Catathrenia

Catathrenia is a rapid eye movement sleep parasomnia consisting of end-inspiratory apnea (breath holding) and expiratory groaning during sleep. The term catathrenia originates from the Greek kata (below) and threnia (to lament) and describes a rare condition which occurs during sleep being characterized by monotonous irregular groans also known as nocturnal groaning. Multiple studies have described nocturnal vocalisation among animals and have also reported some cases in humans, especially in patients with Parkinson’s disease. The nocturnal vocalisation can be groaning, moaning, or different sounds produced while asleep, the most encountered being catathrenia and sleep talking (somniloquy). The duration of the groaning sound varies from two to 49 s and it is known to appear more often during expiration REM sleep than in NREM sleep. Catathrenia is distinct from both somniloquy and obstructive sleep apnea (OSA). The sound is produced during exhalation as opposed to snoring, which occurs during inhalation. It is usually not noticed by the person producing the sound but can be extremely disturbing to sleep partners. 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. Catathrenia is a rapid eye movement sleep parasomnia consisting of end-inspiratory apnea (breath holding) and expiratory groaning during sleep. The term catathrenia originates from the Greek kata (below) and threnia (to lament) and describes a rare condition which occurs during sleep being characterized by monotonous irregular groans also known as nocturnal groaning. Multiple studies have described nocturnal vocalisation among animals and have also reported some cases in humans, especially in patients with Parkinson’s disease. The nocturnal vocalisation can be groaning, moaning, or different sounds produced while asleep, the most encountered being catathrenia and sleep talking (somniloquy). The duration of the groaning sound varies from two to 49 s and it is known to appear more often during expiration REM sleep than in NREM sleep. Catathrenia is distinct from both somniloquy and obstructive sleep apnea (OSA). The sound is produced during exhalation as opposed to snoring, which occurs during inhalation. It is usually not noticed by the person producing the sound but can be extremely disturbing to sleep partners. 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. Catathrenia typically, sometimes even exclusively, occurs during REM sleep, although it may also occur to a lesser degree during NREM sleep. Catathrenia begins with a deep inspiration. The person with catathrenia holds her or his breath against a closed glottis, similar to the Valsalva maneuver. Expiration can be slow and accompanied by sound caused by vibration of the vocal cords or a simple rapid exhalation with no sound. Despite a slower breathing rate, no oxygen desaturation usually occurs. Certain side effects include sore throat, fatigue, and dizziness. There is debate about whether the cause is physical or neurological, a question that requires further study. While some speculate about a direct correlation to high anxiety and stress or the concept that catathrenia is purely psychological, there is only anecdotal evidence of either proposed cause. Catathrenia has been defined as a parasomnia in the International Classification of Sleep Disorders Diagnostic and Coding Manual (ICSD-2), but there is debate about its classification. Importantly, in the latest version of the International Classification of Sleep Disorders (ICSD-3), catathrenia has been included in the category of respiratory disorders, and thus it has been removed from the parasomnia category, as it was in the second version of the manual; nevertheless, a debate about the nature and classification of the disorder, still exist. Because catathrenia itself is not considered life-threatening, there has been very little research done in the medical community, and many experts assume that the way to treat catathrenia is to treat the underlying sleep apnea, though there is no conclusive evidence published that catathrenia results from sleep apnea, and sleep studies show that not all people with catathrenia have been diagnosed with sleep apnea. While doctors tend to dismiss it as an inconvenience, people with catathrenia routinely describe the condition's highly negative effects on their daily lives including tiredness, low energy, dizziness and vertigo, work problems, relationship and social issues, and other physical and mental problems that could be associated with low sleep quality.