“Menstrual-associated sleep disorder is a disorder of unknown cause, characterized by a complaint of either insomnia or excessive sleepiness, that is temporally related to the menses or menopause.” Premenstrual excessive sleepiness is a sometimes dramatic disorder that appears within the first 2 years after the onset of menstruation. Periodic episodes of hypersomnolence tend to occur 6 to 10 days before the onset of menses. The disorder is treated successfully with birth control pills. Menopausal insomnia is characterized by recurrent awakenings, often associated with hot flashes or night sweats. Premenstrual insomnia is common, characterized by difficulty both initiating and maintaining sleep, and is often associated with other symptoms attributed to the premenstrual syndrome.

“Sleep-related laryngospasm refers to episodes of abrupt awakenings from sleep with an intense sensation of inability to breathe, and stridor.” The disorder is frightening but apparently benign. Otolaryngologic examination reveals no abnormality. The disorder usually recurs several times and then resolves. It is more common in smokers and patients with esophageal reflux. Sleep apnea and upper-airway abnormality need to be considered.