Final Assessment

1. Sequelae of insomnia – Which of the following conditions is the SINGLE LEAST likely to be a consequence of long term insomnia? *

2. Benefits of effective sleep management – Which of the following is the SINGLE most likely effect of psychological treatment for insomnia? *

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? *

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? *

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? *

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? *

7. Features of newer hypnotic drugs – According to current evidence which is the SINGLE most likely feature of newer hypnotic (Z) drugs? *

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 experienced for hypnotics? *

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? *

10. What do practitioners need to understand about insomnia? – Which is the SINGLE most likely to be true of patients seeking treatment for insomnia? *

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? *

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. *

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 *

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. *

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? *

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? *

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? *

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. Which of the following is the SINGLE most appropriate advice? *

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 *

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 *

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 *

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 *

23. Withdrawal from long term hypnotic drugs – Which is the SINGLE most appropriate method for withdrawal of a long term hypnotic agent? *

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? *

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. *

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. *

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 *

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. *

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. *