Eating and sleep disorders: residual sleepiness in sleep apnoea: 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: residual sleepiness in sleep apnoea

Sample item

A 50-year-old obese man with obstructive sleep apnoea uses CPAP nightly with a good adherence record, yet he still has marked daytime sleepiness. Other causes are excluded. Which drug may be added?

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

The answer and the reasoning

A. Modafinil

Residual excessive sleepiness despite adequate CPAP can be treated with a wake-promoting agent such as modafinil. Sedative-hypnotics and benzodiazepines worsen upper airway collapse and should be avoided in sleep apnoea.

Option by option

  • A. Modafinil (correct)

    Correct. Modafinil is the wake-promoting agent used for residual sleepiness.

  • B. Alprazolam

    Alprazolam is a benzodiazepine that reduces airway tone and increases sedation.

  • C. Zolpidem

    Zolpidem is a hypnotic that can worsen sleep-disordered breathing.

  • D. Amitriptyline

    Amitriptyline is sedating and anticholinergic, and adds weight gain.

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.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Modafinil. Residual excessive sleepiness despite adequate CPAP can be treated with a wake-promoting agent such as modafinil.

Why is "Alprazolam" not the answer?

Alprazolam is a benzodiazepine that reduces airway tone and increases sedation.

Why is "Zolpidem" not the answer?

Zolpidem is a hypnotic that can worsen sleep-disordered breathing.

Why is "Amitriptyline" not the answer?

Amitriptyline is sedating and anticholinergic, and adds weight gain.

What concept does this question test?

It tests Eating and sleep disorders: residual sleepiness in sleep apnoea in Psychiatry. Sedative-hypnotics and benzodiazepines worsen upper airway collapse and should be avoided in sleep apnoea.

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 Eating and sleep disorders: residual sleepiness in sleep apnoea?

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.