Catathrenia as a REM predominant disorder of arousal
Bibliographic record
Abstract
Catathrenia is an uncommon and poorly understood disorder, characterized by groaning during sleep occurring in tandem with prolonged expiration. Its classification, pathogenesis and clinical relevance remain debated, substantially due to the limited number of cases reported to date. We report a series of consecutive cases of catathrenia, their clinical and PSG characteristics, and their subsequent management. Consecutive patients with catathrenia who had undergone full PSG in our institution over a 5-and-half-year period were included. Catathrenia events (CEs) were examined in clusters, formulating catathrenia periods (CPs). The relationships between CPs, sleep stage distribution, EEG arousals, and other sleep parameters were assessed, along with the clinical presentation and management of catathrenic patients. A total of 427 CPs were identified in 38 patients, 81% arising from REM sleep. EEG arousals preceded or coincided with the onset of 84% of CPs, which were of longer duration than those not associated with an arousal (57.3±56.8 vs 32.2±29.4 sec, p<0.001). Each CE had a characteristic airflow signal, with inspiration preceding a protracted expiration, followed by deep inspiration. Although the majority of patients were referred on the basis of bed-partner complaints, 44.7% complained of daytime sleepiness. CPAP and sleep-consolidating pharmacotherapy lead to subjective improvement, but were limited by poor long-term adherence. In the largest series of catathrenia patients reported to date, we found that this rare disorder is characterized by a distinct breathing pattern, and arises predominantly from REM sleep, with arousals almost uniformly preceding or coinciding with the onset of catathrenia periods.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".