title: Catathrenia (Nocturnal Groaning): A Social Media Survey and State-of-the-Art Review.
abstract: OBJECTIVE
  Catathrenia is an underrecognized nocturnal vocalization phenomenon that can be a source of perplexity to patients, bed partners, and medical providers. Catathrenia is distinct from both sleep talking (a parasomnia with loud talking during sleep) and snoring (noise due to vibration of upper airway soft tissues related to variations in airway resistance). The objective of this review is to provide an evidence-based resource to help the practitioner reliably evaluate and manage patients with this condition.
  
  
  METHODS
  Data were gathered from: (1) PubMed, Scopus, Web of Science, and Google Scholar; and (2) catathrenia social media groups (Yahoo and Facebook).
  
  
  RESULTS
  Data collected were (1) 15 case reports and 17 case series describing 191 patients with catathrenia; (2) questionnaires from 47 catathrenia subjects; (3) 5 audio files.
  
  
  CONCLUSIONS
  Catathrenia is a noise produced during sleep (distinct from snoring) with identifiable harmonics, a computable main frequency, and high-decibel intensity that involves active adduction and vibration of the vocal cords during expiration. The quality of groaning in catathrenia is monotone, and often presents with a morose or sexual connotation, causing a significant social problem for patients. Although there is no association with risk of physical harm, catathrenia does present a significant disturbance to the bed partner and has been associated with subjective impairments to sleep quality, including unrefreshing sleep and fatigue. Polysomnography can be useful if performed properly to confirm the diagnosis and to evaluate for comorbid sleep disturbances, such as obstructive sleep apnea or parasomnia. Directions for further research could involve consideration of deep breathing exercises, yoga, meditation, or myofunctional therapy to help abate symptoms.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Jose
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii.|Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, California.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Chhetri
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, California.
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Soroush
authors.initials: S
authors.lastname: Zaghi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D020447:Parasomnias / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D017286:Polysomnography; D012135:Respiratory Sounds / Q000503:physiopathology*; D061108:Social Media; D011795:Surveys and Questionnaires
keywords: catathrenia; nocturnal groaning; nocturnal moaning; sleep-disordered breathing; vocalization