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Anatomical characteristics of catathrenia (nocturnal groaning) in upper airway and orofacial structures

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Abstract

Background

Catathrenia is a rare sleep disorder characterized by repeated groaning in a protracted expiration preceded by a deep inspiration. This study aimed to explore whether anatomy is one of pathophysiology of catathrenia by investigating the anatomical features associated with catathrenia in the upper airway, craniofacial structures, and dental patterns.

Material and methods

Twenty-two patients with catathrenia (7 males, 15 females; age 22 to 69 years) were recruited as well as 66 patients matched by age and gender (matching proportion 1:3) with obstructive sleep apnea syndrome (OSAS). Both groups underwent cephalograms and dental casting, and cephalometric measurements and the Peer Assessment Rating (PAR) index was applied. Differences between the two groups were evaluated and cephalometric measurements in catathrenia group were compared with control values of Chinese patients from previous studies.

Results

As for airway-related measurements, increased PNS-R, PNS-UPW, and H-FH and decreased SPT and TGL were found in catathrenia group compared to normal values. Such trends were found even more evident when compared with the OSAS Group. As for craniofacial parameters, values of U1/NA and U1/SN were found increased in the catathrenia group compared with normal values and values of MP/FH and Y decreased. The differences were more distinct from the OSAS Group. Increased arch lengths and upper inter-first molar widths, and decreased overbite and PAR index, were found in catathrenia group compared with the OSAS Group.

Conclusion

Catathrenia patients present with a broad upper airway, yet protrusive upper incisors and flat mandibular angles. Anatomical characteristics of catathrenia are different from those associated with OSAS, namely a wide airway, large skeleton, and good occlusion.

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Acknowledgment

The subject was partly supported by the National Natural Science Foundation of China (81470272), and the Seeding Grant for Medicine and Engineering Sciences of Peking University (BMU20140397).

Conflict interest

We declare that there is no commercial or associative interest that presents conflict with the work submitted.

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Author notes

    Authors and Affiliations

    1. Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People’s Republic of China

      Zeliang Hao, Jingjing Zhang & Xuemei Gao

    2. PKU-Upenn Sleep Center, Peking University International Hospital, Beijing, 102206, People’s Republic of China

      Liyue Xu

    3. Department of Pulmonary Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China

      Fang Han

    4. Department of Pulmonary Medicine, Aerospace Central Hospital, Beijing, 100049, People’s Republic of China

      Xueli Lan

    Authors
    1. Zeliang Hao
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    2. Liyue Xu
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    3. Jingjing Zhang
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    4. Xueli Lan
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    5. Xuemei Gao
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    6. Fang Han
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    Corresponding authors

    Correspondence to Xuemei Gao or Fang Han.

    Additional information

    Zeliang Hao and Liyue Xu contributed equally to this work.

    Appendix

    Appendix

    Measurements of craniofacial structures are summarized in Appendix Table 5.

    Table 5 Craniofacial and upper airway measurements
    Full size table

    Measurements of the upper airway, and surrounding structures are summarized in Appendix Table 6.

    Table 6 Measurements of dental models
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    Hao, Z., Xu, L., Zhang, J. et al. Anatomical characteristics of catathrenia (nocturnal groaning) in upper airway and orofacial structures. Sleep Breath 20, 103–111 (2016). https://doi.org/10.1007/s11325-015-1191-1

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    • DOI: https://doi.org/10.1007/s11325-015-1191-1

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