Deck 9: Sleep-Wake Disorders

Question 1

Antidepressants are currently the most effective and well-tolerated treatment for insomnia.

Answer 1

False

Question 2

DSM-5 diagnostic criteria for insomnia are based on objective measures of significant sleep disturbance using either polysomnography or actigraphy.

Answer 2

False

Question 3

According to a two-process model of sleep regulation, sleep and wake are dependent on:

A) Sleep homeostasis.
B) Information processing and long-term memory around sleep onset.
C) The endogenous circadian clock.
D) Both a and c.

Answer 3

B

Question 4

According to DSM-5 diagnostic criteria, which of the following can co-occur with a diagnosis of insomnia?

A) Restless legs syndrome
B) Delayed sleep phase disorder
C) Sleep apnea
D) None of the above

Question 5

The comorbidity rate between insomnia and other psychiatric or medical illnesses may be as high as:

A) 75%
B) 30%
C) 12%
D) 90%

Question 6

Can insomnia be treated in the presence of other psychiatric or medical diagnoses?

A) Yes, treatment of insomnia may lead to symptomatic improvement of other psychiatric or medical diagnoses as well.
B) Yes, but must be a combination CBT and BzRA treatments.
C) No, you must treat the underlying co-occurring disorder first.
D) No, treatment of insomnia is incompatible with treatments for other psychiatric disorders, such as anxiety and depression.

Question 7

The ratio of NREM to REM sleep changes drastically over the course of development.

Question 8

Paradoxical intention is a component of CBT-I focused on:

A) Altering faulty beliefs about sleep by education and discussion about sleep requirements, the biological clock and the effects of sleep loss on sleep-wake functions.
B) Instructing patients to stay awake for as long as possible with the aim of reducing performance anxiety related to sleep.
C) Reducing the time spent in bed so that time in bed is equivalent to the time the patient estimates he or she spends sleeping.
D) Setting a regular sleep schedule with a consistent waking time and no daytime naps.

Question 9

NREM sleep is thought to be important for:

A) Learning
B) Conservation of energy and restoration
C) Memory consolidation
D) Emotional processing

Question 10

The three-P model of insomnia posits that insomnia occurs as a result of:

A) Traits, such as a tendency to worry.
B) Life stressors, such as an acute trauma.
C) Poor coping strategies, such as daytime napping.
D) All of the above.

Question 11

The DSM-5 has eliminated the diagnosis of "primary insomnia" and has introduced the use of the diagnosis of "insomnia disorder" instead

Question 12

REM sleep can be subdivided into three stages (N1 - sleep onset; N2; N3-slow-wave sleep)

Question 13

According to one cognitive model, insomnia is maintained by a cascade of cognitive processes that operate at night and during the day. Which of the following is a key cognitive process that can compromise this cascade?

A) Worry and rumination
B) Misperception of sleep and daytime deficits
C) Dysfunctional beliefs about sleep
D) All of the above

Question 14

Which method is considered a "gold standard" measure of sleep?

A) Actigraphy
B) Polysomnography
C) Pittsburgh Sleep Quality Index
D) Sleep diaries