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Psychological disorders

Psychological disorders

Psychological disorders




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USMLE® Step 1 questions

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High Yield Notes

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USMLE® Step 1 style questions USMLE

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A group of researchers is studying the effects of alcohol on sleep. Alcohol is administered prior to nocturnal sleep to assess its physiological impact on sleep variables in healthy volunteers and control samples. Which of the following is most likely to be true in the patients given alcohol?  

External References

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AChE inhibitors p. 569

barbiturates for p. 566

benzodiazepines p. 566

marijuana withdrawal p. 595

nonbenzodiazepine hypnotics p. 567

stimulants causing p. 594



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.


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