random pop culture
Who was the lead actor in the movie by the same name as our topic?
Robin Williams (would also accept Al Pacino)
Chronic insomnia disorder is defined as difficulty initiating or maintaining sleep, or early morning awakening, occurring at least what period of time?
at least 3 nights per week for ≥ 3 months
Which behavioral treatment is considered first-line for chronic insomnia?
CBT
Which two neurotransmitters are primarily responsible for promoting wakefulness in the brain’s ascending arousal system?
norepinephrine and acetylcholine
Benzodiazepines promote sleep by enhancing activity at which specific GABA receptor subtype?
GABA-A receptors
Which classic Disney princess famously falls into a deep sleep after a cursed spindle injury — but unlike patients with chronic insomnia, her condition wasn’t helped by CBT or low-dose doxepin?
Sleeping Beauty
What percentage of adults experience chronic insomnia symptoms?
10-15%
What OTC antihistamine was discouraged because of anticholinergic effects and tolerance?
Diphenhydramine
Which pair of hypothalamic neuropeptides plays a central role in maintaining wakefulness and are targeted by suvorexant?
orexin A and orexin B (hypocretins)
Compared to benzodiazepines, “Z-drugs” like zolpidem selectively bind to which receptor subunit?
α1 subunit of the GABA-A receptor
Which Batman villain says “I haven’t slept in days” while spiraling into madness... a reminder that chronic sleep deprivation worsens mood and cognitive function
the Joker
Insomnia is most prevalent in which demographic groups?
older adults and women
Although commonly self-prescribed, which hormone supplement was not recommended for either sleep-onset or maintenance insomnia?
Melatonin
In healthy individuals, which sleep stage predominates in the first third of the night? (whereas REM dominates in the final third)
slow-wave (N3) sleep
Which class of OTC agents is strongly discouraged in older adults due to their anticholinergic properties?
first generation antihistamines (diphenhydramine, doxylamine)
Name the actor's name who voices Coach McGuirk
H. Jon Benjamin
Name one biological system that demonstrates hyperactivity in chronic insomnia
HPA axis, autonomic nervous system, or arousal-related neural circuits
Despite widespread off-label use, which antidepressant was not recommended due to limited efficacy evidence?
Trazodone
Chronic insomnia patients show reduced deactivation in which cortical region on functional neuroimaging, reflecting persistent cognitive hyperarousal?
medial prefrontal cortex
Which medication is a melatonin-receptor agonist used for sleep-onset insomnia which acts selectively at MT1 and MT2 receptors in the suprachiasmatic nucleus?
ramelteon
Which wizarding world professor was constantly described as exhausted, disheveled, and tired.. but unlike real insomniacs, his main problem was the full moon
Professor Lupin
Neuroimaging studies of chronic insomnia show increased metabolic activity in which brain region even during rest?
ascending reticular activating system (or thalamocortical regions) reflecting persistent wake activation
What term describes the process of adjusting bedtime, wake time and behaviors to strengthen circadian alignment?
sleep hygiene and circadian optimization
Chronic insomnia is an independent predictor of mortality primarily through which physiologic mechanism?
autonomic dysregulation leading to cardiovascular morbidity
Which “Z-drug” has the shortest half-life in its class, making it useful specifically for patients who struggle to fall asleep, but not stay asleep?
zaleplon