Catathrenia (Nocturnal Groaning)

What is catathrenia?

Catathrenia is a sleep-related breathing disorder that causes moaning or groaning during sleep. The noise happens as you exhale. It’s loud and lasts for a couple of seconds or up to 40 seconds. It can happen nightly, during REM and non-REM sleep.

Nocturnal groaning may wake you up. But most often, you won’t notice or hear yourself as it happens. Your sleeping partner or someone within your household is usually the first to tell you that they heard you. In the morning, you may feel like you didn’t get a full night’s rest.

How common is catathrenia?

Two studies in different parts of the world calculated that catathrenia is uncommon. It affects 0.17% (25 of 15,052 people over 10 years) in Japan and 0.4% of people (4 of 1,004 people in one year) in Norway. The frequency may be underreported because many people don’t realize they have the condition or mention it to their healthcare provider. Catathrenia may be mistaken for snoring.

What are the symptoms of catathrenia?

The main symptom of catathrenia is moaning or groaning during sleep. It happens when you exhale and stops when you inhale. It can sound:

• Loud.
• Monotone.
• Sexual.
• Gloomy.
• Humming.
• Cracking.
• Ending with a grunt or sigh.

This symptom typically occurs nightly. While many people with catathrenia don’t have any sleep-related complaints, some may report:

• Snoring.
• Mouth breathing.
• Sleep interruptions.

In the morning, you may experience:

• Fatigue.
• Grogginess.
• Dry mouth.
• Hoarse voice.
• Sore throat.
• A headache.
• Difficulty concentrating.

Morning symptoms happen because of the breathing technique used when sleeping (using your mouth only). They also affect your quality of sleep. You may sleep lighter or wake up often during the night.

What causes catathrenia?

The exact cause of catathrenia is unknown. Research suggests it could happen due to malfunctioning neurons (nerve cells) in your brain at the respiratory center (medulla oblongata). These neurons cause prolonged exhaling. When you exhale, your vocal cords vibrate to create a moaning or groaning sound.

Can anxiety cause catathrenia?

It isn’t clear if anxiety causes catathrenia. Studies are still ongoing to learn more and to determine if other conditions like stress can trigger symptoms.

Is catathrenia hereditary?

Current research suggests you’re more at risk of nocturnal groaning if someone in your biological family also has this condition.

Is catathrenia dangerous?

Catathrenia isn’t dangerous to your physical health, but it can affect how well you sleep (sleep quality) and your interpersonal relationships.

Catathrenia can cause stress or social embarrassment. It can be frustrating not to be in control of the noises your body makes as you sleep. As a result, you might avoid certain situations like overnight stays with others to prevent them from hearing you.

How is catathrenia diagnosed?

A healthcare provider will diagnose catathrenia after a clinic visit, which will include taking a medical history to ask about signs and symptoms, a physical exam and possibly further testing. Your provider will ask you how you feel when you wake up and what other people have heard or observed while you are sleeping.

If possible, record yourself sleeping so your provider can play back the audio and listen. This can help them rule out other conditions like sleep talking or snoring.

A primary care physician may refer you to a sleep specialist (somnologist). You may need to participate in a sleep study (polysomnogram). This overnight test at a sleep center monitors your brain activity, breathing and how other body systems work as you sleep.

How is catathrenia treated?

Catathrenia doesn’t always require treatment. However, a healthcare provider may recommend one or a combination of the following treatments for catathrenia:

• Wearing oral appliances (like a retainer) to keep your upper airway open at night.
• Using a continuous positive airway pressure (CPAP) machine at night.
• Referral to an ear, nose and throat specialist (otolaryngology) for a surgical evaluation.

What’s the outlook for catathrenia?

There are no known long-term health consequences of catathrenia. Though it may sound alarming to your friends or family who hear you at night, this condition can have a significant impact on your mental health.

Treatment options are available to reduce or eliminate nightly groaning. Your provider will likely offer nonsurgical treatment options first. Many people notice their symptoms stop when they use a CPAP machine.

In addition, many people find comfort in speaking with a mental health professional if their symptoms affect their mental health or social well-being.

When should I see a healthcare provider?

Visit a healthcare provider if you experience nighttime groaning or someone lets you know that they heard you. Always talk to a provider if you’re not getting the quality or amount of sleep you need.

What questions should I ask my healthcare provider?

• Do I need to participate in a sleep study?
• Do you want to talk to my bed partner about what they heard while I was sleeping?
• What type of treatment do you recommend?
• Are there side effects of treatment?

How is catathrenia different than snoring?

Catathrenia and snoring are both noises you can make during sleep. Snoring happens as you inhale. Catathrenia happens as you exhale. Groaning with catathrenia comes from your larynx (voice box), while the snoring sound comes from your pharynx (throat).