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To the Editor:
Iriarte et al. report a patient with catathrenia and mild obstructive sleep apnea whose polysomnographic recording showed a respiratory dysrhythmia during all sleep stages that caused secondary oxygen desaturations and irregular movements of the abdominal wall. A trial with continuous positive airway pressure (CPAP) improved this condition.1 These features are somehow atypical for catathrenia.2,3
Over 90% of the reported bradypneic events in catathrenia occur only, or predominantly, during REM sleep.2 There is an internal, brainstem-based, excitatory drive to the respiratory system during REM sleep possibly independent of chemical stimuli.4 The hallmark of catathrenia is a deep inspiration followed by a short expiratory phase and a long expiratory period with sound production. The output signal of the respiratory thoracoabdominal bands is flat or very low during these expiratory …
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