2 CASES OF PREMENSTRUAL SLEEP TERRORS AND INJURIOUS SLEEP-WALKING

There are currently three recognized menstrual-related sleep disorders : premenstrual insomnia, menopausal insomnia and premenstrual hypersom nia. Another category, premenstrual parasomnia (sleep behavior disorde r), is now suggested. Case 1, a 17-year-old female, presented with a 6 -year history of exclusively premenstrual sleep terrors and injurious sleep-walking that began 1 year after menarche. During the four nights preceding each menses, she would scream and run from her bed. There w as no history of premenstrual syndrome. Neurological evaluations had b een unrevealing, apart from mild mental retardation and attention defi cit disorder; there was no psychiatric history. Polysomnography 3 days before the onset of menses confirmed the diagnosis of sleep-walking. Pharmacotherapies were not satisfactory, but self-hypnosis at bedtime was rapidly effective with benefit sustained at 2.5-year followup. Cas e 2, a 46-year-old woman without psychiatric disorder, presented with a 5-year history of sleep terrors and injurious sleep-walking that ini tially was not menstrually related, but beginning 8 months prior to re ferral, she developed an exclusively premenstrual parasomnia that, aft er polysomnography, was partially controlled with bedtime self-hypnosi s and clonazepam, 0.25 mg.