Sleep Education

American Academy of Sleep Medicine 

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Sleep related groaning, also called catathrenia, causes you to groan vocally while you sleep. Sleep related groaning is a long-lasting disorder that often occurs nightly.

The groaning sound is usually quite loud. Your breathing becomes unusually slow during a groaning episode. You take in a slow, deep breath. Then you make a long exhale that includes the moaning sound. The sound can last from only a few moments to more than 40 seconds. It always ends with a sigh or a grunt. Groans often repeat in clusters for two minutes to one hour. These clusters of groaning may recur many times per night.

Facial expressions are calm and do not reflect anguish. Despite the moaning sound, the groans do not seem to be related to any emotional feelings. Groaning can occur when lying in any position. But it tends to stop when you change positions in bed. Then it may resume again later in the night.

The person who groans is usually unaware of the sounds. It is much more disturbing to the bed partner, roommate or family member who hears it. Other descriptions of the groaning sound include the following:

  • High-pitched or cracking sounds
  • Loud humming
  • Loud roaring

The cause of sleep related groaning is not known. It is not related to any problem with breathing. There is also no abnormal brain activity involved. A physical exam tends to show no related medical cause. There also does not appear to be any link to mental disorders.

A mild case of restless sleep or daytime fatigue may be a result. Otherwise, there is usually no major sleep complaint. The groaning is more likely to disturb the sleep of the bed partner or others in the household. A hoarse voice or sore throat might appear in the morning.

The groaning appears more often during the stage of rapid-eye-movement (REM) sleep. There are five stages of sleep that make up one sleep cycle. You normally complete four to six sleep cycles in one night. The fifth stage of each cycle is called REM sleep. It usually begins about 90 minutes after you fall asleep. REM sleep makes up about 20 percent to 25 percent of your total sleep time.

The first REM period tends to last for only a few minutes. The REM stage gets longer during each sleep cycle. Your last period of REM sleep may last as long as an hour. These latter periods of REM sleep include most episodes of groaning. Groaning may occur from time to time during non-REM sleep.

A moaning sound can also occur during an epileptic seizure. This sound would not occur on a regular basis like groaning does. A moaning type of sound can also be made by snoring. But the primary sound of snoring occurs when you inhale. Groaning occurs when you exhale. Some people can make a harsh, shrill, creaking sound when they breathe. This is called stridor. It may occur mainly when they sleep. But stridor happens with almost every breath. Unlike groaning, it does not appear in blocks of time in the night.

Diagnosis and Treatment

You may need to see a sleep specialist if sleep related groaning severely disrupts your bed partner’s sleep. You should also see a sleep specialist if you can’t sleep well or are very tired during the day.

The doctor will need to know when the groaning began. He or she will want to know how often it occurs and how long it lasts. The doctor will need to know your complete medical history. Be sure to inform him or her of any past or present drug and medication use.

Tests are not normally needed for someone who has sleep related groaning. Your doctor may have you do an overnight sleep study if your problem is severely disturbing your sleep. This study is called a polysomnogram. It charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This study will help reveal if your nightmares are related to any other sleep disorder.

A patient will usually be referred to an ENT (ear, nose, and throat) specialist for a thorough exam. The doctor will make sure that other conditions are not the cause of the groaning. There is no specific treatment for groaning. The bed partner may need to wear ear plugs. In extreme cases he or she may need to sleep in another room.

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