturnal arrhythmias in patients with respiratory sleep apnea are one of the main causes of sudden death. 1, definition Respiratory sleep apnea syndrome refers to a clinical syndrome in which various causes lead to recurrent apnea and (or) hypoventilation in the sleep state, causing hypoxemia, hypercapnia, and thus a series of pathophysiological changes in the organism. In 1983, Guilleminault et al [2] first reported the relationship between respiratory sleep apnea syndrome and atrial fibrillation, and since then, a large number of studies have shown that atrial fibrillation is closely related to respiratory sleep apnea syndrome. Sauer et al [3] showed that respiratory sleep apnea syndrome was an independent predictor of failure of pulmonary vein isolation in atrial fibrillation. The recurrence rate after acute pulmonary vein reconnection rate after pulmonary vein isolation was significantly higher in patients with untreated respiratory sleep apnea syndrome with atrial fibrillation compared to patients with respiratory sleep apnea syndrome combined with atrial fibrillation who were treated with continuous positive pressure ventilation. Slow-type arrhythmias; in the 1980s it was clinically reported that slow-type arrhythmias were more common in patients with respiratory sleep apnea syndrome than in healthy subjects of the same age, with an incidence ranging from approximately 5% to 50% [4].Simanti-rakis et al [5] studied patients with moderate to severe respiratory sleep apnea syndrome, using an insertable loop recorder, and observed their long-term ( 16 months) incidence of slow-type arrhythmias and the effect of continuous positive pressure ventilation after treatment. The results showed that 47% of the patients developed severe nocturnal bradyarrhythmias (bradycardia and prolonged arrest) mostly during the night before treatment with continuous positive pressure ventilation. After 8 weeks of treatment with continuous positive pressure ventilation, the total number of bradyarrhythmic episodes tended to decrease, and no bradyarrhythmias were recorded during the six-month follow-up period. 3. Possible mechanisms Long-term sympathetic excitation under conditions of hypoxia, hypercapnia, and increased catecholamines promotes heart rate variability and thus arrhythmia; during nighttime sleep in patients with respiratory sleep apnea syndrome, the incongruity between myocardial oxygen demand and insufficient arterial blood oxygen content causes transient myocardial ischemia, which lowers the threshold of myocardial ectopic excitation points and potentially promotes The hypoxic state during sleep in patients with respiratory sleep apnea syndrome directly impairs the function of the sinus node and increases the excitability of the ectopic pacing point; patients with respiratory sleep apnea syndrome expand the thorax during sleep because breathing becomes deep and fast, pulling the atria or ventricles, which in turn promotes the occurrence of arrhythmias through mechanical electrical feedback mechanisms [6]. 4, treatment Repeated apnea in patients with respiratory sleep apnea syndrome produces intermittent hypoxia and hypercapnia is the key to the occurrence of arrhythmias, which also suggests that our treatment should be based on improving ventilation and relieving the above pathological changes, thus reducing the occurrence of all types of arrhythmias. 1, general treatment: weight loss treatment; posture training side sleep, elevate the head of the bed; quit smoking and alcohol, avoid sedatives; 2, the efficacy of drug treatment is not sure, non-specific anti-inflammatory drugs nasal spray; 3, device treatment: transnasal continuous positive pressure ventilation is the preferred method for treatment of moderate and severe respiratory sleep apnea syndrome, which can increase FRC, reduce upper airway resistance, increase upper airway tension, prevent upper airway collapse during sleep, and It effectively improves snoring, improves sleep architecture, improves nocturnal apnea and hypoventilation, and improves symptoms. Other appliance treatments include bi-level positive pressure ventilation (BiPAP); auto-regulated intelligent ventilator treatment (Auto-CPAP); and oral orthosis (OA) treatment. Surgical treatment: nasal surgery: nasal septum correction, nasal polyp removal, etc. Uvulopalatopharyngoplasty (UPPP): it is the most commonly used surgical method; laser-assisted pharyngoplasty; cryogenic radiofrequency ablation pharyngoplasty; orthognathic surgery.