Moans In The Night

An interesting article in a recent sleep medicine journal describes a rare condition where women moan intensely while sleeping. Contrary to what you may have been thinking, these women were not moaning due to either pain or erotic dreams. These seven women sought treatment at Stanford’s sleep clinic due to a condition which has been coined catathrenia. They were all embarrassed by their condition, as well as having family members who were alarmed by the strange noises. Catathrenia has been classified in the parasomnia category, which are disturbances that occur during sleep-wake transitions, in contrast to sleep-breathing problems such as obstructive sleep apnea. This condition is typically seen in younger, premenopausal women, who are relatively thin.

When these women underwent an overnight sleep study, none were found to have obstructive sleep apnea. However, they all had in common the typical feature of multiple breathing pauses with arousals, leading to inefficient sleep. All these women also had in common smaller jaw sizes and a history of dental extractions for crowding or orthodontic problems. Many also complained of chronic fatigue symptoms as well.

This article caught my attention because of the nature of the cure for this condition. All the women were essentially cured with treatment that’s normally given for people with obstructive sleep apnea. Yet, they didn’t have obstructive sleep apnea. What they really had was upper airway resistance syndrome (UARS). As I’ve described at length in other articles, UARS is a variation/precursor to obstructive sleep apnea, where people have narrowed upper airway anatomy that causes brief obstructions and breathing pauses that are not severe enough to be called obstructive sleep apnea.

To receive a diagnosis of obstructive sleep apnea, you have to stop breathing completely or partially for 10 seconds or more, at least 5 times every hour while you sleep. But if you stop breathing 15 times every hour, but wake up after 2-3 seconds each, then your apnea score is 0 and you’re told you don’t have obstructive sleep apnea. These UARS patients are constantly tired and suffer from various other chronic conditions such as recurrent sinus pain or infections, low blood pressure, cold hands or feet, various gastrointestinal symptoms, anxiety/depression, and almost invariably, prefer not to sleep on their backs.

The lead author of this article (Dr. Guilleminault at Standford University) was the first to describe UARS as well. In his original UARS paper, he treated these constantly tired people with CPAP, or continuous positive airway pressure. This is a device that delivers gentle air pressure through the nose, thereby keeping their breathing passageways open. For the most part, they all did well, but in the long term, they could not continue sleeping with masks and hoses attached to their faces. Most UARS patients, due to heightened sensitivities, are unable to tolerate this device.

In this current study describing catathrenia, many of the patients tried CPAP as well, which worked, but they all refused to use it continuously. Most of the patients subsequently underwent various surgical procedures of the throat, and were reported as being “cured.”

It’s amazing how often I find studies that link common and uncommon medical conditions to sleep-breathing disorders. Knowing that sleep-breathing disorders (obstructive sleep apnea or upper airway resistance syndrome) may be linked to depression, anxiety, cold hands, migraines, irritable bowel syndrome, chronic fatigue syndrome, polycystic ovarian syndrome, obesity, ADHD, TMJ, diabetes, high blood pressure, high cholesterol, heart disease, heart attack and stroke, could a breathing problem during sleep be the common link? I’ve even seen articles linking obstructive sleep apnea to epilepsy, cluster headaches, and even cancer. In my book, Sleep, Interrupted, I propose that the this may be a possibility. It may be a bit of a stretch to say a definite yes, but I’m confident that in 10 to 15 years, the answer to the above question will be more clear. This just goes to show that what we generally take for granted my have an alternate explanation.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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19 thoughts on “Moans In The Night

  1. My wife reports my sleep (with CPAP avg. AHI 1.0 to 1.7 with 16.0 cm) is accompanied by “humming” and I still do have cold extremities, cognitive issues and residual sleepiness. Interesting to now consider and question the CPAP therapy not addressing latent UARS (or UARS creep). Though, personnally, affecting variables may be related to sleep hygiene and postion.

  2. I know of one 70-year-old woman and one 85 year-old woman who moan when they sleep and it is not because of pain. The 85-year-old has untreated sleep apnea. I don’t know the 70-year-old that well, but she said she had complaints of people hearing her moan when she sleeps.

  3. I asked Dr. G (from Stanford) to put me in touch with these 7 women but he cites privacy etc. Honestly, I don’t believe they did proper follow up and I don’t believe they were truly cured. I’ve never met ANYONE with this condition who has been cured. I’ve tried all of the things in his study: CPAP, surgery and oral appliance and nothing worked. I’ll believe it when I see it…

  4. I discovered my-apparent-obstructive condition, when frequently swakening-during the night-coughing: I would sit on the side of my bed for a few minutes, until I recovered. Then I would go back to sleep. Eventually, I went to the doctor for an examination. My-initial-diagnosis was, Sleep Apnea Common (obstructive). So, I received throat surgery to remove some fatty-tissue from my throat, in an attempt to clear my airway: That surgical proceedure appeared to have helped-for a short term. But, the same awakening, and coughing routine continued.

    Later, I was given a sleep study (I can’t remember what came first, the surgery or the sleep test). However, through the sleep study it was discovered that I had a condition called, Sleep Apnea Central. My doctor prescribed a CPAP machine. But, I’ve not been able to get the proper CPAP settings: My understanding was that the doctor, and the technicians modified the hose to the CPAP, in order to induce breathing. I was living in Los Angeles, when first diagnosed and treated. But, now I’m in South Bay (Long Beach), and, I was told that I would have to go to Los Angeles for specialized treatment. In addition to having the most serious type of Sleep Apnea, I am dissatisfied with the current treatment.
    I would like to know the status of research on Sleep Apnea Central.

  5. So my husband complains that i moan in my sleep. n he
    thinks im having crazy dreams but i dont. its ridiculous.
    i tell him i dont do it on purpose. im glad its actually a condition
    not just some weird thing i do when i sleep :l

  6. My hubby moans and groans as he sits watching tv. I find it distracting and anoring. Each breath out includes a sound he says he is not aware of. I have cronic pain and make an effort to control what I would sometimes gladly scream out from the pain.. How can he not know he is making these noises. Our children confirm it is not just me. He says he can’t control what he doesn’t realize he is doing. I see no info on a codition that happes while awake.

  7. Whilst i was pregnant with my 4th child. My husband, family members noticed that I would moan in my sleep or when I would be drifting off to sleep. I had even heard myself doing this& it had woken me up. It’s now been 10yrs & I still do it. I must admit it can be quite embembarrassing. Even my children apparently laugh at me whilst I’m doing it. I’m glad to know that it isn’t anything serious to worry about. But I would like to say that I do to suffer from depression, diabetes, low blood pressure, anxiety & I am always tired & do happen to wake up each night between 3-6 times. I am overweight. But when this started 10yrs ago I wasn’t. But I’m so relieved to know that I don’t have to be concerned with sleep apnea or anything like that. And I’m also glad that there is a name for it & it’s not some crazy weird dreams I’m having ;)

  8. Lyndsey,

    Thanks for commenting. Catathrenia is now considered a variation of a sleep-breathig related disorder. A woman who is overweight and has diabetes has about an 80% chance of having obstructive sleep apnea. Not sleeping well due to frequent obstructions and arousals can definitely aggravate depression and anxiety. Low blood pressure is associated with upper airway resistance syndrome, which is another variation of obstructive sleep apnea. I write extensively in my blog about this.

  9. Omg is nice to know that I’m not the only one with this problem. I’ve had some family members tell me I was moaning in my sleep. My son told me I was doing it one night but I didn’t believe him because I felt like I hadn’t fallen asleep yet. I’m not really sure how long I’ve been doing it but I too am overweight, plus I have hypothyroidism, and my dr just currently increased my paxil to 30 mg because I was feeling tired all the time even after sleeping at least 8 hours, sometimes longer.

  10. I only moan when my husband is in bed with me. I can’t determine why. If it’s because the bed is too small and he is touching me or somehow him being here adds to my stress levels? I can’t find anything on moaning only at certain times. I’ve recorded myself alone and there’s no moaning. We have tried him sleeping in another room and he checks on me. We leave the door open and only do I moan when he’s here in bed with me!! Please help!!

  11. i do this before i fall asleep, it has only started in the last few months, it is a sort of whimpering noise, i have low bp, v cold feet, insulin resistance, post menopausal, overweight etc, also have mild asthma. Wd b reassuring to know it was related to something.

  12. I’ve been moaning in my sleep since I could remember. I get complaints from family. My partner tells me it sounds like I’m haveing a very erotic dream. What is the cause of this? It’s very embarrassing.

  13. My 4 year old son has moaned just like this pretty much since he was born. I just listened to a 9 minute stretch of groaning. I’ve always felt guilty that it may be my fault. my hubby and I were separated during my second trimester of pregnancy. I was so miserable during that time that I would moan myself to sleep. I always wondered if that imprinted itself on him in utero, and he does that to comfort himself in his sleep. It sounds farfetched that this would be the cause, but I wonder if any of your mothers had a similar experience while pregnant.

  14. I have moaned in my sleep since childhood and now forty. I have extremely cold hands and feet during winter, I find it hard to exchange a handshake during this season.
    And to cap it all, I lost some teeth during my childhood, had no access to dental care so my teeth which appeared on any unsuitable space of my gum owing to having a small jaw were removed. Now I have gaps since the milk teeth which were crowding out my adult teeth eventually fell off.
    At least I have an idea of what’s happening to me. And i have been diagnosed as having a growth on my thyroid gland, apart from the excessive exhaustion.

  15. Dear Dr. Park, I really hope you read this. I am a 49 year old sufferer of this, and I seem to have all of the related conditions as well. I have a severe problem. My husband and I have had separate rooms now for half of our 11 year marriage. When I sleep, I always feel as if I am not really if I am dozing. I sometimes wake myself up moaning. I am always exhausted and no matter how much caffeine, vitamins, B12 shots etc. I take, it makes no difference. My husband says I make the most noise when I am really tired, but now I am always really tired, so it is every night. I moan, mumble, sometimes sound like I am carrying on a conversation, although no one can make out the words. My husband can’t stand it. He finds it very creepy and scary. It is humiliating. There are times when I am sick, or so lonely and I will ask if I can sleep with him for just a few hours. Occasionally, he will let me, like last night, but he says he really would prefer if I didnt. I also have anxiety/depression, am always cold and have Raynauds in my hands, I have low blood pressure, high cholesterol, nausea, constipation. I suffer severe headaches almost daily. I have irritable bowel and poly cystic ovary disease, and insomnia. I had very early stage thyroid cancer, and my thyroid was removed 11 years ago. I do not drink alcohol or use drugs, but due to severe arthritis, I am on pain management therapy. The moaning occurs whether I take any medicine or not. I have insomnia and wake up about every 2 hours. I never sleep through the night or get a good nights sleep.
    In short, my health and quality of life is terrible. Although, I have a good marriage(stable, with no arguments or issues), this sleep problem is so terrible that my husband and I are like cousins now almost. Because, my husband and son sleep at one end of the house, and I sleep at the other. While they sleep at night, I am up and down, dozing and waking, moaning myself awake, and trying to get through the long nights alone. Basically, I think I scare them. I sound like someone in a horror movie, and they can’t handle listening to me moaning and thrashing in the dark. And I don’t blame them. I looked this up today, because I am like an outcast in my own house. I feel like a leper in my own leper colony
    I have very good insurance. If you think there is any hope for me, please tell me who I might contact or what tests I might be able to take. Unfortunately, this isn’t fatal, so I probably have another 30 years or so of this exile to look forward to, and it’s getting to the point where I don’t even want to get up in the morning. I am always sick, always tired, Lways in pain, and I can’t even curl up at night with someone who will tell me that everything will be OK..because it won’t. My family is afraid of me, like I am possessed or something. This is ruining my life.
    Please if you can think of anything, or anyone else out there can, let me know. I am in New Jersey.

  16. Cheryl,

    Sorry to hear.

    My general recommendation for someone with these symptoms is to first see a sleep physician for a full sleep evaluation and possibly undergo a sleep study. Even if you don’t have obstructive sleep apnea, you could have upper airway resistance syndrome, which you can read more about on this website.

    Good luck…and please keep us posted.