Just when you thought you were dropping off to sleep, your partner irritably shakes you awake. A conversation along these lines takes place:
‘You’re making those weird noises again!’
‘You know, with that horrible groaning sound that goes on for ages. I can’t sleep with you doing that…’
If this sounds familiar, then it may be that you are suffering from catathrenia.
What is Catathrenia?
Sometimes known as nocturnal groaning, catathrenia is a rare sleep disorder which falls under the category of parasomnias. Parasomnias are most basically defined as strange night-time occurrences. And the sound made by catathrenia sufferers in their sleep can be very strange indeed.
People who have catathrenia will typically breathe in deeply while sleeping. They then hold their breath for a short while. Then emit a long groaning, moaning or shrieking noise which can last from a few seconds up to a minute. At the end of the groan will be a secondary noise like a snorting, or the person might also wake up.
The noise made can be very loud, and for some people can even strangely sound like a sexual noise. This of course can be quite disturbing or annoying for other people in the household who can hear it.
Catathrenia usually occurs during the Rapid Eye Movement (REM) stage of sleep. Though it is possible for it to happen during other stages. Most people report it happening later in the night, which mirrors the fact that there is more REM sleep later on during sleeping.
People who have catathrenia will usually experience it for many years. And during this time will in many cases experience it most nights. And unless their partner is one of the lucky few people who can sleep through any noise, they will also experience it second hand!
What Catathrenia is not:
Catathrenia could be confused for other sleep disorders or heath issues. So it is important to understand that it is not any of the following:
- Related to snoring. The easy way to tell the difference is that snoring usually takes place on the in-breath, whereas catathrenia takes place during the out-breath
- Related to exhalatory snoring (yes, this does appear to contradict the first point!). The noise in this kind of snoring is also made on the out-breath. However, the distinction is that only with catathrenia does the person hold their breath after they breathe in
- Sleep apnea. Even though both disorders involve a pause in breathing, there is a difference. With apnea the pause happens after breathing out; with catathrenia, the pause happens after breathing in
- Stridor – which is a potentially dangerous condition where a person lets out a high pitch sound due to a constriction of the airways
- Related to sleep talking. Despite the fact that sometimes people can make a very strange sound, it is not the same as sleep talking
- Moaning as occurs during epileptic seizures
- Related to any other breathing disorder
- Related to any dream states or mental suffering
When diagnosing catathrenia, a medical professional would want to rule out the above possibilities, particularly the more threatening ones like apnea, epilepsy and stridor.
What causes catathrenia?
As with many sleep disorders, the cause of catathrenia is still in debate among the medical and scientific community. There have been various theories put forward, including:
- Obstruction or restriction of the upper airway
- During REM sleep, the vocal chords may partially close off. A forced out-breath then takes place to push through this closure and unblock the vocal chords
- Damage to brain structures that control breathing
- There have also been suggestions it is connected to high stress levels
Unfortunately there is a lack of studies that have been done to work out the exact causes. Since Catathrenia results in more social problems than being medically dangerous, researchers are for the most part focused on sleep disorders which can be harmful.
Despite the lack of consensus as to the cause, it does appear that many researchers believe it is an obstruction or restriction of the airways that causes catathrenia. Because of that, some argue that it should not be classed as a parasomnia, but a sleep-related breathing disorder.
Many people do not even realise they have catathrenia until a partner or someone sleeping in their house tells them about the noise. The first step is of course to identify that it is not a different sleep disorder.
Talking with a medical professional or having a sleep study conducted is the best way to make sure catathrenia is identified correctly. You may be diagnosed purely from your history and reported symptoms. Otherwise you may be asked to have a polysomnogram, which is an over-night sleep study.
Following this there are 2 ways of looking at treatment:
- Should the sufferer look at ways to address the problem?
- Should the person who is being disturbed find ways to block out the noise?!
For actual treatment of the patient, it seems either an oral device or a CPAP machine are currently the main options, with surgery also a possibility.
In 2008, a study at Standford University of 7 catathrenia sufferers found that a Continuous Positive Airways Pressure (CPAP) machine helped resolve the nocturnal groaning for all 7 people.
A CPAP machine delivers air gently through the nose to keep the airways open. Interestingly it is normally only used by people who have Obstructive Sleep Apnea.
In that study though, all 7 of the people refused to keep wearing the machine, and most had surgery after the study. The researchers reported that those who did have surgery were cured of their catathrenia.
Since catathrenia is seen as a mild disorder, and more of an inconvenience for sufferers and their families, treatment is not usually rushed, and the least intrusive options offered first.
So the alternative is for people who are being disturbed by the noise to take action. Wearing ear plugs make help in some circumstances, though possibly not for the loudest of groaners.
I have also heard suggestions of using a white noise machine to mask the sound. This is unlikely to work though if you are in the same room. Maybe if you are hearing it from another bedroom in the same house, but not if you are right next to the person making the sounds.
So if you are unable to find ways for you and anyone else living with you to cope, or are concerned that you might have a different sleep disorder, you may find seeking medical advice a good first step.