Sleep disorders: parasomnias: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Sleep disorders: parasomnias

Sample item

A 5-year-old child sits up screaming, with a racing heart and dilated pupils, about an hour after falling asleep. He cannot be consoled, and does not remember the episode the next morning. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Night terror (sleep terror), occurring in deep non-REM sleep

Sleep terrors arise from slow-wave (stage N3) non-REM sleep, in the first third of the night, with sudden screaming, autonomic arousal and difficulty in waking, followed by amnesia. Nightmares occur in REM sleep, late in the night, and are remembered in detail. Sleep terrors are common in children and usually resolve. Sleep deprivation and fever can trigger them.

Option by option

  • A. Nightmare, occurring in REM sleep

    Nightmares occur in REM sleep, later in the night, with vivid recall.

  • B. Night terror (sleep terror), occurring in deep non-REM sleep (correct)

    Correct. Early-night arousal from deep sleep with amnesia is typical.

  • C. Nocturnal seizure

    Seizures would show stereotyped movements and a postictal state, which are absent here.

  • D. REM sleep behaviour disorder

    REM sleep behaviour disorder occurs in older adults with dream enactment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Night terror (sleep terror), occurring in deep non-REM sleep. Sleep terrors arise from slow-wave (stage N3) non-REM sleep, in the first third of the night, with sudden screaming, autonomic arousal and difficulty in waking, followed by amnesia.

Why is "Nightmare, occurring in REM sleep" not the answer?

Nightmares occur in REM sleep, later in the night, with vivid recall.

Why is "Nocturnal seizure" not the answer?

Seizures would show stereotyped movements and a postictal state, which are absent here.

Why is "REM sleep behaviour disorder" not the answer?

REM sleep behaviour disorder occurs in older adults with dream enactment.

What concept does this question test?

It tests Sleep disorders: parasomnias in Psychiatry. Nightmares occur in REM sleep, late in the night, and are remembered in detail. Sleep terrors are common in children and usually resolve. Sleep deprivation and fever can trigger them.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Sleep disorders: parasomnias?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.