INSOMNIA GUEST LECTURE Flashcards
Very few questions on this
Which of the following is a primary complaint in the diagnosis of insomnia?
A) Excessive daytime sleepiness
B) Dissatisfaction with sleep quantity or quality
C) Excessive dreaming during sleep
D) Difficulty staying awake during the day
B) Dissatisfaction with sleep quantity or quality
How long must the symptoms of insomnia occur to meet the diagnostic criteria?
A) At least 1 week
B) At least 1 month
C) At least 3 months
D) At least 6 months
C) At least 3 months
Which of the following is NOT considered a type of insomnia according to the diagnostic criteria?
A) Initial insomnia (difficulty falling asleep)
B) Middle insomnia (difficulty staying asleep)
C) Late insomnia (awakening too early)
D) Persistent insomnia (chronic sleep disturbance)
D) Persistent insomnia (chronic sleep disturbance)
For insomnia to be diagnosed, how often must the sleep difficulties occur?
A) At least once a week
B) At least twice a week
C) At least three times a week for 3 months
D) Every night
C) At least three times a week for 3 months
What must insomnia lead to in order to meet the diagnostic criteria?
A) Weight gain and appetite changes
B) Daytime fatigue, disturbed mood, and/or impairment in functioning
C) Increased daytime alertness and improved mood
D) Physical pain or discomfort during the day
B) Daytime fatigue, disturbed mood, and/or impairment in functioning
How is insomnia classified if it lasts between 1 to 3 months?
A) Acute insomnia
B) Chronic insomnia
C) Transitional insomnia
D) Persistent insomnia
A) Acute insomnia
Which of the following defines chronic insomnia?
A) Insomnia lasting for less than 1 month
B) Insomnia lasting for 1 to 3 months
C) Insomnia lasting for more than 3 months
D) Insomnia lasting for less than 6 months
C) Insomnia lasting for more than 3 months
Which of the following is a requirement for the diagnosis of insomnia?
A) The complaints must be fully explained by a lack of sleep opportunity
B) The complaints must be fully explained by an inadequate sleep environment
C) The complaints cannot be fully explained by a lack of sleep opportunity or an inadequate sleep environment
D) The complaints must only occur at night
C) The complaints cannot be fully explained by a lack of sleep opportunity or an inadequate sleep environment
What percentage of individuals experience at least one insomnia symptom in the past year?
A) 25-35%
B) 10-15%
C) 5.5%
D) 51%
D) 51%
What percentage of individuals are estimated to experience mild or occasional insomnia?
A) 51%
B) 5.5%
C) 10-15%
D) 25-35%
D) 25-35%
Which of the following is a key symptom of sleep apnea?
A) Frequent daytime sleepiness
B) Excessive coughing at night
C) Morning dizziness
D) Loud sneezing during sleep
A) Frequent daytime sleepiness
According to the STOP-BANG screening tool, which of the following is a criterion for screening for sleep apnea?
A) Age over 50
B) BMI less than 20
C) Neck circumference less than 14 inches for males
D) Female gender
A) Age over 50
What percentage of obstructive sleep apnea (OSA) patients meet the criteria for an insomnia disorder?
A) 10%
B) 25%
C) 38%
D) 50%
C) 38%
Which of the following is NOT part of the STOP-BANG screening tool?
A) Snoring
B) Morning headaches
C) High blood pressure
D) BMI greater than 35
B) Morning headaches
What diagnostic test is required to definitively rule out sleep apnea?
A) MRI
B) Polysomnography
C) Blood tests
D) Sleep diary
B) Polysomnography
Sleep disturbances are a risk factor for which of the following?
A) Unipolar depression only
B) Bipolar depression only
C) Both unipolar and bipolar depression
D) Only general anxiety disorder
C) Both unipolar and bipolar depression
Sleep complaints are more common in which group?
A) Those who have never been depressed
B) Those who are currently depressed
C) Those with a history of depression
D) Individuals without any mental health conditions
C) Those with a history of depression
What role does sleep disturbance play in depression?
A) It has no significant role
B) It increases the likelihood of first onset and recurrence of depression
C) It only affects the severity of symptoms during an acute episode
D) It has a protective role against depression
B) It increases the likelihood of first onset and recurrence of depression
Which intervention has been shown to help increase remission from depression in patients with sleep disturbances?
A) Sleep medications only
B) Cognitive Behavioral Therapy for Insomnia (CBT-I)
C) Electroconvulsive therapy (ECT)
D) Exercise therapy
B) Cognitive Behavioral Therapy for Insomnia (CBT-I)
Insomnia is associated with an increased risk for which of the following?
A) Hypertension
B) Anxiety disorders
C) Cardiovascular disease only
D) Respiratory infections
A) Hypertension
Short sleep is associated with which of the following physical health risks?
A) Increased muscle mass
B) Obesity
C) Improved immune function
D) Lower cholesterol levels
B) Obesity
What is the relationship between short sleep duration and early mortality?
A) Direct linear relationship
B) Curvilinear relationship
C) No relationship
D) Inverse relationship
B) Curvilinear relationship
Insomnia has been linked to an increased risk of which of the following metabolic disorders?
A) Diabetes
B) Hyperthyroidism
C) Hyperlipidemia
D) Metabolic disorder
D) Metabolic disorder
Which of the following is a major economic consequence of sleep disorders?
A) Increased work promotions
B) Higher absenteeism and imapired job performance
C) Higher job satisfaction
D) Increased work-life balance
B) Higher absenteeism and imapired job performance
The economic cost of sleep disorders is estimated to range between:
A) $50 million to $75 million
B) $92.5 million to $107.5 million
C) $150 million to $200 million
D) $10 million to $20 million
B) $92.5 million to $107.5 million
Which of the following is a common self-medication method for treating sleep issues?
A) Exercise
B) Alcohol
C) Meditation
D) Prescription painkillers
B) Alcohol
Also use cannabis, overcounter sleep aids (melotonin)
What is a potential consequence of using hypnotic drugs for sleep?
A) Immediate improvement without side effects
B) Reduced daytime productivity
C) Dependence, tolerance, and residual daytime symptoms
D) Enhanced sleep quality without any risks
C) Dependence, tolerance, and residual daytime symptoms
Many people with sleep issues tend to:
A) Immediately seek professional help
B) Read, watch TV, or listen to the radio while trying to fall asleep
C) Use only prescription medications
D) Ignore the problem and continue with their daily routines
B) Read, watch TV, or listen to the radio while trying to fall asleep
Cognitive Behavioral Therapy (CBT) for insomnia can be delivered:
A) Only through in-person sessions
B) Only through digital platforms
C) Through both digital and in-person methods
D) Only in hospital settings
C) Through both digital and in-person methods
Why is it difficult to study sleep in people with insomnia?
A) They have trouble falling asleep.
B) They cannot accurately report their sleep patterns.
C) They don’t experience deep sleep stages.
D) They are unable to use EEG equipment.
B) They cannot accurately report their sleep patterns.
What does polysomnography measure?
A) Heart rate and blood pressure during sleep.
B) Electrical activity in the brain.
C) Muscle movement during sleep.
D) Eye movement during different sleep stages.
B) Electrical activity in the brain.
What is the definition of sleep?
A) A state of deep relaxation.
B) A state of unconsciousness.
C) A period of reduced brain activity.
D) A time when the body rests and repairs itself.
B) A state of unconsciousness.
How can we distinguish between different stages of sleep?
A) By measuring the heart rate.
B) By tracking eye movements.
C) By monitoring breathing rates.
D) By analyzing brain wave patterns.
D) By analyzing brain wave patterns.
What is a characteristic feature of paradoxical or REM sleep?
A) High amplitude brain waves.
B) Rapid eye movements.
C) Deep muscle activity.
D) Slow brain waves.
B) Rapid eye movements.
What is the EEG activity like during REM sleep?
A) High-frequency, high-amplitude waves.
B) Mixed frequencies and low amplitude.
C) Slow, large waves.
D) No brain activity.
B) Mixed frequencies and low amplitude.
Which of the following is observed during REM sleep?
A) Muscle atonia.
B) Increased muscle activity.
C) Elevated heart rate and blood pressure.
D) Shallow breathing.
A) Muscle atonia.
What is muscle atonia?
A) Increased muscle tone during sleep.
B) A condition where muscles are paralyzed or relaxed during sleep.
C) Enhanced muscle activity during REM sleep.
D) The ability to move muscles freely during deep sleep.
B) A condition where muscles are paralyzed or relaxed during sleep.
What is REM sleep?
A) A stage of sleep characterized by deep relaxation and slow brain waves.
B) A stage of sleep where rapid eye movements, low muscle tone, and vivid dreaming occur.
C) A stage of sleep where the body is completely awake but inactive.
D) A stage of sleep where the body is fully active but the mind is at rest.
B) A stage of sleep where rapid eye movements, low muscle tone, and vivid dreaming occur.
What does Process S (Homeostatic) refer to in sleep-wake regulation?
A) The biological clock that controls sleep-wake cycles.
B) The regulation of body temperature during sleep.
C) The body’s response to environmental light changes.
D) The accumulation of sleep propensity across the day.
D) The accumulation of sleep propensity across the day.
What does Process C (Circadian) refer to in sleep-wake regulation?
A) The tendency for sleep to increase after long periods of wakefulness.
B) The biological clock that controls the sleep-wake cycle.
C) The effect of stress on sleep patterns.
D) The regulation of sleep through environmental factors.
B) The biological clock that controls the sleep-wake cycle.
Which brain structure is involved in the control of Process C (Circadian)?
A) Hippocampus
B) Medulla oblongata
C) Suprachiasmatic nucleus of the hypothalamus
D) Amygdala
C) Suprachiasmatic nucleus of the hypothalamus
According to the Conditioning Model (Bootzin), what is the bedroom environment considered?
A) A neutral stimulus for sleep.
B) A discriminative stimulus for sleep.
C) A stimulus that induces wakefulness.
D) An unconditioned stimulus for relaxation.
B) A discriminative stimulus for sleep.
What happens when stimuli incompatible with sleep are present in the bedroom environment?
A) It enhances sleep quality.
B) It causes the bedroom to become a place of anxiety and frustration.
C) It improves the ability to fall asleep.
D) It increases the body’s natural sleep drive.
B) It causes the bedroom to become a place of anxiety and frustration.
What is a characteristic of chronobiological dysfunction in insomnia?
A) Poor timing of the body’s internal sleep-wake cycle.
B) Difficulty falling asleep at night.
C) Increased sleep duration during the night.
D) Increased frequency of REM sleep.
A) Poor timing of the body’s internal sleep-wake cycle.
What is Delayed Sleep Phase Syndrome?
A) A condition where individuals wake up too early and cannot return to sleep.
B) A disorder where individuals experience excessive daytime sleepiness.
C) A sleep disorder where individuals fall asleep and wake up later than usual, disrupting the sleep-wake cycle.
D) A condition where individuals have an irregular sleep-wake pattern.
C) A sleep disorder where individuals fall asleep and wake up later than usual, disrupting the sleep-wake cycle.
How does early evening bright light therapy affect individuals with sleep maintenance insomnia?
A) It increases the amount of deep sleep.
B) It shifts the circadian rhythm of core body temperature and improves PSG-defined sleep.
C) It helps individuals fall asleep more quickly.
D) It causes early morning wakefulness.
B) It shifts the circadian rhythm of core body temperature and improves PSG-defined sleep.
What is the effect of morning light exposure on sleep?
A) It reduces sleep onset latency (SOL).
B) It disrupts the sleep-wake cycle.
C) It causes more frequent awakenings during the night.
D) It increases the total duration of sleep.
A) It reduces sleep onset latency (SOL).
What is a common tendency of people with insomnia regarding their sleep?
A) They tend to overestimate sleep duration.
B) They tend to underestimate sleep disturbances and overestimate sleep duration.
C) They accurately report their sleep duration.
D) They underestimate sleep duration and overestimate sleep disturbances.
BD) They underestimate sleep duration and overestimate sleep disturbances.
How do insomniacs typically perceive themselves when woken up during stages I or II of sleep?
A) They report feeling more rested than good sleepers.
B) They report being awake more often than good sleepers.
C) They report being more alert than good sleepers.
D) They report experiencing fewer sleep disturbances than good sleepers.
B) They report being awake more often than good sleepers.
What is a characteristic of hyperarousal related to body temperature?
A) Decreased core body temperature.
B) Increased core body temperature.
C) No change in core body temperature.
D) Fluctuations in core body temperature during sleep.
B) Increased core body temperature.
Which of the following is elevated during hyperarousal?
A) Skin conductance
B) Muscle relaxation
C) Slow brain wave activity
D) Slow heart rate
A) Skin conductance
In individuals with hyperarousal, how does brain glucose metabolism change from wakefulness to sleep?
A) It shows a greater reduction than in good sleepers.
B) There is no change from wakefulness to sleep.
C) It shows a lower reduction than in good sleepers.
D) It increases during sleep.
C) It shows a lower reduction than in good sleepers.
What is typically observed in the EEG of individuals with hyperarousal?
A) Greater delta activity during the day and night.
B) Increased beta activity during the day and night.
C) More alpha activity during sleep.
D) No changes in brain wave activity.
B) Increased beta activity during the day and night.
According to the Psychobiological Inhibition Model, what is required for sleep to occur?
A) Increased physiological arousal and cognitive engagement.
B) The presence of environmental noise and light.
C) Optimal setting conditions such as physiological and cognitive de-arousal.
D) Strong emotional excitement and mental stimulation.
C) Optimal setting conditions such as physiological and cognitive de-arousal.
Which of the following is considered an optimal setting condition for sleep?
A) High levels of emotional excitement.
B) A state of cognitive and physiological de-arousal.
C) Excessive intentional effort to sleep.
D) Increased focus on sleep threats.
B) A state of cognitive and physiological de-arousal.
What does the concept of “automaticity” refer to in the Psychobiological Inhibition Model?
A) The process of forcing oneself to sleep.
B) Sleep occurring without conscious effort, supported by adaptive conditioning.
C) The intentional effort to remain awake.
D) Selective attention to sleep disruptions.
B) Sleep occurring without conscious effort, supported by adaptive conditioning.
What is meant by “plasticity” in the context of sleep?
A) The ability to maintain a fixed sleep routine regardless of external factors.
B) The flexibility to adjust sleep behavior in response to changing circumstances.
C) The difficulty in adapting to new sleep patterns.
D) The constant regulation of sleep efforts to improve sleep quality.
B) The flexibility to adjust sleep behavior in response to changing circumstances.
What can occur when there is impaired inhibition of de-arousal in the Psychobiological Inhibition Model?
A) The ability to fall asleep is improved.
B) There is an increase in sleep quality.
C) There is heightened attention to sleep threats, leading to sleep disturbances.
D) Cognitive and physiological de-arousal is enhanced.
C) There is heightened attention to sleep threats, leading to sleep disturbances.
What is the paradoxical effect of sleep efforts according to the Psychobiological Inhibition Model?
A) Increased effort to sleep leads to better sleep quality.
B) Trying hard to sleep often results in greater difficulty falling asleep.
C) Sleep efforts improve sleep duration significantly.
D) Sleep efforts reduce the need for sleep entirely.
B) Trying hard to sleep often results in greater difficulty falling asleep.
What is a characteristic of cognitive hyperarousal in people with insomnia?
A) Reduced thoughts about sleep.
B) Overactive mind with anxious and depressed thoughts.
C) Complete absence of cognitive activity before sleep.
D) Improved ability to control thoughts at bedtime.
B) Overactive mind with anxious and depressed thoughts.
What is a common feature of dysfunctional thinking in people with insomnia?
A) Accurate understanding of sleep promoting practices.
B) Unrealistic sleep expectations.
C) Clear knowledge of the causes of insomnia.
D) Enhanced perception of control over sleep
B) Unrealistic sleep expectations.
Dysfunctional thinking about insomnia may involve which of the following?
A) Misconceptions about the causes of insomnia and misattributions of its consequences.
B) A clear understanding of the impact of poor sleep on health.
C) Realistic assessments of the impact of sleep difficulties.
D) Acceptance of natural sleep patterns.
A) Misconceptions about the causes of insomnia and misattributions of its consequences.
Which of the following are NOT daytime and nighttime safety behaviours? (Preventative for insomnia)
a) napping
b) reducing social activity
c) going to bed early
c) watching the clock
d) reading in bed
d) reading in bed
CBT-I is effective in treating which of the following types of insomnia?
A) Primary insomnia only.
B) Insomnia associated with depression.
C) Insomnia in children under the age of 12.
D) Insomnia related to excessive daytime sleepiness.
B) Insomnia associated with depression.
Which of the following groups can benefit from CBT-I?
A) Only individuals with primary insomnia.
B) Only people who experience sleep disruptions due to stress.
C) Individuals without any sleep disturbances.
D) Individuals with insomnia associated with chronic pain, such as fibromyalgia.
D) Individuals with insomnia associated with chronic pain, such as fibromyalgia.
According to CBT for insomnia, what is the focus of treatment?
A) Targeting the precipitating factors of insomnia.
B) Treating the underlying medical conditions causing insomnia.
C) Targeting the maintaining factors of insomnia.
D) Reducing excessive daytime sleepiness.
C) Targeting the maintaining factors of insomnia.
Which of the following is a maintaining factor for insomnia that CBT addresses?
A) Regular sleep-wake schedule.
B) Excessive time spent in bed.
C) Daily physical activity.
D) Stable sleep environment.
B) Excessive time spent in bed.
What is one of the common maintaining factors of insomnia that CBT aims to address?
A) An irregular sleep-wake schedule.
B) Regularly scheduled naps during the day.
C) Consistent sleep hygiene practices.
D) The use of sleep medications.
A) An irregular sleep-wake schedule.
How does CBT for insomnia approach excessive worry over sleep loss?
A) By recommending medications to reduce anxiety.
B) By focusing on reducing rumination about negative daytime consequences.
C) By eliminating any cognitive thoughts during the day.
D) By encouraging more sleep effort and control.
B) By focusing on reducing rumination about negative daytime consequences.
What are safety behaviours against insomnia?
Self-monitoring sleep diaries
Sleep Hygiene education
Relaxation
Stimulus control
Sleep restriction
What is the main goal of stimulus control for insomnia?
A) To associate sleep with wakefulness.
B) To re-associate sleep stimuli with drowsiness and sleep, rather than wakefulness.
C) To spend more time in bed to try and increase sleep chances.
D) To avoid any activities in bed except sleeping.
B) To re-associate sleep stimuli with drowsiness and sleep, rather than wakefulness.
What activity is recommended for people who are unable to sleep in the middle of the night?
A) Stay in bed and try to fall asleep.
B) Engage in a quiet activity such as reading or listening to the radio.
C) Eat a light snack to promote sleep.
D) Watch TV or scroll through social media to relax.
B) Engage in a quiet activity such as reading or listening to the radio.
What is the recommendation regarding napping during the day?
A) Napping is encouraged to catch up on missed sleep.
B) Naps should be avoided completely, even if feeling tired.
C) If naps occur, they should be short (15-20 minutes) and at least 9 hours before bedtime.
D) Napping can be done anytime during the day without affecting nighttime sleep.
C) If naps occur, they should be short (15-20 minutes) and at least 9 hours before bedtime
What is the recommendation regarding waking up in the morning to help with circadian rhythm?
A) Wake up at different times on weekdays and weekends to adjust to various schedules.
B) Arise at the same time every morning, even on weekends, regardless of sleep duration.
C) Wake up only when feeling completely rested, even if it’s after noon.
D) Sleep in on weekends to recover from the week’s sleep loss.
B) Arise at the same time every morning, even on weekends, regardless of sleep duration.
What sleep efficiency target should be aimed for in CBT-I sleep restriction?
A) 60%
B) 75%
C) 85%
D) 100%
C) 85%
What should be done if sleep efficiency exceeds 85% in CBT-I sleep restriction?
A) Increase the sleep window.
B) Decrease the time spent in bed.
C) Continue with the same sleep window.
D) Reduce sleep duration even further.
A) Increase the sleep window.
What is the main goal of cognitive therapy for insomnia?
A) To provide medication for better sleep.
B) To modify faulty beliefs and unrealistic expectations about sleep and insomnia.
C) To increase the time spent in bed for longer sleep duration.
D) To encourage patients to nap more during the day.
B) To modify faulty beliefs and unrealistic expectations about sleep and insomnia.
What is one of the key targets of cognitive therapy for insomnia?
A) Misconceptions about the causes of insomnia, such as pain, depression, or allergies.
B) The habit of exercising right before bed.
C) Sleeping more than 10 hours each night.
D) To stop worrying about sleep and ignore insomnia.
A) Misconceptions about the causes of insomnia, such as pain, depression, or allergies
What is an example of a misattribution and amplification of consequences in insomnia?
A) Believing that insomnia is caused by a lack of exercise.
B) Catastrophizing the negative consequences of sleep loss, leading to increased worry.
C) Thinking that sleeping too much during the day causes insomnia.
D) Believing that insomnia only affects sleep patterns during the weekend.
B) Catastrophizing the negative consequences of sleep loss, leading to increased worry.
How do ones unrealistic sleep expectations impact sleep?
A) It leads to a more relaxed sleep pattern.
B) It helps patients achieve deeper sleep.
C) It increases self-imposed pressure to attain a “normal” sleep pattern, which interferes with sleep.
D) It decreases the time spent in bed, improving sleep.
C) It increases self-imposed pressure to attain a “normal” sleep pattern, which interferes with sleep.
What strategy is used to address performance anxiety in cognitive therapy for insomnia?
A) Encourage the patient to try harder to fall asleep.
B) Use paradoxical intervention, such as “try not to sleep.”
C) Limit the amount of time spent in bed.
D) Focus on increasing caffeine intake during the day.
B) Use paradoxical intervention, such as “try not to sleep.”
What is a common faulty belief patients may have about sleep-promoting practices?
A) The best strategy is to stay in bed and try harder to sleep.
B) The best strategy is to sleep as much as possible, even during the day.
C) Taking naps in the morning is essential for good sleep.
D) Meditation before bed is the only solution to insomnia.
A) The best strategy is to stay in bed and try harder to sleep.
What is one example of a behavioral experiment used in CBT-I for insomnia?
A) Monitoring of daytime fatigue symptoms.
B) Encouraging patients to take naps throughout the day.
C) Prescribing medication for fatigue.
D) Reducing time spent in bed to increase sleep duration.
A) Monitoring of daytime fatigue symptoms.
In which of the following situations is sleep compression preferred over sleep restriction?
A) For patients with chronic pain.
B) For bipolar patients.
C) For patients who do not have trouble falling asleep.
D) For people who already get an adequate amount of sleep.
B) For bipolar patients.
What is the typical duration of therapy for insomnia in CBT-I?
A) 1 hour per session for 1 week.
B) 5 hours over 4-6 weeks.
C) 10 hours over 2 weeks.
D) 3 hours per session for 3 weeks.
B) 5 hours over 4-6 weeks.
How is sleep compression different from sleep restriction in the context of CBT-I?
A) Sleep compression is used for patients who sleep too much.
B) Sleep compression reduces time in bed gradually, rather than abruptly.
C) Sleep compression involves eliminating naps completely.
D) Sleep compression is recommended for people with no sleep issues.
B) Sleep compression reduces time in bed gradually, rather than abruptly.
What is one contraindication for using sleep restriction in CBT-I?
A) Patients who suffer from excessive daytime sleepiness.
B) Patients operating motor vehicles or heavy machinery.
C) Patients who experience minimal insomnia symptoms.
D) Patients who have a normal sleep schedule.
B) Patients operating motor vehicles or heavy machinery.
