Skip to content




Behavioral sciences

Psychological disorders

Mood disorders
Anxiety disorders
Obsessive-compulsive disorders
Stress-related disorders and abuse
Psychotic disorders
Cognitive and dissociative disorders
Eating disorders
Personality disorders
Somatoform and factitious disorders
Substance use disorders and drugs of abuse
Sleep disorders
Sexual dysfunction disorders
Pediatric disorders
Psychiatric emergencies
Psychological disorders review



0 / 13 complete


1 / 3 complete
High Yield Notes
5 pages


13 flashcards

USMLE® Step 1 style questions USMLE

3 questions

USMLE® Step 2 style questions USMLE

2 questions

A 24-year-old woman comes to the clinic because of insomnia. She says she has suffered from insomnia intermittently for many years, but it did not bother her in college very much since she mostly took night classes. It has become problematic with her new career which requires her to wake up at 6am to get to work on time. She has been late to work on several occasions recently, which resulted in a missed opportunity for a pay raise. She goes to bed at 10pm every night but often lies awake in her dark room unable to sleep until 2am. She reports feeling more refreshed on the weekends when she can sleep until 10am. She drinks 2-3 cups of coffee most mornings, but she often still wishes to nap and struggles to keep herself awake sometimes. Which of the following treatment methods is this patient most likely to benefit from?

External References


Have you ever had one of those nights where you just can’t seem to fall asleep?

While that happens to everyone every occasionally, people with insomnia have to deal with these symptoms night after night.

Some people with insomnia have trouble falling asleep, whereas others wake up throughout the night, and struggle to fall back asleep.

These disturbances typically happen at least 3 times each week.

Acute insomnia lasts less than a month, whereas chronic insomnia lasts over a month.

Insomnia affects both the quantity and quality of sleep, which makes it hard for individuals to reach restorative levels of sleep, leading to daytime sleepiness and fatigue, and over time, feelings of irritability, anxiety, and depression.

This can cause professional and personal problems, as make day-to-day activities like driving more challenging and dangerous, with people struggling to stay awake on the road.

Although insomnia can happen without an underlying cause, it can also accompany and worsen other problems like pulmonary diseases, psychiatric conditions, and a whole variety of conditions that might cause pain.

Insomnia is also a common side effect of stimulants like caffeine, as well as depressants like alcohol, which can both disrupt the regular sleep cycle.

Finally, and probably most commonly, insomnia can be the result of daily stresses from work or relationships as well environmental factors such as having to work a night shift, or having a newborn baby.

There are a number of biological factors associated with insomnia.

Studies have shown that people with insomnia might have heightened levels of the stress hormone cortisol, which plays a role in the process of waking up every morning.

People with insomnia are also more sensitive to the effects of cortisol, typically waking up at much lower levels of cortisol compared to the general population.

Additionally, insomnia is also associated with reduced levels of estrogen and reduced levels of progesterone, which can happen during menopause.

Some individuals with insomnia resort to self-medicating with alcohol and benzodiazepines which can be extremely dangerous.

Insomnia is a sleep disorder. People with insomnia have trouble sleeping: difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.