Department of Neurology, Charles University in Prague, General Teaching Hospital, Czech Republic.
Sleep Med. 2009 Oct;10(9):1051-5. doi: 10.1016/j.sleep.2008.09.019. Epub 2009 Mar 31.
Nocturnal groaning (catathrenia) is a chronic sleep disorder classified as parasomnia with unclear effects on sleep and life quality. It is characterized by repeated episodes of monotonous vocalization in prolonged expiration (episodes of bradypnea) occurring mostly in REM sleep. We sought to assess its impact on sleep microstructure, i.e., the frequency of arousals relative to the groaning episodes. The frequency, duration and sleep-stage distribution of the groaning episodes were also studied.
Eight patients with nocturnal groaning (5 male, 3 female, age range 11-32 years, mean age 23+/-7.1) were evaluated. All underwent standard neurologic examination and nocturnal videopolysomnography for two consecutive nights. The second night polysomnography data were used to evaluate sleep parameters. The groaning episodes (bradypneic events) were counted separately, not as clusters.
Sleep macrostructure revealed no specific changes. The number of groaning episodes/bradypneic events during the night varied from 40 to 182 (total number 725). The duration of bradypnea was from 2 to 46s (mean duration 12.5s). Groaning episodes prevailed in REM sleep (76.5%). The rate for NREM 2 was 21.5%, and only sporadic episodes were noted in delta sleep (1.9%); 63.3% of the events were associated with arousals, and in 94% of them an arousal occurred before or together with the onset of bradypnea. The arousal index was increased in 5 patients (mean 20.4). Bruxism was present in 4 cases, in 1 patient appearing in close association with groaning episodes. Ronchopathy was noted in 4 cases.
Almost two-thirds of the groaning episodes were connected with arousals. Hypothetically, nocturnal groaning may well be a source of sleep disruption (mainly REM) in some cases. Because an arousal mostly preceded or coincided with groaning we believe that arousal mechanisms may be involved in the pathogenesis of nocturnal groaning.
夜间呻吟（catathrenia）是一种慢性睡眠障碍，被归类为睡眠障碍，其对睡眠和生活质量的影响尚不清楚。它的特征是在 REM 睡眠中反复出现单调的发声（呼吸暂停发作），主要发生在呼气延长时。我们试图评估它对睡眠微结构的影响，即相对于呻吟发作的觉醒频率。还研究了呻吟发作的频率、持续时间和睡眠阶段分布。
评估了 8 例夜间呻吟（5 名男性，3 名女性，年龄 11-32 岁，平均年龄 23+/-7.1）患者。所有患者均接受标准神经检查和连续两晚的夜间视频多导睡眠图检查。第二晚多导睡眠图数据用于评估睡眠参数。呻吟发作（呼吸暂停发作）单独计数，不作为簇计数。
睡眠宏观结构未显示出特定变化。夜间呻吟发作/呼吸暂停发作的次数从 40 次到 182 次不等（总次数为 725 次）。呼吸暂停的持续时间从 2 秒到 46 秒不等（平均持续时间为 12.5 秒）。呻吟发作主要发生在 REM 睡眠中（76.5%）。NREM 2 的发生率为 21.5%，仅在 delta 睡眠中偶发（1.9%）；63.3%的事件与觉醒有关，在 94%的事件中，觉醒发生在呼吸暂停开始之前或与之同时发生。5 名患者的觉醒指数增加（平均 20.4）。4 例患者存在磨牙症，1 例患者的磨牙症与呻吟发作密切相关。4 例患者出现打鼾。
近三分之二的呻吟发作与觉醒有关。假设夜间呻吟可能是某些情况下睡眠中断（主要是 REM）的来源。由于觉醒大多发生在呻吟之前或与之同时发生，我们认为觉醒机制可能参与了夜间呻吟的发病机制。
