Anxiety and related disorders: nocturnal panic attack: 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 · Anxiety and related disorders: nocturnal panic attack

Sample item

A 30-year-old man repeatedly wakes from deep sleep in terror with palpitations, chest tightness and breathlessness. He is fully alert, recalls it clearly, and cannot recall any dream. He also has similar attacks while awake. What is the most likely diagnosis?

ANightmare disorderBREM sleep behaviour disorderCPanic disorder with nocturnal panic attacksDSleep terror disorder

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

The answer and the reasoning

C. Panic disorder with nocturnal panic attacks

Nocturnal panic attacks wake the person from non-REM sleep with intense fear and autonomic arousal, with clear recall and no dream content, and usually occur in someone who also has daytime attacks. Sleep terrors give amnesia and no clear recall, and nightmares are vivid dreams recalled on waking.

Option by option

A. Nightmare disorder
Nightmare disorder involves recalled frightening dream content, which is absent here.
B. REM sleep behaviour disorder
REM sleep behaviour disorder involves dream enactment with REM sleep without atonia.
C. Panic disorder with nocturnal panic attacks (correct)
Correct. Clear recall of an awakening attack without dream content and with daytime attacks indicates panic disorder.
D. Sleep terror disorder
Sleep terrors leave the person confused and amnesic for the event.

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Panic disorder with nocturnal panic attacks. Nocturnal panic attacks wake the person from non-REM sleep with intense fear and autonomic arousal, with clear recall and no dream content, and usually occur in someone who also has daytime attacks.

Why is "Nightmare disorder" not the answer?

Nightmare disorder involves recalled frightening dream content, which is absent here.

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

REM sleep behaviour disorder involves dream enactment with REM sleep without atonia.

Why is "Sleep terror disorder" not the answer?

Sleep terrors leave the person confused and amnesic for the event.

What concept does this question test?

It tests Anxiety and related disorders: nocturnal panic attack in Psychiatry. Sleep terrors give amnesia and no clear recall, and nightmares are vivid dreams recalled on waking.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Anxiety and related disorders: nocturnal panic attack?

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.