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Common characteristics in reported cases[ edit ] There are reported characteristics that are shared among patients with catathrenia. The main characteristics are: Vocal sound: Sounds are usually a short or long vocalisation of the same letter mainly an [a], [e], [o] sound or something in between. Appearing during expiration: The sounds show up exclusively on expiration  and are interrupted during inspiration. Unawareness of the problem: Patients usually sleep normally despite the sounds and the effort to breath. The latter highlights the importance of reassuring entourage about the benignity of the disease.