Sleep Board Review Questions: The Late Riser

Tauseef Afaq, MD¹

Rohit Budhiraja, MD^1,2

¹ Department of Medicine, Section of Pulmonary, Allergy, Critical Care and Sleep Medicine, The University of Arizona, Tucson, AZ, 85724, USA. tafaq@deptofmed.arizona.edu

² Department of Medicine, Southern Arizona Veterans Affairs Health Care System (SAVAHCS), Tucson, AZ 85723, USA. rohit.budhiraja@va.gov

A 22-year-old male presents to Sleep Clinic for sleep onset insomnia and difficulty waking up in the morning.  He plans to begin a new job in a few weeks, which would require him to wake up at 6 AM. He usually goes to sleep at 2 AM and wakes up at 10 AM.  He remembers having this problem through high school and college. He admits to being unable to sleep even if he goes to bed at an earlier time.  He reports sleeping through alarms in the morning.  His sleep log and actigraphy (non-invasive method of monitoring activity) are consistent with delayed sleep phase disorder (DSPD). 

In order to maximally advance the sleep-wake phase in this patient, when should the administration of bright light take place? 

1. Between 5 AM to 6 AM.
2. Between 8 AM to 9 AM.
3. Between 2 AM to 3 AM.
4. Between 10 PM to 11 PM.

Reference as: Afaq T, Burhiraja R. Sleep board review questions: the late riser. Southwest J Pulm Crit Care 2012;5:176-8. PDF