Section: Coach Sleep — The Deeper Architecture
This section covers Chapter 3, Lessons 3.1 through 3.3.
Part A — Vocabulary (20 points, 2 points each)
Select the best answer for each question.
1. REM atonia is:
A) A type of dream B) Temporary muscle paralysis during REM that prevents dream enactment C) The deepest sleep stage D) A breathing pattern
2. PGO waves are:
A) Brain waves only seen during waking B) Ponto-geniculo-occipital waves during REM, involved in dream generation and memory processing C) Stress-response waves D) Heart rhythm waves
3. The overnight therapy hypothesis proposes that REM sleep:
A) Erases negative memories entirely B) Strips emotional charge from memories while preserving their content C) Replaces bad memories with neutral ones D) Is the cause of nightmares
4. Growth hormone (GH) is:
A) Released primarily during waking B) A sleep-released hormone driving growth, repair, and adolescent development; concentrated in early-night deep sleep C) Identical to cortisol D) Only released in childhood
5. Cortisol Awakening Response is:
A) A drop in cortisol at bedtime B) A sharp cortisol rise in the first 30-45 minutes after waking, supporting morning alertness C) An anxiety disorder D) A response to stress only
6. Anabolic state refers to:
A) Tissue breakdown B) A tissue-building physiological state; sleep is the body's primary anabolic window C) A catabolic process D) Energy expenditure
7. Insomnia disorder clinically requires:
A) One bad night of sleep B) Sleep difficulty 3+ nights/week for 3+ months, with daytime impairment C) Sleep duration under 4 hours D) Inability to fall asleep ever
8. CBT-I stands for:
A) Cognitive Behavioral Therapy for Insomnia B) Calmness, Breath, Tranquility, Imagery C) A type of sleep medication D) A sleep tracker brand
9. Obstructive Sleep Apnea (OSA) is:
A) Difficulty falling asleep B) Recurrent airway collapse during sleep; symptoms include snoring, gasping, daytime sleepiness; treatable C) A type of insomnia D) Sleep without dreams
10. Sleep extension refers to:
A) Sleeping in late one day B) Deliberately increasing nightly sleep duration for a period; shows performance gains in athletes C) Extending the sleep cycle length D) A medical procedure
Part B — Concept Comprehension (20 points, 2 points each)
Select the best answer for each question.
11. During REM sleep, the brain's neurochemistry is characterized by:
A) High norepinephrine and serotonin, low acetylcholine B) Low norepinephrine and serotonin, high acetylcholine C) High levels of all major neurotransmitters D) Low levels of all major neurotransmitters
12. REM atonia is best described as:
A) A dangerous condition requiring treatment B) Temporary muscle paralysis preventing dream enactment C) Loss of breathing during REM D) Reduced brain activity during dreams
13. The overnight therapy hypothesis proposes that REM:
A) Erases negative memories entirely B) Strips emotional charge from memories while preserving content C) Replaces bad memories with neutral ones D) Is the cause of nightmares
14. Growth hormone is released primarily during:
A) REM sleep B) Stage 1 light sleep C) Stage 3 deep sleep, concentrated early in the night D) Waking hours
15. The Stanford basketball player sleep extension study found:
A) No measurable performance change B) Approximately 5% faster sprints and 9% better shooting accuracy C) Worse performance from too much sleep D) Improvement only in fatigue, not skill
16. Sleeping fewer than 6 hours per week has been associated in research with cold susceptibility approximately:
A) Equal to well-rested individuals B) 4.2 times the rate of those sleeping 7+ hours C) 1.1 times higher D) Less susceptibility due to immune adaptation
17. The clinical threshold for insomnia disorder is approximately:
A) Two bad nights in a row B) 3+ nights per week for 3+ months, with daytime impairment C) Any difficulty sleeping D) Sleep duration under 4 hours
18. Cognitive Behavioral Therapy for Insomnia (CBT-I) compared to sleep medications:
A) Has worse long-term outcomes B) Has stronger long-term outcomes with no side effects C) Is only for adults over 25 D) Requires expensive equipment
19. Restless Legs Syndrome in adolescents is often associated with:
A) Caffeine consumption only B) Iron deficiency, particularly during rapid growth C) Excessive exercise D) Purely genetic causes
20. Loud snoring with observed breathing pauses and excessive daytime sleepiness most suggests:
A) Normal teenage sleep B) Possible obstructive sleep apnea, warranting evaluation C) Restless legs syndrome D) A parasomnia
Part C — Application (30 points, 6 points each)
Write 2-4 complete sentences for each question. Show your reasoning.
21. Explain why cutting sleep short in the morning costs proportionally more REM than cutting it short in the evening, and what consequences follow from REM loss.
22. A teen athlete is training intensely and sleeping 6 hours per night. Using research on sleep and athletic performance (including the Stanford sleep-extension study), evaluate whether this approach maximizes their training adaptation.
23. Describe the daily cortisol curve in a healthy individual. What does chronic sleep loss do to this curve, and how would the disruption feel from the inside?
24. A friend says they have been unable to fall asleep most nights for the past four months and is now afraid of bed. Apply what you learned about insomnia disorder and CBT-I to advise them.
25. Describe the difference between a parasomnia that is benign and one worth medical evaluation. Give an example of each.
Continue to the next section.