Usmle Step 1 MCQ's # 14

Title: Usmle Step 1 MCQ's # 14
Subject: Behavioral Science

Q NO 14: A 78 year-old woman complains to her physician of not feeling rested after a night’s sleep. Physical examination and routine laboratory studies are unremarkable. The physician explains to her that the sleep patterns of normal elderly persons differ from those of younger individuals in which of the following ways?

A. Increased need for sleep

B. Increased REM sleep

C. More arousal and awakening at night

D. More total nighttime sleep

E. Significant sleep disturbances are more common

Explanation:

The correct answer is C. Sleep patterns differ from person to person, however some generalizations can be made regarding age and sleep. Elderly individuals have more awakening and arousal at night, they tend to awaken earlier, and have less total sleep. Multiple factors can contribute to sleep disturbances in the elderly, including primary sleep disorders sleep disorders secondary to other physical and psychiatric conditions, as well as medication-induced sleep problems.

With increased age, the needs for sleep decreases (compare with choice A). A newborn might sleep up to 22 hours daily, but an adult can generally feel rested with 6 to 8 hours of sleep.

The amount of time spent in REM sleep decreases with age (compare with choice B)’ starting at about age 50.

The elderly generally achieve less total nighttime sleep (compare with choice D).

Mild sleep disturbances (compare with choice E ) can be associated with normal aging, however any significant sleep disturbance that impairs daily activity or causes increased daily sleepiness requires further evaluation.