An evaluation for sleep apnea needs to be done for patients with slow heart rhythms as sinus node dysfunction, bradycardia, and sinus pauses. I also feel these patients should be screened for Lyme disease . It has been shown that treatment of sleep apnea offer cardiovascular benefits beyond reduction in nocturnal slow heart rates ( bradycardia)
It is important to make a correlation with appropriate testing of the amount of bradycardia in the face of sleep apnea. We do know that permanent pacemakers are recommended regardless of symptoms for patients with acquired second degree AV block Mobitz Type II, high grade block or third degree block.
Permanent pacemakers are not recommended for patients with AV block that are due to reversible causes as Lyme carditis.
Any patient with a history of snoring and day time tiredness should be evaluated for sleep apnea. There is also a major correlation between sleep apnea and coronary artery disease