Moans In The Night

June 17, 2012

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.

10 Responses to “Moans In The Night”

  1. S.A. on June 18th, 2012 11:22 am

    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. Jane on June 18th, 2012 3:59 pm

    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. Stop Snoring News | on July 6th, 2012 8:54 am

    [...] You can read the full article here Moans In The Night [...]

  4. T on July 19th, 2012 12:03 pm

    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…

  5. Arthur Morgan on November 9th, 2012 9:39 am

    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.

  6. pRla on November 12th, 2012 3:03 am

    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

  7. ruby on January 5th, 2013 9:24 pm

    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.

  8. Lyndsey on November 16th, 2013 8:58 am

    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 ;)

  9. Steven Park on November 16th, 2013 1:53 pm

    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.

  10. Sherri Hendrix on January 30th, 2014 1:35 am

    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.

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