AANP Family Nurse Practitioner (FNP) Certification ExamPlanMedium
A 45-year-old female presents with primary insomnia, reporting difficulty falling asleep and staying asleep for the past 6 months, affecting her daily functioning. She denies substance use and has tried over-the-counter sleep aids with minimal success. Her medical history is unremarkable. As part of a comprehensive plan, the FNP recommends cognitive behavioral therapy for insomnia (CBT-I). Which of the following is a key component of CBT-I?
- AStrict adherence to a consistent sleep-wake schedule, even on weekends.
- BPrescribing zolpidem nightly for long-term use.
- CConsuming alcohol before bed to induce relaxation.
- DEngaging in stimulating activities in bed, such as watching TV or using smartphones.
Show answer & explanationAnswer & explanation
Correct answer: A. Strict adherence to a consistent sleep-wake schedule, even on weekends.
CBT-I emphasizes behavioral strategies to improve sleep. Maintaining a consistent sleep-wake schedule, even on weekends, helps to regulate the body's natural circadian rhythm, which is a fundamental principle of sleep hygiene taught in CBT-I.
Why the other options are wrong
- B. Pharmacological interventions are not the primary focus of CBT-I, and long-term use of hypnotics is generally discouraged due to tolerance and dependence.
- C. Alcohol disrupts sleep architecture and can worsen insomnia in the long run; it is generally advised to avoid it before bed.
- D. Stimulating activities in bed are counterproductive to sleep and should be avoided as part of good sleep hygiene and CBT-I.
CBT-I Components
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component therapy focusing on cognitive restructuring and behavioral changes to improve sleep.
- Sleep restriction and stimulus control.
- Cognitive restructuring of maladaptive sleep thoughts.
- Sleep hygiene education and relaxation techniques.
Memory trick: SLEEP SMART: Stimulus, Light, Exercise, Environment, Pacing, Schedule, Mindset, Avoid.