What’s all that sighing, moaning and groaning about?

by Carolyn Thomas    @HeartSisters

blue eye abstractWhen I first saw exhaustion described as the leaky emotion of chronic illness, it reminded me of something else. (This happens to me a lot, by the way, a fizzy stream of consciousness that bubbles ideas around my cranium like pinballs until one finally settles in with a *plink*).  The plink this time was that, along with the chest pain, exhaustion and the damned relentlessness that can so often accompany episodes of my refractory angina (or many other symptoms of chronic illness for others), there’s another response I’ve only recently begun to learn about.  

And that’s the sound of soft little moaning, groaning, or sighing noises.

Remember that, for many of us who’ve already survived a heart attack, every twinge afterwards between neck and navel feels like the grim threat of another one, any minute now.

For those living with a cardiac arrhythmia like atrial fibrillation, every fleeting palpitation looms large as a possible warning of more to come.

For those diagnosed with heart failure (still waiting for cardiologists, by the way, to come up with a far less horrible name), every bout of shortness of breath is frightening.

Any one of these episodes may call for moaning, groaning and sighing.

I assumed that my own moaning may have started with a kind of reflexive whisper: “Oh, no, no, no….  This can’t be another heart attack….  I don’t want this to be happening. Not now. Not today. Oh, pleeease. No. No. No-o-o-o-o-o-oooo….” 

But soon it became so “normal” for me to be moaning, groaning and sighing all over the place during these episodes that I now often forget to notice I’m even making any sounds at all – unless my family or friends who happen to be nearby ask me: “What’s wrong?” (Wrong? Nothing’s wrong! Can’t a person moan and groan around here?!)

It turns out that some of these audible yet unbidden sounds may actually have some beneficial health purpose. 

Take sighing, for example. A study on sighing published in the journal Nature was co-authored by UCLA’s Dr. Jack Feldman, who explained Sighing 101 like this:

“Sighing starts out as a normal breath, but before you exhale, you take a second breath on top of it. Whether you realize it or not, you do this about 12 times an hour, and even more than that when you’re stressed or anxious.”

No wonder I tend to make this sighing sound more often when I’m in the middle of feeling stressed or anxious during a flare-up of scary cardiac symptoms. But although some components of sighing do relate to an emotional state, Dr. Feldman says that the mechanism behind the emotional roots of conscious sighing “remains a mystery”.

The physiological purpose of sighing, he explains, is to inflate the alveoli, the half-billion tiny, delicate, balloon-like sacs in the lungs where oxygen enters and carbon dioxide leaves the bloodstream. But sometimes, individual sacs can collapse. According to Dr. Feldman:

“If you don’t sigh every five minutes or so, these alveoli will slowly collapse, causing lung failure. When alveoli collapse, they compromise the ability of the lung to exchange oxygen and carbon dioxide. The only way to pop them open again is to sigh, which brings in twice the volume of a normal breath.

“If you don’t sigh, your lungs will fail over time. That’s why patients in early iron lungs had such problems, because they never sighed. The machines had not been programmed to give patients regular deep, lung-filling breaths. Current ventilators regularly deliver a large inflation of air that mimics a sigh.”

From this, I learned that sighing is good, so I plan to do lots more of it from now on.

Go ahead and join me. Let’s try a nice deep lung-filling *s-i-g-h* right now . . .

Next, let’s consider the audible moaning and groaning I’ve started adding to my sighing repertoire.

If I were engaging in this kind of unconscious moaning in my sleep, doctors might know it as something called catathrenia or nocturnal groaning that typically occurs during our sleep-wake transitions.(1) 

It’s often only apparent to those unfortunates whose sleep is disturbed by all the racket caused by their moaning companion. The phenomenon usually starts during one’s late teens or early 20s.  It sounds like a low, sustained, mournful sound, often repeated in clusters ranging from two minutes to one hour, many times per night.  Not surprisingly, it may seem like these sounds indicate sorrow or pain, but facial expressions are typically calm and do not reflect discomfort or anguish. Despite the sleepy moaning sounds of catathrenia, the groans don’t seem to be related to any particular emotional feelings, according to the American Academy of Sleep Medicine.

New York City sleep specialist Dr. Steven Park has spent decades treating sleep disorders, including catathrenia.  He explains that this diagnosis is usually associated with something known as upper airway resistance syndrome (UARS), often a precursor or variation of obstructive sleep apnea. Here’s how he describes the average UARS patient:

“These UARS patients are constantly tired and suffer from various other chronic conditions such as recurrent sinus pain or infections, low blood pressure, cold hands or feet, various gastrointestinal symptoms, anxiety/depression, and almost invariably, prefer not to sleep on their backs.”

By the way, Dr. Park has reported for years on studies suggesting that sleep-breathing disorders are linked to far bigger problems than just having trouble getting a good night’s sleep. He has long advocated that sleep disorders are actually linked to many medical conditions, both common and uncommon, including heart disease.  For example, here’s his comprehensive response to my article on KevinMD about women and heart attacks. This theory makes sense when you consider how chronically impaired sleep patterns can impact the entire body’s ability to function. 

But what about moaning/groaning when we’re wide awake and conscious?  This might be a different animal compared to sleep moaning. For examples:

  • Tired babies moan during self-soothing.
  • Adults moan during sex, except social scientists give it a fancy name: “copulatory vocalization”.
  • People living with fibromyalgia or other forms of chronic pain report that they’ll often moan and grimace during painful episodes.
  • Researchers suggest that surgical patients recovering from general anaesthesia will “grimace, frown, exhibit muscle tension, and make sounds (e.g. sighs, moans, and groans) in proportion to their pain intensity.”(2)
  • Some people make a harsh, shrill, creaking sound when they breathe, most often heard when inhaling. This is called stridor. It may occur during sleep, except that stridor happens with almost every breath. Unlike groaning, it doesn’t appear in blocks of time during the night. Stridor can sound something like this.
  • Some people do make a moaning type of sound while snoring.  But the primary sound of snoring occurs when you inhale. Groaning, on the other hand, occurs when you exhale.  Try it out right now and you’ll see.

Resources: Dr. Jack Feldman, Dr. Steven Park, American Academy of Sleep Science, Mayo Clinic


(1) Christian Guilleminault.  “Catathrenia: Parasomnia or Uncommon Feature of Sleep Disordered Breathing?” Sleep. 2008 Jan 1; 31(1): 132–139.

(2)  Kathleen A. Puntillo et al. “Pain behaviors observed during six common procedures: Results from Thunder Project II.”  Critical Care Medicine. 03/2004; 32(2):421-7. 

Q: Have you noticed your own sighing or moaning lately?

NOTE FROM CAROLYN:   I wrote much more about becoming a patient in my book, A Woman’s Guide to Living with Heart Disease . You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 20% off the list price).

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See also:

Are your sleep problems linked to increased heart disease risk?

Sleep problems can lead to heart problems for women

Exhaustion: the ‘leaky emotion’ of chronic illness

Depressed? Who, me? Myths and facts about depression after a heart attack

25 tips to manage the crushing fatigue of heart disease

Get over yourself: how to stop boring others with your heart attack story

 

19 thoughts on “What’s all that sighing, moaning and groaning about?

  1. My father, 63, is in great shape, never had any surgery, but has a lifelong habit of sighing, groaning, moaning, blurting out, “WELP” and various other depressing sounds, but I noticed it’s only when other people are around. If he thinks he’s alone, he never makes any sounds.

    I did it as well up until my 20’s when someone close to me pointed it out. I stopped doing it and I generally feel a lot better about everything day to day. I think these sounds make my dad feel worse than he needs to feel. How do I bring up the subject without triggering him?

    Liked by 1 person

    1. Interesting story about your Dad, Geoffrey. I think it’s hard to tell if these sounds make him feel “worse than he needs to feel” (a chicken-and-egg dilemma: does he moan because he feels bad, or does he feel bad – so he moans?)

      Or is this something that bothers you – but not necessarily himself? I’m no expert on this subject, of course, but it seems that if this only happens when others are around (and really, you can’t know that for sure because nobody is witnessing him when he is truly alone and unaccompanied), then this “habit” unconsciously might simply lead to some kind of interaction with others around him?

      In answer to your ‘how do I bring up the subject’ question, I’d turn it around to ask YOU how that ‘someone close’ to you in your 20s pointed out your own tendencies – which prompted you to stop?

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  2. My son is 41. He groans loudly all night long. He has sleep apnea but can’t wear the mask. Please let me know what are other treatments. He lives with me and stays in the spare bedroom. I don’t get any sleep. He also takes BP medicines. It’s bad. Read bad. Please help. I wish he could go somewhere to be studied. This can’t be normal.

    Like

    1. Hi Janet – this sounds like an upsetting situation. But let’s start with YOU. You need to protect YOUR sleep (with ear plugs, running a fan (“white noise”), moving your son farther away from your bedroom, whatever you can do so that you can get a good night’s sleep).

      I’m not a doctor so cannot comment on your son’s groaning, but I do know that C-PAP machines (I’m guessing that’s what the ‘mask’ is) are prescribed to people who suffer from poor sleep due to a sleep breathing disorder. He needs to see his doctor for further recommendations, instead of just saying he “can’t wear the mask”.

      If that’s true, what else can his doctor recommend? Here’s more info on sleep disorders.

      “Interrupted breathing leads to interrupted deep sleep, which causes a massive physiologic stress response, which can heighten your nervous and immune systems. The root cause is under-developed jaws, with narrowing of the upper airway from nose to voice box area. Inflammation that arises within your airways and your body narrows the upper airway even further, causing more obstructions. Over time, poor sleep causes hormonal and metabolic changes that can promote weight gain (which narrows the throat even more).”

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  3. Moans & groans all th time for the
    last 2 years, when sitting up in a chair,
    sometimes loud, sometimes barely
    audible. If I lay on my back, quite loud.
    On my stomach can’t hear them. If I drink 5 r more glasses of water a day
    sometimes th sounds r very light r
    not at all

    ater a day

    sometimes there is no sounds

    Like

  4. My husband who has had heart surgery, spinal surgery and has a damaged vocal cord has begun making little “sigh” noises with every exhale, especially when at rest. He is not aware of doing this. Is this cause for medical concern or is it just an annoying tic?

    Liked by 1 person

    1. Hello Linda – I’m not a physician so of course can’t tell you if your husband’s sighing is a medical concern, an annoying tic, or something entirely different! He might want to mention this phenomenon to his doctor (“my wife claims that…”) to get a professional perspective. Interesting that he’s not even aware he’s sighing (which was also my own experience too).

      Like

  5. As a person whose had CFS for 27+ years, I take 3-5 half hour naps daily (they revive me for a couple of hours, during which I may get something done).

    It is my current practice, if I don’t fall asleep during those nap/rest periods, to do a deep breathing technique which calms me AND fills those alveoli periodically: deep breath in through the nose, count 8 heart beats during which I hold the breath while very relaxed, let it out slowly through the mouth.

    If you listened to me, you’d think I was sighing and groaning, but now I think it’s even a better idea than before, given your article – and the reasons for filling those lungs deeply periodically.

    It is also wonderful for your singing voice! Great lung capacity.

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  6. I have a-fib and have been awakened by the audible moaning sound on several occasions. When I mentioned it to a health professional, I was told I might need to “see an exorcist”! I’ve been afraid to mention it again since then, thinking I really was going crazy.

    Thank you for this article that helped me to see there really is a physiological reason for the moans and subsequent (less noisy) breathing. I thought it might have been caused by my position while sleeping and the stress on my heart. I found your article while doing a Google search for audible moaning sounds from the heart/lungs. Thank you!

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  7. What about yawning? I have extended periods when I yawn frequently, usually during the day so it doesn’t seem to be because I’m more tired than usual.

    Liked by 1 person

    1. I’m tempted to yawn just thinking about yawning, Kathy! Apparently, around 50% of people who observe a yawn will yawn in response. We also yawn during times of stress: elite athletes often do it before a race, while musicians sometimes yawn before a concert. Fetuses even yawn in the womb. One of the most interesting theories about yawning comes from Andrew Gallup at the State University of New York, who suggested that yawning might help to chill the brain and stop it from overheating (in the January 2013 journal, Frontiers in Neuroscience). For example, he found that in normal conditions, 48% of people studied felt the urge to yawn, but when he asked them to hold a cold compress to their foreheads, just 9% yawned. So give that strategy a try and see if that affects your daytime yawning!

      Like

  8. Sometimes reading this kind of material is very beneficial to take in. Not to be overly sensitive, but then there are times when reading material like this, (sighing?😵) is enough to make you afraid to live! If it’s not ridiculous diets, it’s “watch out for this or that food… It causes this or that!” Foods at restaurants taste different from what you buy at your local market, but that’s okay since ours is loaded with artificial this, GMO that, genetically altered this and that… It’s ridiculous. Much of the safety of it all is as unsafe as it is scary. You can’t be sure what to do or what to eat anymore!

    Like

  9. To your question, “Have you noticed your own sighing or moaning lately?” I will now! I always learn a lot from your blogs and today I’ve learned that sighing has a very real, even life-sustaining upside. Who knew?
    Thanks, Carolyn.

    Like

  10. Every time I read a blog post by you it reminds me of how glad I am that I read Ladies Home Journal that month several years ago. You have such great insight to heart issues.

    I tell people about your blog all of the time.

    Michelle

    Liked by 1 person

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