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Menstruation-related periodic hypersomnia

A case study with successful treatment

Departments of Neurology, (Dr. Sachs), Clinical Neurophysiology, (Dr. Persson) and Obstetrics-Gynecology, (Dr. Flagenfeldt) Karolinska Hospital, Stockholm, Sweden.

A 16-year-old girl suffered from 1 to 2-week periods of hypersomnia associated with each menstruation. Serum hormone levels were normal. CSF concentrations of homovanillic acid and 5-hydroxyindolacetic acid were lower in hypersomniac than in symptom-free phases. 3-methoxy-4-hydroxyphenylethylene glycol was not affected. The sleep periods occurred only in connection with ovulatory menstrual cycles. When ovulation was inhibited by a combination of ethinylestradiol and lynestrenol, an oral contraceptive pill, the hypersomnia ceased. Thus, the hypersomnia seemed to be linked to the occurrence of ovulatory menstruations.

Address correspondence and reprint requests to Dr. Sachs, Department of Neurology, Karolinska Hospital S-104 01 Stockholm 60, Sweden.

Accepted for publication May 13, 1982.

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