Rosh Psychiatry Board Practice Exam

What type of sleep disturbance might a patient with major depressive disorder experience?

1. Insomnia

2. Hypersomnolence

3. Sleep apnea

4. Nightmares

The correct answer is: Hypersomnolence

Patients with major depressive disorder often experience alterations in their sleep patterns, and hypersomnolence can be a significant feature of this condition. Hypersomnolence refers to excessive daytime sleepiness and prolonged nighttime sleep, which can lead to feeling unrefreshed even after extended periods of sleep. This symptom aligns with the depressive state, where individuals may find themselves sleeping longer than usual, but still not achieving restorative sleep. In major depression, there can also be a disruption of the typical sleep architecture, which might contribute to feelings of fatigue and low energy, reinforcing the cycle of depression. Insomnia is indeed common among individuals with depression, but hypersomnolence, which is characterized by excessive sleeping rather than difficulty falling or staying asleep, can also occur. This differentiation highlights the varying presentations of sleep disturbances in major depressive disorder and the importance of considering both aspects when assessing a patient. Sleep apnea, while it can co-occur with various psychiatric conditions, is not a direct consequence of major depressive disorder itself. Nightmares may be experienced by individuals with depression, but they are not as universally prevalent or defining of the disorder as hypersomnolence can be.