Two neurokinin receptor antagonists are now available for vasomotor symptom (VMS)-related sleep disruption, with elinzanetant's (Lynkuet) NK1 and NK3 dual-receptor profile potentially offering more targeted sleep benefit than fezolinetant's (Veozah) NK3-selective mechanism—but effective management requires systematic screening for obstructive sleep apnea, restless leg syndrome, and primary insomnia before attributing sleep disruption to VMS alone