Final Assessment

Section Self Assessment

1. Sequelae of insomnia

Which of the following conditions is the SINGLE LEAST likely to be a consequence of long term insomnia? Select ONE option only

2. Benefits of effective sleep management

Which of the following is the SINGLE most likely effect of psychological treatment for insomnia? Select ONE option only

3. Long term treatment of insomnia

According to current evidence, which of the following is the SINGLE most effective treatment licensed long term for insomnia in adults? Select ONE option only

4. Effects of hypnotic drugs

A 70-year old man has insomnia for the past 6 weeks. He has had sleeping tablets previously and asks you to prescribe sleep tablets on repeat prescription.

Which is the SINGLE most appropriate advice to give when explaining the benefits versus harms of sleeping tablets compared with placebo? Select ONE option only Select ONE option only

5. Treatment of comorbid insomnia

Which of the following conditions associated with sleep difficulty would you not consider treating with cognitive behavioural therapy for insomnia? Select ONE option only

6. Management of insomnia

A 65-year old woman is distressed and unable to sleep for 3 nights following a recent bereavement. You decide to prescribe a hypnotic.

Which of the following is the SINGLE most appropriate treatment for short term drug treatment of insomnia? Select ONE option only

7. Features of newer hypnotic drugs

According to current evidence which is the SINGLE most likely feature of newer hypnotic (Z) drugs? Select ONE option only

8. Long term hypnotic prescribing

A 48-year old woman attends surgery for review of her repeat prescription of hypnotics.

Which is the SINGLE most likely treatment recommendation/regime that she is likely to be on? Select ONE option only

9. Expectations of patients seeking care for insomnia

Which is the SINGLE most likely behaviour, experience or expectation of a patient seeking treatment for insomnia? Select ONE option only

11. Benefits of sleep assessment

A 35-year old man has difficulty sleeping over the past month. You decide to assess him using an insomnia severity index (ISI) and sleep diary.

Which is the SINGLE most likely benefit of using sleep assessment tools (ISI and sleep diary) in the primary care consultation? Select ONE option only

12. Abnormal sleep patterns

A 34-year-old man takes 1-2 hours to get off to sleep but then sleeps 7 hours each night.

Select the most likely abnormal sleep pattern for the patient detailed above. Select ONE option only

13. Abnormal sleep patterns

A 45-year-old man gets off to sleep easily but then wakes for 15-20 minutes at a time 3-4 times every night.

Select the most likely abnormal sleep pattern for the patient detailed above. Select ONE option only

14. Abnormal sleep patterns

A 23-year-old woman sleeps for 7 hours and wakes unrefreshed after spending 9 hours in bed.

Select the most likely abnormal sleep pattern for the patient detailed above. Select ONE option only

15. Sleep assessment tools

A 43-year-old man has been having severe sleep problems for over a year with chaotic waking and sleep onset times, occasional napping during the day and a reported time in bed of 3-4 hours each night. You decide to assess his sleep pattern in primary care.

Which is the SINGLE most appropriate sleep assessment tool for this patient? Select ONE option only

16. Behavioural techniques in cognitive behavioural therapy for insomnia (CBTi)

Which of the following is the SINGLE LEAST likely to be a component of CBTi? Select ONE option only

17. Cognitive techniques in cognitive behavioural therapy for insomnia (CBTi)

Which of the following is the SINGLE most likely to be a component of CBTi? Select ONE option only

18. Psychological treatment for insomnia (CBTi)

A 23-year-old man had difficulty sleeping for the past 2 weeks. He has recently changed jobs. He lays awake with thoughts racing through his head. He is not depressed or stressed. He has difficulty getting off to sleep, taking 2-3 hours but then sleeps until the morning. Select ONE option only

19. Cognitive behavioural therapy for insomnia (CBTi) techniques

For the following processs described, select the SINGLE most appropriate technique from the list below

Alternate contraction and relaxation of muscle groups Select ONE option only

20. Cognitive behavioural therapy for insomnia (CBTi) techniques

For the following processs described, select the SINGLE most appropriate technique from the list below

Avoidance of noise, television, reading or eating in bed Select ONE option only

21. Cognitive behavioural therapy for insomnia (CBTi) techniques

For the following processs described, select the SINGLE most appropriate technique from the list below

Reducing sleep time followed by a graded increase Select ONE option only

22. Cognitive behavioural therapy for insomnia (CBTi) techniques

For the following processs described, select the SINGLE most appropriate technique from the list below

Modification of sleep schedule, caffeine, alcohol intake and exercise Select ONE option only

23. Withdrawal from long term hypnotic drugs

Which is the SINGLE most appropriate method for withdrawal of a long term hypnotic agent? Select ONE option only

24. Adjunct to withdrawal from long term hypnotic drugs

Which is the SINGLE most appropriate technique which can be used to support withdrawal of a hypnotic drug? Select ONE option only

25. Management of recent insomnia

A 56-year-old man has a 3 month history of difficulty getting off to sleep and waking several times each night since he suffered work stress which has now resolved. He has no other symptoms. His PHQ9 is 3 out of 27. His weight is normal, collar size 9 and he does not snore or have any abnormal movements.

Which is the SINGLE most appropriate response? Select ONE option only

26. Comorbid and specific and sleep disorders

For the following patient described, select the SINGLE most appropriate diagnosis from the list below

A 66-year-old man with repetitive leg or arm movements every 20-40 seconds lasting 2-3 hours each night and waking him from sleep. Select ONE option only

27. Comorbid and specific and sleep disorders

For the following patient described, select the SINGLE most appropriate diagnosis from the list below

A 45-year-old woman with several weeks of an uncontrollable urge to move her legs at night making it difficult to go to sleep. Select ONE option only

28. Comorbid and specific and sleep disorders

For the following patient described, select the SINGLE most appropriate diagnosis from the list below

A 55-year-old man whose partner complains he snores and stops breathing during sleep. He complains of morning headache and irritability. Select ONE option only

29. Comorbid and specific and sleep disorders

For the following patient described, select the SINGLE most appropriate diagnosis from the list below

A 46-year old woman who wakes early in the morning and is irritable with poor motivation since her mother died 3 months previously. Select ONE option only

30. Comorbid and specific and sleep disorders

For the following patient described, select the SINGLE most appropriate diagnosis from the list below

A 58-year-old man with poor concentration during the day and intermittent confusion which is worse at night when he wakes and sometimes wanders. Select ONE option only