Catathrenia under sodium oxybate in narcolepsy with cataplexy

Francesca Poli, Lara Ricotta, Stefano Vandi, Christian Franceschini, Fabio Pizza, Vincenzo Palaia, Keivan Kaveh Moghadam, Donatella Banal, Roberto Vetrugno, Michael J. Thorpy, Giuseppe Plazzi

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Purpose: This study aims to report on catathrenia occurring in narcolepsy with cataplexy (NC) patients under sodium oxybate (SO) treatment. Catathrenia is a parasomnia characterized by groaning and an abnormal respiratory pattern during sleep. Methods: Fifty-one patients with NC and starting SO therapy underwent a baseline overnight polysomnography (PSG) to detect any sleep-related breathing disorders (SRBD). To avoid risks due to a possible central respiratory control depression by SO, all patients with concomitant obstructive sleep apnea (OSA) were treated with a nasal continuous positive airway pressure (nCPAP) device. After 2 months of treatment with SO, all patients underwent a follow-up overnight PSG to investigate possible newly occurring SRBD. They also underwent a semi-structured clinical interview to monitor other potential SO side effects. Results: At baseline, four out of 51 patients showed simple snoring, and eight, mild to severe OSA. After a titration PSG night, patients with OSA received a nCPAP device. After 2 months of SO treatment, 28 patients (54.9%) showed SO-related side effects, including SRBD in 11 (21.6%). The follow-up PSG showed a respiratory pattern characteristic of catathrenia in seven patients (13.7%) as a newly observed and possibly benign SO side effect, and ruled out a worsening of OSA. Conclusions: Catathrenia should be considered a possible side effect in NC patients under SO treatment and should be accurately identified to prevent unnecessary SO withdrawal.

Original languageEnglish (US)
Pages (from-to)427-434
Number of pages8
JournalSleep and Breathing
Issue number2
StatePublished - Jun 2012


  • Groaning
  • Parasomnia
  • Side effect
  • Sleep apnea
  • Sleep-related breathing disorders

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology


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