What To Know About Catathrenia

It's not necessarily harmful, but it's incredibly annoying.

If anyone sleeping near you has ever complained about you groaning or moaning at night, you may have a rare sleep disorder called catathrenia. It makes you produce those sounds, as well as hold your breath while you sleep.

Luckily, the condition is pretty harmless, but it can still be quite startling (especially when you're not aware someone is experiencing it). Here's what you need to know about catathrenia.

What Exactly Is Catathrenia?

Catathrenia is classified as a rare chronic respiratory disorder in the International Classification of Sleep Disorders, Third Edition, but experts disagreed on whether it should be classified as a parasomnia (a sleep disorder) or a respiratory issue, according to a 2015 review published in the journal Sleep Medicine.

Sometimes referred to as "nocturnal groaning," catathrenia presents itself as a long, monotone groan or moan, made involuntarily while the person is asleep. It may sound like a high-pitched squeak as well.

Catathrenia affects all demographics, according to a 2012 chapter in Fundamentals of Sleep Medicine. The disorder often develops during adolescence or early adulthood. It's exceedingly rare and likely underreported because the sound is often misdiagnosed as snoring, sleep-talking, central sleep apnea, or another sleep-related breathing disorder.

According to a 2017 review published in the Journal of Clinical Sleep Medicine, studies had shown that it presented in only 0.17% of patients in a sleep center in Japan over 10 years, or in 0.4% of patients in another study in Norway over a one-year period.

The groaning differs from snoring because it is made exclusively while exhaling and has a distinct sound, like something is blocking air from escaping the throat. In the 2017 review, the authors wrote, "bed partners generally report hearing the person take a deep breath, hold it, then slowly exhale; often with a high-pitched squeak or groaning sound."

Found in all stages of sleep, the groaning can be interspersed with periods of normal breathing or happen continuously. But, despite the fact that the noises can be quite loud—recorded between 40 decibels (a cricket) and 120 decibels (a chainsaw)—people with catathrenia are often completely oblivious. They mostly find out about their noisemaking when a family member, friend, or partner mentions it the next morning, according to the 2015 review.

However, once the person with catathrenia is aware of their condition, they also tend to wake up from the groaning, according to the 2017 review.

Are There Any Other Symptoms?

Although groaning is the primary manifestation of catathrenia, other physical symptoms can include:

  • Dry mouth due to mouth breathing
  • Morning grogginess or headache
  • Mild oxygen desaturation during sleep (lowering of the amount of oxygen in your blood, which can be measured by a device such as a pulse oximeter, according to the National Library of Medicine's MedlinePlus resource)
  • General fatigue, or in rare cases, excessive daytime sleepiness

According to the 2017 review, however, the biggest problem that most people face is significant fear of distress to their bed partner. The sound can cause social embarrassment and have a negative effect on sex lives and relationships.

What Causes Catathrenia?

Experts aren't sure what causes catathrenia, but the groaning is thought to originate in the larynx, which houses the vocal cords.

"Whenever you make a sound, it's because of a vibration of the structures," Soroush Zaghi, MD, a sleep surgeon at The Breathe Institute, told Health. "In snoring, what's vibrating is the back of the throat…but in catathrenia, it's the vocal cords that are vibrating, so the sound is coming from the voice box."

One 2011 case study, published in the European Respiratory Journal, looked at a 29-year-old person with catathrenia. The researchers performed a laryngoscopy—a procedure to look at the voice box and nearby structures in the back of the throat, according to the American Cancer Society—on her during sleep sedation.

Researchers found that, while she was groaning, the part of the larynx that connects the lungs and the mouth almost completely closed. According to the study authors, this showed that the groaning caused by catathrenia used the same mechanics as everyday speech, once again linking the vocal cords to the disorder.

But it's still unclear why people are groaning in the first place. Some believe that catathrenia could be linked to jaw size. Dr. Zaghi believed that catathrenia could be several different disorders with different causes.

Are There Any Treatment Options?

The good news is that, while catathrenia may be annoying for a bed partner, it's pretty much harmless. Most people with catathrenia sleep just fine.

"We know it's annoying, but we're not exactly sure how to fix it," Dr. Zaghi said. "We have some guesses that maybe it's related to some kind of stress, something therapy or deep breathing exercises might help, but we're not going to push it too much because honestly we don't know."

There are some steps that can be taken for those whose catathrenia is impacting their sleep quality. Several studies, such as one published in 2017 in the Pulmonology Journal, have found that catathrenia could be successfully treated with a CPAP machine—a machine typically used to treat sleep-related breathing disorders that "uses mild air pressure to keep breathing airways open while you sleep," according to the National Heart, Lung, and Blood Institute.

It is recommended people with symptoms schedule a sleep study to make sure that catathrenia is actually the issue. But positive airway pressure doesn't work for everyone. For some, asking their sleep partners to wear earplugs or use a white noise machine is the best option.

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