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Sleep Medicine MOC Sample Question 1

Which of the following statements pertaining to antidepressant medications is true?

  • AAmitriptyline increases REM latency and decreases the relative percentage of REM sleep.
  • BFluoxetine increases REM latency and increases the relative percentage of REM sleep.
  • CPhenelzine decreases REM latency and increases relative percentage of REM sleep.
  • DTrazadone decreases REM latency and causes sedation.
  • EVenlafaxine decreases REM latency and increases REM sleep
Sleep Medicine MOC Sample Question 2

A 30-year-old physician presents to you with complaints of insomnia and sleepiness related to shift work. He recently finished a critical care fellowship, and started work as a night intensivist in an ICU approximately 4 months ago. He has no significant past medical history. He states that he always had “trouble” with intermittent night shifts as a resident and fellow but still took a night intensivist job because he figured his “body would adapt to nights” if he worked night shifts more regularly. He reports significant sleepiness during work which he feels compromises his decision making at times. He states that brief naps improve his sleepiness but he is rarely able to fit them in. After his shift he attempts to sleep between 9 am and 5 pm, but reports sleep maintenance insomnia resulting in a total sleep time of less than 6-6.5 hours on most days. He currently works three to four 7 pm to 7 am shifts per week. On days off he returns to a conventional sleep-wake schedule in order to spend more time with his family. He reports that on a recent 2 week vacation he slept on a “normal” schedule and did not have any daytime sleepiness or insomnia. He has sleep logs which corroborate his given sleep history. He believes he has shift work disorder (SWD) and has considered requesting a change to day shifts but has also read that stimulants or shifting his circadian phase may be beneficial. He would like to immediately pursue the most effective treatment. Which of the following is likely to be the MOST effective treatment for this patient?

  • AModafinil at the start of each shift
  • BChange to day shift schedule
  • CMelatonin at the end of each shift
  • DBright light for two hours at the start of each shift
  • EZolpidem before his daytime sleep periods

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