There are many types of sleep disorders, and some have overlapping presentations. At The Insomnia and Sleep Institute of Arizona, we treat all sleep disorders, including breathing disorders like obstructive sleep apnea (OSA) and parasomnia events. 

Dubbed the Face of Sleep Medicine in the Phoenix area, we are staffed by sleep specialists who concentrate in sleep medicine. From your consultation onward, you work with an expert to ensure a correct diagnosis followed by proper testing and treatment, if necessary. As an outcome-driven clinic, you can rest easy knowing help for your sleep disturbance is available. 

What Is Catathrenia?

What Is Catathrenia?

Catathrenia is a disorder that is currently being reclassified. For years, catathrenia was considered a type of parasomnia, but it is now more often defined as a type of sleep-related breathing disorder, most notably by the third edition of the International Classification of Sleep Disorders (1). 

Oftentimes, the patient’s bed partner points out the event because it is so unusual. Instead of more “typical” presentations of a breathing disorder, such as snoring, those with catathrenia often groan, emit a squeak, or moan (1).

The term catathrenia was first introduced in a landmark 2001 paper by Dr. Roberto Vetrugno and colleagues. Their report described four patients between the ages of 15 and 25 who produced expiratory groaning during sleep. The authors referred to this phenomenon as catathrenia, defining it as a distinctive parasomnia (2, 3, 4).

Diagnosing Catathrenia and Other Sleep Disorders

For those who do not routinely share their bed with others, they might be completely unaware of their catathrenia. Unfortunately, the way this disorder presents can be embarrassing for the person with catathrenia and uncomfortable for those who witness it. 

The groaning associated with catathrenia is regularly described as sexual, though erotic dreams are not necessarily occurring at the time (4). Catathrenia can occur in people of all ages, including children (5), so it is unsurprising that it can be especially embarrassing for children during a sleepover.

Catathrenia Breathing Pattern vs Snoring

Acoustic research shows that catathrenia produces a distinctive sound pattern. Studies describe the vocalization as “monotonous sinusoidal,” meaning the sound tends to follow a steady rhythm with a consistent pitch rather than fluctuating noise (6, 7).

This is one of the key differences between catathrenia and snoring. Snoring produces an irregular acoustic signal, while catathrenia more closely resembles a sustained vocal tone (8).

Clinically, listeners may describe the sound as a prolonged moan, hum, or monotone vocalization that occurs during exhalation (9). Because the sound is steady and vocal in quality, it can be striking and sometimes misunderstood as intentional or emotional rather than a sleep-related breathing phenomenon.

Talking About Catathrenia

If you have noticed groaning during sleep in yourself, your partner, or your child, catathrenia may be something to discuss with a sleep doctor.  Many people first find answers through online communities, and researchers have even used these groups to recruit participants and collect real-world details such as sleep history and medical background (10).

Research also shows catathrenia can affect children and adults, as well as males and females (5). It’s still considered uncommon and not fully understood, which helps explain why many people struggle to get clear guidance at first (11).

Sleep Stage Patterns and Associated Factors

Catathrenia can occur in different sleep stages, but research shows it most often appears during REM sleep (12). At the same time, studies confirm episodes are not limited to REM sleep and can also happen during non-REM sleep (10).

This helps explain why symptoms may vary from night to night. A person may experience episodes during different parts of the sleep cycle, which is one reason the condition can be difficult to recognize without a sleep study.

Catathrenia in Children

Catathrenia can occur in children (13). In many cases, parents or caregivers are the first to notice the nighttime groaning and bring the concern to a clinician (13).

The presentation in children looks similar to adults, involving a prolonged exhalation followed by a groaning sound during sleep (13). Because unusual sleep sounds can overlap with other conditions, including breathing disorders or parasomnias, evaluation may be helpful when the noises are persistent or concerning.

Pediatric sleep assessment focuses on determining whether the sounds represent catathrenia or another sleep condition that may affect breathing or sleep quality.

When Should Someone See a Sleep Specialist for Catathrenia?

A sleep specialist may be considered when nighttime groaning is frequent, worsening, socially distressing, or difficult to distinguish from snoring or sleep apnea. 

Evaluation is also appropriate if bed partners report pauses in breathing, fragmented sleep, or daytime symptoms such as fatigue. A sleep study can help clarify whether the sounds represent catathrenia or another sleep disorder

Treating Catathrenia

Treatment for catathrenia depends on symptoms and how disruptive the sounds are. Research suggests continuous positive airway pressure (CPAP) can reduce or even eliminate groaning episodes in some patients (14). Because catathrenia may involve abnormal breathing patterns during sleep, CPAP is often considered when symptoms affect sleep quality or daytime functioning (15).

Some patients improve when upper-airway surgery is combined with therapies such as oral appliances, highlighting that treatment is often individualized rather than standardized (16)

When to Seek Evaluation for Catathrenia or Other Sleep Disorders

If you are struggling with a disorder involving breathing, parasomnia events, or any issues related to getting the quantity and quality of sleep you need, help is available. There is no referral necessary to book your consultation with The Insomnia and Sleep Institute, making it easy to get support for sleep struggles. We treat patients as young as two years old and are committed to starting your journey with a correct diagnosis.

The Insomnia and Sleep Institute of Arizona provides care across multiple convenient locations, including Phoenix, Scottsdale, and Gilbert, allowing patients to access specialized sleep evaluation close to home. Each location offers comprehensive testing, expert consultation, and individualized treatment planning guided by board-certified sleep specialists.

References

  1. Drakatos, P., Higgins, S., Duncan, I., Stevens, S., Dastagir, S., Birdseye, A., Lykouras, D., Muza, R., Gildeh, N., Rosenzweig, I., Williams, A. J., Leschziner, G. D., & Kent, B. D. (2017). Catathrenia, a REM predominant disorder of arousal? Sleep Medicine, 32, 222–226. https://doi.org/10.1016/j.sleep.2016.06.010
  2. Vetrugno, R., Provini, F., Plazzi, G., Vignatelli, L., Lugaresi, E., & Montagna, P. (2001). Catathrenia (nocturnal groaning): A new type of parasomnia. Neurology, 56(5), 681–683. https://doi.org/10.1212/wnl.56.5.681
  3. Bansal, R., Kodali, L., & Weingarten, J. A. (2015). Nocturnal Groaning: Strange Sounds in the Night. Annals of the American Thoracic Society, 12(1), 128–130. https://doi.org/10.1513/annalsats.201407-316cc
  4. Vetrugno R;Provini F;Plazzi G;Vignatelli L;Lugaresi E;Montagna P. (2026). Catathrenia (nocturnal groaning): a new type of parasomnia. Neurology, 56(5). https://doi.org/10.1212/wnl.56.5.681
  5. Martel, Q., Maranci, J.-B., Philippe, C., & Arnulf, I. (2024). Lamentations in the night: A systematic review on catathrenia. Sleep Medicine Reviews, 75, 101944. https://doi.org/10.1016/j.smrv.2024.101944
  6. Koo. (2026). Acoustic characteristic of catathrenia and snoring: different subtypes of catathrenia. Sleep Medicine, 13(7). https://doi.org/10.1016/j.sleep.2012.04.002
  7. Ji, K.-H. (2023). Atypical Catathrenia Mimicking Sleep Choking Sound of Obstructive Sleep Apnea. Sleep Medicine Research, 14(2), 123–125. https://doi.org/10.17241/smr.2023.01634
  8. Koo, D. L., Hong, S. B., & Joo, E. Y. (2012). Acoustic characteristic of catathrenia and snoring: Different subtypes of catathrenia. Sleep Medicine, 13(7), 961–964. https://doi.org/10.1016/j.sleep.2012.04.002
  9. Catathrenia: What It Is, Causes, Symptoms & Treatment. (2024, August 28). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/catathrenia
  10. Alonso, J., Camacho, M., Chhetri, D. K., Guilleminault, C., & Zaghi, S. (2017). Catathrenia (Nocturnal Groaning): A Social Media Survey and State-of-the-Art Review. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 13(4), 613. https://doi.org/10.5664/jcsm.6556
  11. Drakatos, P., Higgins, S., Duncan, I., Stevens, S., Dastagir, S., Birdseye, A., Lykouras, D., Muza, R., Gildeh, N., Rosenzweig, I., Williams, A. J., Leschziner, G. D., & Kent, B. D. (2017). Catathrenia, a REM predominant disorder of arousal? Sleep Medicine, 32, 222–226. https://doi.org/10.1016/j.sleep.2016.06.010
  12. Panagis Drakatos, Higgins, S., Duncan, I., Stevens, S., Sakina Dastagir, Birdseye, A., Dimosthenis Lykouras, Muza, R., Gildeh, N., Rosenzweig, I., Williams, A. J., Leschziner, G. D., & Kent, B. D. (2016). Catathrenia as a REM predominant disorder of arousal. Sleep Medicine, 32, 222. https://doi.org/10.1016/j.sleep.2016.06.010
  13. Langley, R. J., Hill, L., Hill, E. A., & Urquhart, D. S. (2017). The curious incident of groaning in the night-time. Breathe, 13(2), 123–126. https://doi.org/10.1183/20734735.017816
  14. Kingshott, R. (2008). Catathrenia can be successfully treated with CPAP, reports new study. American Academy of Sleep Medicine – Association for Sleep Clinicians and Researchers. https://aasm.org/new-study-in-the-journal-sleep-finds-that-catathrenia-can-be-successfully-treated-with-cpap/
  15. Petitto, L., Com, G., Jackson, R., Richter, G., & Jambhekar, S. (2019). Catathrenia and Treatment With Positive Airway Pressure in the Pediatric Population. Journal of Clinical Sleep Medicine, 15(12), 1853–1857. https://doi.org/10.5664/jcsm.8100
  16. Catathrenia: What It Is, Causes, Symptoms & Treatment. (2024, August 28). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/catathrenia

 

Disclaimer: The information provided in this blog post is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a licensed healthcare provider for recommendations specific to your individual health needs.