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Catathrenia in severe obstructive sleep apnea: A novel entity never described before. | LitMetric

Catathrenia in severe obstructive sleep apnea: A novel entity never described before.

Sleep Med

Department of Pulmonology, Leuven University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven Campus Gasthuisberg, Leuven, Belgium; Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium.

Published: December 2023

AI Article Synopsis

  • Catathrenia is a unique sleep disorder characterized by groaning during sleep, particularly in patients with severe obstructive sleep apnea, which has not been previously documented.
  • A case study involving nine obese male patients revealed groaning episodes linked to cortical arousals and "rescue" respirations after apneas or hypopneas, indicating a complex interaction between obstructive events and breathing patterns.
  • The study found that positive airway pressure treatment effectively eliminated these groaning episodes, suggesting a potential therapeutic approach for managing this condition.

Article Abstract

Study Objectives: Catathrenia, derived from the Greek κατά (kata) meaning below and θρηνώ (threnia) to lament, is characterized by expiratory groaning episodes during sleep. In a case series of nine patients with severe obstructive sleep apnea, we observed a peculiar groaning entity that has not been described before.

Methods: We described and illustrated the cases with polysomnographic tracings and additional audio recordings.

Results: All patients were men, obese (body mass index 39 ± 6 kg/m) with an apnea-hypopnea index ranging from 47 to 125/h. In addition, we identified groaning events that were consistently preceded by a cortical arousal associated with a "rescue" respiration after an obstructive hypopnea or apnea. These events exhibited characteristics of "mixed apnea's", but the "central apnea-like part" was a prolonged expiratory groaning phase, with immediately after the terminal expiratory snort appearance of an obstructive apnea. In case the duration of this expiration was at least 10 s we calculated these events separately and the index was 8.4 ± 7.7/h. More rarely (index 0.6 ± 0.5/h) a "central apnea mimicking event" with groaning not followed by an obstruction, was observed. We also observed groaning episodes during expiration with a shorter duration (less than 10 s), not calculated separately. Positive airway pressure, which was well tolerated, eliminated these events.

Conclusions: This novel catathrenia entity preceded by a cortical arousal and "rescue" respiration in response to obstructive events is intriguing. Possible explanations for these observations are further discussed in this article.

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Source
http://dx.doi.org/10.1016/j.sleep.2023.10.023DOI Listing

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