Sleep-Wake Disorders

What is the effect of early morning natural light exposure on melatonin production?

What is the average sleep duration needed for adults?

Which statement accurately describes how sleep patterns change with increased age?

How is sleep deprivation defined according to the DSM-5 TR?

According to the AAA Foundation for Traffic Safety, getting how much sleep in a 24-hour period doubles the risk of a motor vehicle accident?

Growth hormone is primarily secreted during which stage of sleep?

Which comorbid condition has the highest percentage reported with short sleep duration?

According to the information, what percentage of U.S. adults are affected by sleep disorders annually?

A patient reports difficulty falling asleep, staying asleep and wakes up several times during the night causing distress. To meet the diagnostic criteria for insomnia disorder, how long should the symptoms last?

All of the following questions are helpful to ask a patient when evaluating for insomnia disorder, EXCEPT:

Which of the following is considered the most definitive sleep test for diagnosing sleep disorders?

A patient with insomnia also has benign prostatic hypertrophy (BPH). Which sleep disorder would this patient be at risk for?

Which medication is LEAST likely to cause sleep disturbances?

What is the first line treatment recommended for insomnia?

A patient is undergoing sleep restriction therapy. After two weeks, their average total sleep time is calculated to be 5 hours per night. If the patient is working, what should be the recommended minimum sleep time?

What is the rationale for avoiding benzodiazepines in older adults as a first-line treatment for insomnia?

A patient is prescribed a 'Z' medication for insomnia and begins to exhibit complex sleep behaviors. Which of the following is the MOST appropriate action?

A patient reports experiencing increased wakefulness during the night and has difficulty falling back asleep. A medication that is known for selectively binding to melatonin receptors may be prescribed. Which of the following medications work in this way?

According to the provided content, what is a rare, but serious risk from medications that should be avoided?

Daylight Savings Time has a negative impact that results in increased sleep deprivation. What cardiovascular risk is present because of this event?

Jet lag is classified as what type of sleep disorder?

What is the primary treatment for circadian rhythm disorders?

A patient reports recurrent episodes of sleepwalking. During this phase, which of the following would you expect to observe?

What is the first step in managing a patient with sleep terrors?

When does nightmare disorder typically occur?

In REM Sleep Behavior Disorder, what is a significant safety concern that should be addressed?

A patient presents with complaints of dropping things due to muscle weakness when laughing. This symptom is associated with daytime sleepiness. What is the term for this?

What is the underlying cause of narcolepsy?

A patient diagnosed with narcolepsy is prescribed pitolisant (Wakix). What is the mechanism of action of pitolisant?

What type of medication is sodium oxybate (Xyrem), used in the treatment of cataplexy?

While evaluating a 30-year-old female patient complaining of an irresistible urge to move her legs, especially at night, what is the first step in the evaluation?

Which of the following exacerbates restless leg syndrome?

Which of the following RLS treatments has the potential to actually worsen symptoms over time?

What is the primary recommendation for individuals experiencing desynchrony with normal light/dark cycles and inner rhythm during Daylight Savings Time?

A patient goes to bed at 10 PM each night. She regularly wakes up at 12:30 AM and does not get back to sleep until 3:00 AM. She then sleeps until 6 AM, when she has to wake up to go to work. Over the last 2 weeks, an average, she slept 5 hours and 30 minutes a night. As part of sleep restriction therapy, what time should she go to bed for the next week?

A 45-year-old patient reports experiencing recurrent, vivid, and disturbing dreams that cause significant distress and impair daytime functioning. The patient is oriented and alert upon awakening and can clearly recall the dream content. What is the most appropriate diagnosis?

A patient uses zolpidem for sleep. His wife has observed him getting up to eat and tries to initiate sex with her, but he seems strange and then goes back to sleep. This would be classified as which of the following?

Which sleep stage is characterized by the deepest sleep state, with heart rate and breathing at their slowest rate?

Which of the following accurately describes a key function of sleep?

What is the primary function associated with REM sleep?

In the context of sleep disorders, what does WASO stand for?

Which of the following statement reflects scientific findings?

Which of the following physiological processes is NOT typically associated with sleep?

During which stage of sleep are delta brain waves most prominent?

What physiological change is characteristic of REM sleep?

What biological process is most closely tied to the sleep cycle?

At approximately what time of day does melatonin secretion typically begin?

Which sleep stage is associated with the elimination of amyloid?

What contributes to insomnia?

What percentage of U.S. middle schoolers do not get enough sleep?

According to the American Academy of Pediatrics, middle and high schools should aim to start no earlier than what time to optimize students' sleep?

According to the DSM 5 TR, how is sleep deprivation defined?

Being awake for how many hours is equivalent to a blood alcohol content (BAC) of 0.10%?

Which of the following chronic health conditions has the highest percentage reported among individuals with short sleep duration?

If a patient describes difficulty initiating or maintaining sleep, or experiences early-morning awakening, and these symptoms occur at least three nights per week for at least three months, what condition should be considered?

When evaluating a patient for insomnia, which of the following questions is most relevant?

Which evaluation tool involves monitoring a patient's brain waves, eye movements, and muscle activity overnight?

Which statement about the Epworth Sleepiness Scale is most accurate?

Which medical condition can contribute to sleep disturbances?

Which substance is least likely to cause sleep disturbances?

What is the most recommended first-line treatment for insomnia?

What is a primary component of sleep hygiene?

Which medication is most appropriate to prescribe for a patient experiencing insomnia with difficulty falling asleep? Assume all options are otherwise safe for the patient.

What is a potential long-term risk associated with the use of sleep medications?

Melatonin is synthesized from what?

What is a known effect of photosensitizing medications in conjunction with bright light therapy?

A patient is traveling from New York to London. What is the best strategy to minimize jet lag?

What cardiovascular event is most likely to occur during the week after Daylight Savings Time?

After daylight savings time, what is helpful to minimize the effects of desynchrony with normal light/dark cycles?

Which of the following is consistent with a diagnosis of hypersomnolence disorder?

What is an initial step in evaluating a patient for possible restless legs syndrome (RLS)?

Why are anti-Parkinson’s medications not recommended for restless leg syndrome?

What is often associated with a diagnosis of narcolepsy?

Which medication used in the treatment of narcolepsy increases histamine concentration in the brain?

What is a serious consideration when treating cataplexy with sodium oxybate (Xyrem)?

A patient reports vivid, disturbing dreams and is fully alert upon awakening and clearly recalls the dream. What is the most likely diagnosis?

What is the hallmark of REM sleep behavior disorder?

Which of the following is a treatment option for REM Sleep Behavior Disorder?

Which sleep disorder is characterized by abnormal behavior (experiential of physiological), occurring during specific sleep stages or sleep transition?

When do sleepwalking and sleep terrors typically occur?

First line treatment for both sleepwalking and sleep terrors includes each of these except?

Of the known parasomnias, which is most likely to include amnesia of the event?

A patient reports vivid, disturbing dreams along with complex motor behaviors during REM sleep. EEG findings demonstrate disrupted REM sleep architecture. They are oriented upon awakening. Which medication is most likely to be trialed for this?

What should patients avoid with a diagnosis of narcolepsy?

According to research presented, what is one potential mental health consequence of a lack of REM sleep?

Which statement best describes the function of sleep in relation to amyloid?

During which NREM sleep stage are delta brain waves most prominent, indicating the deepest sleep state?

In what stage of sleep does the energizing of the brain and body occur, along with the elimination of amyloid?

What physiological process is synchronized by the circadian rhythm, influencing the sleep cycle?

At what time of day does the circadian rhythm typically trigger the start of melatonin secretion?

What is one of the key actions of early morning natural light exposure in regulating sleep?

What is the average recommended sleep duration for adults to maintain optimal health and alertness?

As individuals age, what changes are typically observed in their sleep patterns?

According to the information, what is the definition of sleep deprivation based on hours of sleep per night?

According to a study by the AAA Foundation for Traffic Safety, how does getting only 5 to 6 hours of sleep affect the risk of a motor vehicle accident?

What is the effect of being awake for 24 hours on cognitive abilities?

Insufficient sleep is associated with which of the following as seen in the 2014 Behavioral Risk Factor Surveillance System?

Insomnia disorder is characterized by a decreased sleep quantity or quality with one or more of the following, except:

What timeframe defines the chronicity of insomnia, as defined by the DSM 5 TR?

What is considered the gold standard definitive evaluation tool for diagnosing sleep disorders?

Cognitive Behavioral Therapy for Insomnia (CBT-I) encompasses all of the following components, EXCEPT:

What is an appropriate minimum sleep time that should be recommended as part of sleep restriction therapy if the patient is working?

What specific receptors are selectively targeted by nonbenzodiazepine hypnotics (Z-drugs) to promote sleep?

Early AM natural light has the effect of which of the following?

A 24-year-old woman with no past medical history presents complaining of "waking up confused and groggy" after what she describes as long nights of sleep. She works a sedentary job and has difficulty feeling fully alert even after 9 hours of sleep. Her vitals are stable, and exam is non-focal. Which of the following features would most strongly support a diagnosis of hypersomnolence disorder?

A patient with a history of depression is prescribed zolpidem for insomnia. One week later, his roommate reports finding him eating cold pizza while mumbling unintelligibly in the kitchen, despite appearing asleep. Which regulatory concern most specifically applies to this presentation?

Which of the following findings would best distinguish REM sleep behavior disorder from sleep terrors?

A 55-year-old man presents with dream-enactment behavior. He has hit his wife during sleep and is now undergoing evaluation. His sleep study shows absence of muscle atonia during REM. Which of the following long-term concerns is most appropriate?

A patient undergoing sleep restriction therapy for chronic insomnia improves their sleep efficiency to 87%. Which is the correct next step?

A middle-aged woman reports difficulty falling asleep until 2 a.m., despite being in bed by 10 p.m. She wakes at 10 a.m. feeling rested, but her schedule conflicts with work. Which of the following is the most appropriate next step in management?

Which of the following medications is most likely to worsen symptoms in a patient with Restless Legs Syndrome?

A patient presents with 3 months of awakening to a sense of suffocating fear, without dream recall and with unresponsiveness during the episodes. Which of the following interventions is most likely to reduce episode frequency?

A patient with narcolepsy experiences sudden weakness triggered by laughter. What is the likely neurochemical defect?

Which of the following best explains the reduced ability of elderly individuals to fall asleep quickly and stay asleep?

A 67-year-old man presents with excessive movements during sleep that include shouting and punching. He recalls vivid dreams upon awakening. Which of the following is the most appropriate long-term pharmacologic management?

A 30-year-old female is referred for hypersomnolence workup. She reports multiple episodes of excessive sleepiness and naps despite sleeping 8-9 hours a night. She is requesting modafinil. Which of the following is the best next step to confirm the diagnosis?

A patient with narcolepsy has a history of cataplexy. Which of the following medications would be most appropriate to help reduce both excessive daytime sleepiness and cataplexy?

A 45-year-old woman reports difficulty falling asleep and frequent awakenings. She's been prescribed diphenhydramine nightly for the past month. Which of the following is a likely contributor to her symptoms?

Which of the following most accurately describes the risk associated with chronic short sleep duration (<7 hours/night) in the U.S. adult population?

Which of the following would be contraindicated in a 25-year-old female with bipolar disorder undergoing CBT-I?

A patient recently started treatment for RLS and returns with worsening nighttime leg discomfort, now earlier in the evening and involving the arms. What is the term for this phenomenon?

Which of the following is true regarding the role of melatonin in sleep regulation?

A patient with hypersomnolence disorder asks about the difference between modafinil and armodafinil. Which of the following best describes their pharmacological distinction?

A patient with REM behavior disorder is started on levodopa. He returns 4 months later with diminished effectiveness of the medication. Which term best describes this?

A 9-year-old boy wakes up at night screaming with a racing heart and cannot be comforted by his parents. In the morning, he has no recollection of the event. Which of the following best supports this diagnosis over nightmare disorder?

Which of the following patients should be screened for potential hidden neurodegenerative disease based on their sleep disorder?

A 60-year-old patient presents with a chronic urge to move her legs when sitting still, especially in the evening. Labs reveal low ferritin. Which of the following is the first-line treatment?

A 70-year-old man is referred for evaluation of insomnia. He takes an over-the-counter antihistamine nightly. Which of the following side effects is most concerning in older adults with this medication?

A 33-year-old woman is experiencing fragmented sleep, excessive daytime fatigue, and visual hallucinations when waking. She collapses to the ground briefly when laughing. CSF shows low hypocretin. Which is the correct diagnosis and subtype?

A patient using sleep restriction therapy reports sleeping 5.5 hours nightly for a week with a sleep efficiency of 72%. What is the correct action?

Which of the following is a non-scheduled drug that improves narcoleptic symptoms by increasing histamine in the brain?

Which of the following behavioral modifications is most useful to prevent REM-related parasomnias in pediatric patients?

A patient takes an SSRI and begins experiencing worsening of leg discomfort at night. What is the most likely cause?

A patient with insomnia has tried melatonin with no benefit. Which of the following prescription alternatives acts directly on melatonin receptors rather than GABA?