American Board of Psychiatry and Neurology ABPN Sleep Medicine and Neurological Disorders

Question 1

A patient reports excessive daytime sleepiness, sudden loss of muscle tone triggered by strong emotion, sleep paralysis, and hypnagogic hallucinations. What is the MOST likely diagnosis?

Accepted Answer

Narcolepsy type 1

Answer

Idiopathic hypersomnia

Answer

Obstructive sleep apnea

Answer

REM sleep behavior disorder

Question 2

Which neurotransmitter deficiency is associated with narcolepsy type 1?

Accepted Answer

Hypocretin (orexin)

Answer

Dopamine

Answer

Serotonin

Answer

Acetylcholine

Question 3

A patient's polysomnography shows repetitive apneas despite preserved respiratory effort, with oxygen desaturation. What type of sleep apnea does this MOST likely represent?

Accepted Answer

Obstructive sleep apnea

Answer

Central sleep apnea

Answer

Mixed sleep apnea

Answer

Cheyne-Stokes respirations

Question 4

REM sleep behavior disorder (RBD) is characterized by which polysomnographic finding?

Accepted Answer

Loss of normal REM sleep atonia allowing dream enactment

Answer

Sleep spindles and K-complexes during REM

Answer

Periodic leg movements during NREM sleep

Answer

Sleep-onset REM periods (SOREMPs)

Question 5

Idiopathic REM sleep behavior disorder is MOST strongly associated with future development of which neurodegenerative disease?

Accepted Answer

Synucleinopathies (Parkinson's disease, Lewy body dementia)

Answer

Alzheimer's disease

Answer

Huntington's disease

Answer

ALS (amyotrophic lateral sclerosis)

Question 6

Which medication is FIRST-LINE for restless legs syndrome (RLS)?

Accepted Answer

Dopamine agonists (e.g., pramipexole, ropinirole)

Answer

Benzodiazepines

Answer

Opioid analgesics

Answer

SSRIs