Catathrenia

Overview

Catathrenia (kat-uh-THEE-nee-uh), also called sleep groaning, is a rare sleep behavior where a person breathes in, then holds their breath for a moment, and finally lets out a long, low-pitched groan as they breathe out. It happens during sleep, most often in the dream (REM) stage. The person is usually not aware of it, but bed partners may hear it clearly.

No, catathrenia is very rare. Researchers believe it affects less than 1% of people, and it is often unrecognized or mistaken for snoring or sleep apnea.

It can start at any age, but it may appear most often in young adults. Studies do not show a strong difference between men and women. Because it occurs most often during REM sleep, it may be more noticeable later in the night.

Symptoms

Common symptoms

• A long, groaning or moaning sound that happens as the person breathes out during sleep
• Breath-holding episodes that last a few seconds before the groan
• The groans may come in clusters, with several episodes in one night
• Often the bed partner is the one who notices the sound
• The person sleeping usually has no memory of the groaning in the morning

Symptoms in children

• Children can have catathrenia too. The groaning sound may worry parents, but it is usually not painful or harmful for the child.
• Children may also have other sleep behaviors, like sleepwalking, so a full picture helps the doctor understand the situation.

Symptoms in older adults

• In older adults, the sound may be mistaken for snoring or acid reflux. A sleep study can tell the difference.
• If an older adult also has daytime sleepiness or irregular breathing, it is important to check for sleep apnea as well.

Causes

Main causes

• The exact cause of catathrenia is not fully understood. It seems to be linked to the brain's control of breathing during REM sleep.
• In some cases, it may happen alongside other conditions like sleep apnea or teeth grinding, but it is not caused by them.
• Catathrenia is not caused by a mental health problem or by anything the person did wrong.

Risk factors

• There are no clear risk factors. It may run in families, but this is not proven.
• Some people notice more groaning when they are sleep-deprived or under stress.
• Drinking alcohol before bedtime may sometimes make the sounds more frequent, but this is not fully confirmed.

When to see a doctor

See a doctor urgently if:

• Call emergency services or go to urgent care if you or your partner have trouble breathing during the night, turn blue, or have an injury from a night-time fall.

Book a routine appointment if:

• Make a routine appointment with your GP if the groaning is bothering your partner, keeping you from sleeping well, or making you feel anxious.
• Also see your doctor if you have daytime fatigue, morning headaches, or trouble concentrating, because these may point to a different sleep disorder.

Diagnosis

A doctor, usually a general practitioner, will ask about your sleep history and your bed partner's observations. They may refer you to a sleep specialist who can arrange a sleep study.

Tests that may be done

• A sleep study (polysomnography) is the main test. It records your brain activity, breathing, heart rate, and body movements while you sleep.
• Sometimes a home audio/video recording may be suggested as a first step, but a clinic sleep study gives the most reliable information.

What to expect at your appointment

During the sleep study, you will spend one night in a comfortable room at a sleep center. Sensors are attached to your head and body. The test is painless, and you can usually go home the next morning. The specialists will review the recordings and explain the results.

Treatment

There is no specific cure for catathrenia. Treatment is usually not needed unless the sounds are severe, disturb the bed partner, or are linked to another sleep problem. The goal is to protect sleep quality for both the person and their partner.

Self-care at home

• Maintain a regular sleep schedule: go to bed and wake up at the same time each day.
• Create a calm bedtime routine that helps you relax before sleep.
• Avoid alcohol, heavy meals, and screens for a few hours before bed.
• Sleep on your side if you notice the sounds are louder on your back.
• Use earplugs or white noise machines if your partner is easily disturbed.

Medical treatments

A sleep specialist may suggest a continuous positive airway pressure (CPAP) machine or a similar breathing device to keep the airway open, though this is not always needed and should only be started after a full assessment. An oral dental appliance that gently moves the lower jaw forward has also been tried in some cases. Any treatment is individualized and always discussed with your specialist.

When is surgery considered?

Surgery is not a standard treatment for catathrenia. It is not usually recommended.

Living with this condition

If you have catathrenia, the most important step is to accept that it is a harmless sleep behavior and not your fault. Explain this to your bed partner so they do not worry. Many couples find that talking openly and using simple measures like a white noise machine makes it easier to sleep together.

Lifestyle tips

• Keep a consistent sleep routine
• Exercise during the day, but not too close to bedtime
• Limit caffeine and alcohol, especially in the evening
• Manage stress with relaxation techniques like deep breathing or meditation

Diet and exercise

A healthy balanced diet and regular physical activity promote better overall sleep. Avoid drinking too much liquid right before bed to prevent waking up, but do not go to bed dehydrated.

Mental health and emotional wellbeing

Catathrenia can cause embarrassment or worry, especially if a partner mentions the sound. It is important to know that it is not intentional and not dangerous. If the concern is causing anxiety or relationship stress, consider speaking with a counselor or a support group for sleep disorders.

Prevention

There is no known way to prevent catathrenia, because it is likely one of the natural variations of sleep. However, good sleep habits and reducing alcohol and stress may reduce the number of episodes.

Vaccines

There is no vaccine for catathrenia.

Screening programmes

There is no routine screening test for catathrenia.

Complications

If left untreated

• Catathrenia on its own does not usually cause serious complications.
• If left untreated, the groaning may continue to disturb the bed partner's sleep, which can lead to frustration or separate bedrooms.
• In rare cases, if catathrenia is confused with obstructive sleep apnea, the true condition might be missed, which could delay needed treatment.

Long-term outlook

The outlook for catathrenia is very positive. It is not a sign of a serious health problem, and it does not damage the brain or body. In many people, the groaning may even decrease or disappear over time. With reassurance and simple measures, most people can live with it comfortably.

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