Eating and sleep disorders: REM rebound: 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 · Eating and sleep disorders: REM rebound

Sample item

A man who has drunk heavily every night stops abruptly. Over the next few nights he sleeps poorly and has intense, vivid, disturbing dreams, with a polysomnogram showing increased REM sleep. What explains this?

AREM sleep behaviour disorder from synucleinopathyBCentral sleep apnoeaCREM rebound after removal of a REM-suppressing substanceDSleep terror disorder arising from slow-wave sleep

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

The answer and the reasoning

C. REM rebound after removal of a REM-suppressing substance

Alcohol suppresses REM sleep, and on stopping it there is a rebound with more REM, vivid dreams and fragmented sleep. The same phenomenon occurs after withdrawal of benzodiazepines, barbiturates and other REM-suppressing drugs.

Option by option

A. REM sleep behaviour disorder from synucleinopathy
REM sleep behaviour disorder is acting out of dreams due to loss of atonia in older adults and is not the cause here.
B. Central sleep apnoea
Central sleep apnoea gives pauses in breathing without effort, not increased REM with vivid dreams.
C. REM rebound after removal of a REM-suppressing substance (correct)
Correct. Withdrawal of a REM suppressant leads to REM rebound with vivid dreams.
D. Sleep terror disorder arising from slow-wave sleep
Sleep terrors arise from slow-wave sleep with little dream recall, not vivid dreams with REM increase.

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, REM rebound after removal of a REM-suppressing substance. Alcohol suppresses REM sleep, and on stopping it there is a rebound with more REM, vivid dreams and fragmented sleep.

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

REM sleep behaviour disorder is acting out of dreams due to loss of atonia in older adults and is not the cause here.

Why is "Central sleep apnoea" not the answer?

Central sleep apnoea gives pauses in breathing without effort, not increased REM with vivid dreams.

Why is "Sleep terror disorder arising from slow-wave sleep" not the answer?

Sleep terrors arise from slow-wave sleep with little dream recall, not vivid dreams with REM increase.

What concept does this question test?

It tests Eating and sleep disorders: REM rebound in Psychiatry. The same phenomenon occurs after withdrawal of benzodiazepines, barbiturates and other REM-suppressing drugs.

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 Eating and sleep disorders: REM rebound?

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.