Quiz — Chapter 30: Sleep, Energy, and Peak Performance

25 multiple-choice questions covering sleep architecture, circadian biology, the costs of sleep deprivation, memory consolidation, chronotype, ultradian rhythms, energy management, sleep hygiene, and recovery.

Multiple Choice

Question 1 Which of the following best describes the distribution of sleep stages across a full night?

A) REM sleep dominates the first half; slow-wave sleep dominates the second half B) Slow-wave sleep dominates the first half; REM sleep dominates the second half C) REM and slow-wave sleep alternate equally throughout the night D) Slow-wave sleep and REM sleep occur simultaneously in alternating brain regions

Question 2 The glymphatic system, discovered by Nedergaard's research group, performs what function during sleep?

A) Regulates blood pressure and core body temperature during slow-wave sleep B) Consolidates procedural memories into long-term cortical storage during REM sleep C) Clears metabolic waste products — including amyloid-beta and tau proteins — from brain tissue, primarily during slow-wave sleep D) Releases growth hormone and suppresses cortisol during the first half of the night

Question 3 Which neurotransmitter builds "sleep pressure" across the waking day, and how does caffeine affect it?

A) Serotonin; caffeine accelerates serotonin metabolism, temporarily reducing alertness B) Dopamine; caffeine blocks dopamine reuptake, sustaining alertness C) Adenosine; caffeine blocks adenosine receptors, masking accumulated sleep pressure without eliminating it D) Norepinephrine; caffeine increases norepinephrine release, producing wakefulness

Question 4 The circadian clock's primary environmental synchronizer (zeitgeber) is:

A) Core body temperature variation B) Melatonin from the pineal gland C) Social schedule and meal timing D) Light, specifically short-wavelength (blue) light detected by photoreceptors projecting to the suprachiasmatic nucleus

Question 5 Research by Phillippa Lally (discussed in Chapter 29) and chronobiology research both find that the "21 days to form a habit" claim is unsupported. Similarly, which popular belief about sleep is directly contradicted by research in this chapter?

A) Alcohol impairs sleep quality despite initially facilitating sleep onset B) Morning exercise improves sleep C) Seven to nine hours of sleep is the recommended range for most adults D) Chronotype is partly determined by genetics

Question 6 Chronotype describes:

A) The speed with which a person falls asleep after going to bed B) The individual variation in preferred timing of sleep and peak alertness, substantially determined by genetics C) The number of sleep cycles a person completes during a typical night D) The degree to which a person's sleep is disrupted by external noise

Question 7 "Social jetlag" refers to:

A) The sleep disruption caused by transatlantic air travel B) The cognitive impairment produced by sleeping in an unfamiliar social environment C) The discrepancy between a person's biological circadian timing and their socially imposed sleep-wake schedule D) The tendency for social media use to delay sleep onset

Question 8 Research by Van Dongen and colleagues on sleep restriction found that:

A) People accurately perceive the degree of cognitive impairment produced by insufficient sleep B) Six hours of sleep per night for two weeks produced the same cognitive impairment as zero hours of sleep for two days, but subjects significantly underestimated their impairment C) Cognitive performance adapts to chronic sleep restriction within approximately three weeks D) Sleep restriction affects motor performance more severely than cognitive performance

Question 9 Walker and colleagues' research on the amygdala and sleep deprivation found that sleep-deprived subjects showed:

A) Reduced amygdala activation to emotional stimuli, reflecting emotional blunting B) Approximately 60% greater amygdala activation to emotional stimuli, and a decoupling of the prefrontal-amygdala regulatory circuit C) Increased amygdala activation, but with compensatory increase in prefrontal regulation D) No significant change in amygdala activation, but reduced accuracy in identifying others' emotional expressions

Question 10 The "overnight insight effect" demonstrated by Wagner and colleagues refers to:

A) The tendency for nightmares to produce creative problem-solving after waking B) The finding that subjects who slept between two sessions of a mathematical task were three times more likely to discover a hidden shortcut than those who stayed awake C) The improved memory for events occurring just before sleep, due to proximity to consolidation D) The enhanced emotional insight produced by dream content processing

Question 11 What does the research on alcohol and sleep indicate?

A) Moderate alcohol consumption (one to two drinks) improves sleep architecture and reduces waking B) Alcohol accelerates sleep onset but suppresses REM sleep and fragments sleep in the second half of the night, producing net worse sleep quality C) Alcohol's sedative effects produce deeper slow-wave sleep but reduce REM sleep duration D) The effect of alcohol on sleep is highly variable and unpredictable across individuals

Question 12 The Basic Rest-Activity Cycle (BRAC) describes:

A) The approximately 90-minute alternation of NREM and REM sleep stages during the night B) A roughly 90-minute cycle of alertness and recovery that operates during the waking day C) The daily cycle of cortisol rise (morning) and fall (evening) that regulates daytime energy D) A behavioral cycle of work and rest that must be deliberately designed and imposed

Question 13 According to research on chronotype and cognitive performance, analytical tasks requiring focused sequential reasoning are best performed:

A) In the evening, when inhibitory control is reduced and associative thinking is more accessible B) During an individual's chronotype peak alertness window C) Early in the morning, when the brain is freshest from overnight consolidation D) Immediately after a caffeine dose, regardless of chronotype

Question 14 Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the first-line treatment for chronic insomnia because:

A) It is faster and more effective than sleep medication for acute insomnia B) Sleep medication is contraindicated for the majority of insomnia patients C) It produces better long-term outcomes than sleep medication without the side effects, dependency risk, or rebound insomnia D) It is more accessible and less expensive than pharmaceutical treatment in most healthcare systems

Question 15 "Sleep restriction therapy" — a core component of CBT-I — involves:

A) Restricting stimulating activities in the hours before bed B) Temporarily reducing total time in bed to consolidate sleep and build sleep pressure, then gradually expanding time in bed as sleep efficiency improves C) Restricting caffeine and alcohol consumption to improve sleep quality D) Limiting sleep to one consolidated nocturnal period by eliminating napping

Question 16 Loehr and Schwartz's energy management framework proposes that sustainable high performance depends primarily on:

A) Maximizing total work hours through efficient scheduling B) Sustained high energy expenditure across long work periods C) The ability to fully engage and then fully disengage — spending energy and then recovering it — across all timescales D) Eliminating recovery periods to maximize productive output during work hours

Question 17 Research by Sonnentag and colleagues on work recovery identifies "psychological detachment" as:

A) The most frequently practiced recovery activity among high performers B) The recovery dimension most consistently associated with reduced fatigue and improved wellbeing C) A clinical technique requiring professional guidance to implement effectively D) The least effective recovery strategy because it requires active suppression of work-related thoughts

Question 18 Sonnentag's research suggests that which of the following types of non-work activity most effectively restores depleted cognitive resources?

A) Passive leisure — watching television, relaxing without demands B) Social activity — spending time with friends and family C) Challenging mastery activities — non-work pursuits requiring genuine skill and effort D) Sleep — the only true cognitive restoration activity

Question 19 Research on sleep and declarative memory consolidation has found that:

A) Sleep within 24 hours of learning is not necessary if review occurs the following week B) The hippocampus replays newly encoded memories during slow-wave sleep, facilitating transfer to long-term cortical storage C) Declarative memory consolidation primarily occurs during REM sleep, not slow-wave sleep D) Sleep improves retention of motor skills but has no measurable effect on declarative memory

Question 20 The "sleeping on a problem" phenomenon has a proposed neurobiological basis in:

A) The hippocampal replay of problem-relevant memories during slow-wave sleep, enabling integration with pre-existing knowledge B) The reduction of metabolic waste (including stress hormones) during sleep, which reduces emotional interference with problem-solving C) The reactivation of problem-relevant memories during REM sleep in a context of reduced associative constraint, facilitating novel connections D) All of the above mechanisms may contribute, and they are not mutually exclusive

Question 21 Which of the following describes a practical consequence of cutting sleep from eight hours to six hours over an extended period?

A) A proportional reduction in performance, with the sleeper losing approximately one-quarter of their cognitive capacity B) A disproportionate loss of REM sleep — the late-night stage — affecting emotional regulation, creativity, and skill consolidation more severely than other functions C) A primarily physical effect, with cognitive performance largely preserved by adaptation D) Negligible effects in people who "don't need much sleep"

Question 22 The chapter notes that obstructive sleep apnea is "dramatically underdiagnosed." Which combination of symptoms should prompt evaluation?

A) Insomnia, early morning awakening, and difficulty concentrating B) Loud snoring, gasping or breathing pauses observed by others, waking unrefreshed despite adequate hours, and excessive daytime sleepiness C) Restless legs, frequent urination, and light sensitivity in the morning D) Difficulty falling asleep, temperature sensitivity, and vivid dreams

Question 23 Research on vacation recovery found that:

A) The quality of recovery during a vacation matters more than the vacation's length B) Vacations produce sustained wellbeing improvements that persist for at least one month after return C) The primary predictor of post-vacation wellbeing is the total number of recovery days D) Longer vacations produce substantially more lasting recovery than shorter ones

Question 24 A warm bath or shower before bed improves sleep primarily by:

A) Relaxing muscles and reducing physical tension that would otherwise delay sleep B) Cleansing the skin of irritants that disrupt sleep C) Drawing blood to the skin surface and accelerating post-bath core body temperature reduction, which facilitates sleep onset D) Triggering melatonin release through exposure to warm water

Question 25 The four dimensions of recovery identified by Sonnentag's research are:

A) Physical, mental, social, and nutritional recovery B) Psychological detachment, relaxation, mastery, and control C) Sleep, exercise, nutrition, and social connection D) Downtime, recreation, social engagement, and reflective practice

Answer Key

Short-Answer Extensions

Question 26 Explain why cutting sleep from eight hours to six hours removes more than one-quarter of the night's restorative value, using the sleep architecture concepts from the chapter.

Model answer: Sleep stages are not uniformly distributed across the night. Slow-wave sleep (NREM Stage 3) predominates in the first half; REM sleep predominates in the second half. Cutting two hours from the end of an eight-hour sleep window (sleeping six hours instead of eight) disproportionately removes REM sleep — the second-half dominant stage associated with emotional processing, procedural skill consolidation, creative integration, and emotional regulation. The reduction is therefore not linear: losing two of eight hours removes a much larger fraction of the emotionally and cognitively critical REM sleep than a simple 25% calculation would suggest. This explains why people who sleep six hours may notice physical functioning (supported by first-half slow-wave sleep) relatively preserved while experiencing elevated emotional reactivity, reduced creativity, and impaired social perception — functions primarily supported by the REM-rich later hours.

Question 27 Describe the proposed mechanism by which REM sleep facilitates emotional regulation, and explain its clinical implications.

Model answer: Walker's proposed mechanism: REM sleep reactivates emotional memories in a neurochemical environment depleted of norepinephrine (a stress-related neuromodulator). This allows the emotional content of experiences to be processed and integrated without the full physiological stress response that accompanied the original event — producing what Walker calls the "overnight therapy" effect. The emotional sharp edges of distressing memories are attenuated; the informational content is retained. Clinically, this mechanism implies several important relationships: sleep deprivation impairs emotional regulation not just by reducing cognitive resources but by preventing the specific overnight processing that damps emotional reactivity to previous experience; sleep disruption after trauma may worsen long-term outcomes by preventing the natural attenuation of traumatic emotional memories; and many psychological conditions (anxiety, depression, PTSD) involve and are maintained by sleep disruption, making sleep treatment a clinically significant component of psychological intervention, not just a secondary target.

Question 28 Explain the concept of "social jetlag" and its health consequences, distinguishing it from ordinary jetlag and from insomnia.

Model answer: Social jetlag is the discrepancy between a person's biological circadian timing (when they would naturally sleep and wake given no social constraints) and the socially imposed sleep-wake schedule of work, school, and social obligations. It is distinct from ordinary (travel) jetlag in that it is chronic rather than temporary, and produces repeated weekly cycles of misalignment (sleeping later on weekends, waking earlier on weekdays). It is distinct from insomnia in that it is not a problem of sleep initiation or maintenance — the person can sleep, just not at the time their biology prefers. Social jetlag is associated with increased rates of obesity, metabolic syndrome, cardiovascular disease, depression, and cognitive impairment, independently of total sleep duration. The mechanism involves chronic circadian misalignment impairing the coordination of biological processes that depend on timing — hormonal cycles, metabolic regulation, immune function — rather than simply reducing sleep hours. Interventions include chronotype-informed scheduling (giving evening types later start times), gradual circadian shifting with morning light exposure, and organizational changes to school and work start times.