Insomnia: ABFM practice questions

8 board-style questions on insomnia in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 48-year-old woman presents with difficulty falling asleep and maintaining sleep for the past 4 months. She lies in bed for 2 hours before falling asleep and watches television in bed. She wakes at 3 AM and cannot return to sleep. She naps daily at 2 PM. She denies snoring, leg movements, or mood symptoms. She drinks 3 cups of coffee, last at 4 PM. What is the most appropriate initial treatment?

  1. Melatonin 10 mg at bedtime
  2. Trazodone 50 mg at bedtime
  3. Cognitive behavioral therapy for insomnia (CBT-I) with sleep hygiene modifications
  4. Zolpidem 10 mg at bedtime

Sample question 2

A 48-year-old woman presents with a 4-month history of difficulty falling asleep and maintaining sleep. She takes approximately 45 minutes to fall asleep and wakes 2-3 times nightly. She denies snoring, restless legs, excessive daytime sleepiness suggestive of narcolepsy, or symptoms of depression or anxiety. She has implemented sleep hygiene measures without improvement. What is the recommended first-line treatment for chronic insomnia disorder?

  1. Cognitive behavioral therapy for insomnia (CBT-I)
  2. Melatonin 5 mg at bedtime
  3. Zolpidem 10 mg nightly
  4. Trazodone 50 mg at bedtime

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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