What is Catathrenia? Understanding Moaning in Your Sleep

Have you ever woken up abruptly to an unusual gurgling noise at night? If yes, then you or your partner may be suffering from a rare sleep disorder called catathrenia. Nocturnal moaning or groaning is the most common characteristic of this disorder, which can disrupt your sleep and also your partner's. Beyond the obvious sleep disruption, catathrenia can create a complex emotional landscape — from the embarrassment of learning about your nocturnal sounds to the anxiety about their impact on your partner's rest and your relationship's harmony. Fortunately, several treatment methods can help ease your symptoms of catathrenia and improve sleep quality. This enables you to reclaim a restful night's sleep. 

This comprehensive guide examines catathrenia, offering insights into this unusual but manageable condition. 

What is catathrenia?

Catathrenia, popularly known as nocturnal groaning, is characterised by repeated, prolonged moans during sleep. This typically occurs during exhalation. Catathrenia remains undetected because those affected are typically unaware of the sounds they make while asleep. Sleep groaning can disrupt your partner's sleep, leading to anxiety, embarrassment, and stress. While its exact causes are still unclear, it is believed to be related to respiratory issues or abnormal breathing patterns during sleep. Studies suggest that catathrenia affects only about 0.17% to 0.4% of the population around the world, making it a fairly uncommon phenomenon. 

Catathrenia can be classified depending on frequency and duration: 

• Episodic: Groaning occurs in clusters 

• Persistent: Prolonged, regular groaning 

Other classification:

• Central catathrenia: This type originates from brain activity 

• Obstructive catathrenia: This type is related to airway obstruction 

Catathrenia vs other sleep disorders

Sleep disorders encompass a variety of conditions with different causes, characteristics, and symptoms. Catathrenia, for example, involves continuous and prolonged groaning during sleep, often accompanied by loud cracking sounds, snoring, and mouth breathing. Although its exact cause remains unclear, it can be triggered by respiratory issues, stress, or an unsuitable sleep environment. 

Sleep apnoea, commonly caused by airway obstruction, is characterised by frequent pauses in breathing during sleep, loud snoring, or gasping for air. Sleep talking, whose cause is unknown but may be linked to stress or sleep deprivation, involves uttering words or sounds without awareness. 

Sleep terrors, often triggered by stress or genetics, cause episodes of extreme fear, panic, or anxiety during sleep, usually with no recollection, and are often accompanied by screaming, rapid heartbeat, and sweating. On the other hand, restless leg syndrome is linked to genetics, diabetes, and iron deficiency anaemia, and is marked by uncomfortable sensations in the legs that are often relieved by movement, along with twitching or creeping feelings. 

What triggers sleep groaning?

The causes of sleep groaning or catathrenia are not well understood. It may be due to problems with neurons in the brain's respiratory centre. This causes slow and long exhalations that manifest as groaning or moaning. According to some studies conducted by researchers, having a small jaw or small upper airways may play a significant role. 

Below are some common factors that can trigger catathrenia: 

• Irregular breathing during sleep

• Respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD)

• Presence of other sleep disorders like sleep apnoea or restless leg syndrome

• Extreme levels of stress 

• Excess screen exposure close to bedtime or in the

• A poor sleep environment, like a noisy, uncomfortable bedroom, or a squeaky mattress

Catathrenia symptoms and how to recognise them

Catathrenia presents with the following symptoms:

• Loud, prolonged groaning sounds that occur during exhalation or during sleep

• Snoring 

• Mouth breathing 

• Disturbed sleep

• Fatigue, dry mouth, sore throat, headache, irritability, and poor concentration - which becomes apparent the next morning

How to recognise the symptoms:

• Often, a bed partner or someone sleeping nearby notices the groaning sounds 

• Home sleep recordings can help identify the symptoms 

If you suspect you or someone else might have catathrenia, it is better to consult a healthcare professional or a sleep specialist for proper guidance and management.

Catathrenia treatment options 

Treating catathrenia can be challenging. Some of the options include the following: 

Catathrenia treatment at home:

• Establish a consistent sleep schedule by going to bed and waking up at the same time every day, even on weekends

• Create a relaxing sleep environment by making your bedroom dark, cool, and quiet

• Avoid stimulants like caffeine, nicotine, and electronic devices before bedtime 

• Avoid watching TV or using computers, laptops, smartphones, or tablets in bed

• Practise stress-reducing techniques like yoga, meditation, or deep breathing exercises 

• Indulge in regular physical activity like brisk walking or jogging during the day to improve sleep quality 

• Use a white noise machine or ask your bed partner to use ear muffs 

Medical intervention:

• Oral or dental appliances can be used to adjust the jaw positioning and keep the airway open. These appliances are customised according to your oral cavity and worn only at night 

• Specific treatments for sleep apnoea like the use of personal CPAP machines may help deal with catathrenia

• Surgical options may be considered when anatomical abnormalities contribute to catathrenia

When to seek medical help

Seek medical help if you experience severe or persistent groaning during sleep or disrupt your partner's sleep. Also, consult a healthcare professional or sleep specialist if you notice symptoms like breathing issues or daytime fatigue. They can provide personalised treatment options and guidance for improving sleep quality and overall well-being.

Closing insights 

Being woken up by your partner, roommate, or family member due to persistent groaning during sleep can be a cause of concern. Ignoring the issue and falling back asleep might sound tempting, but this can leave all of you tired when you wake up the next day. By understanding catathrenia and seeking medical help, you can improve your sleep quality, ease distress, and enhance your overall well-being. While its causes are unclear, various treatment options and lifestyle changes can help manage symptoms. With proper understanding and management, you can transform those disruptive nights into the peaceful sanctuary that sleep should be. 

Frequently Asked Questions

1. How common is catathrenia?

Catathrenia is an unusual and under-reported condition. It is estimated to affect between 0.17% to 0.4% of individuals. It is also estimated that catathrenia represents less than 1% of patients suffering from sleep disorders.

2. Who does catathrenia affect the most?

Catathrenia mostly affects young individuals, often in their 20s and 30s, with a slightly higher prevalence in males than females. 

3. Can you prevent catathrenia?

There is no known way to definitely prevent catathrenia. However, certain strategies like adjusting sleep position, adopting good sleep hygiene, stress management, and avoiding stimulants before sleep, can reduce its occurrence. 

4. Who is a sleep specialist?

A sleep specialist is a doctor who is trained to diagnose and treat sleep disorders. They have expertise in sleep medicine and work to improve patients’ sleep quality.

5. What anatomical abnormalities can contribute to catathrenia?

Anatomical abnormalities that can contribute to catathrenia include an obstructed or narrow airway, enlarged tonsils, enlarged adenoids, nasal obstruction, a deviated nasal septum (DNS), or jaw or facial structure discrepancies.

6. Is catathrenia dangerous?

Catathrenia is usually not dangerous or life-threatening. But it can disrupt sleep, causing distress for individuals and their bed partners.