Section C — Coach Sleep — Sleep Science
This section covers the Associates chapter on Sleep Science, Lessons 1 through 5: Sleep Architecture and Neural Mechanisms, Memory Consolidation and Sleep, Circadian Biology and Chronobiology, Sleep Disorders and Sleep Health, and Sleep and the Other Coaches. All material is already in the chapter — no new content.
Part A — Vocabulary (20 points, 2 points each)
Select the single best answer for each question.
1. N3 sleep (slow-wave sleep) is characterized by:
A) Rapid eye movements and dreaming B) Predominantly slow, high-amplitude EEG delta waves (0.5-4 Hz), reduced muscle tone, and substantial parasympathetic dominance; the principal stage for physical restoration and glymphatic clearance C) Light fluttering arousal D) Wakefulness with eyes closed
2. REM sleep is characterized by:
A) Slow EEG and low arousal B) Rapid eye movements, mixed-frequency EEG resembling wakefulness, near-complete skeletal muscle atonia, and the bulk of vivid dreaming C) High muscle tone with no eye movement D) Sustained slow-wave activity
3. The suprachiasmatic nucleus (SCN) is:
A) A spinal-cord structure B) The master circadian pacemaker located in the anterior hypothalamus, just above the optic chiasm, with approximately 20,000 neurons coordinating peripheral clocks throughout the body C) An obsolete neuroanatomical concept D) A region of the brainstem
4. Adenosine in sleep biology refers to:
A) A nucleotide that accumulates during waking and signals sleep pressure (Process S), with caffeine acting as a competitive antagonist at adenosine receptors B) An ion involved in muscle contraction C) A peptide hormone D) A monoamine neurotransmitter
5. Hypocretin/orexin deficiency is the principal mechanism of:
A) Insomnia B) Narcolepsy with cataplexy (type 1 narcolepsy) — autoimmune destruction of hypothalamic orexin neurons producing daytime sleepiness, fragmented sleep, and sudden muscle-tone loss C) Sleep apnea D) Restless legs syndrome
6. Sharp-wave ripples in the hippocampus are:
A) Pathological seizure activity B) Brief, high-frequency oscillations during N3 sleep and quiet wakefulness associated with memory replay and consolidation — the neural correlate of offline memory transfer to cortical networks C) Visual phenomena during dreaming D) Brainstem signals controlling muscle atonia
7. Two-process model (Borbély) describes:
A) Sleep regulation as a single pressure B) Sleep timing as the interaction of Process S (homeostatic sleep pressure, adenosine-mediated) and Process C (circadian alerting signal from the SCN); their interplay determines when sleep occurs C) Sleep stages alternating REM and non-REM D) The transition from N1 to N2
8. Obstructive sleep apnea (OSA) is:
A) A psychological inability to sleep B) Repeated episodes of upper airway obstruction during sleep producing oxygen desaturation, fragmented sleep, and cardiovascular and metabolic consequences — substantially underdiagnosed in the US adult population C) The same as snoring D) A pediatric-only condition
9. Social jet lag (Roenneberg) is:
A) The same as travel jet lag B) Chronic mismatch between an individual's biological chronotype and their imposed social schedule (school, work), producing measurable health consequences including elevated cardiometabolic risk C) Jet lag from social travel D) Insomnia from social anxiety
10. CBT-I refers to:
A) Cognitive-behavioral therapy for insomnia: the first-line evidence-based treatment for chronic insomnia, with stimulus control, sleep restriction, cognitive restructuring, and sleep hygiene as core components B) Cognitive behavioral training in infants C) A pharmacological treatment D) An obsolete therapy
Part B — Concept Comprehension (20 points, 2 points each)
Select the single best answer for each question.
11. The Berson 2002 Science paper was foundational because it demonstrated:
A) That rods and cones are the only retinal photoreceptors B) That intrinsically photosensitive retinal ganglion cells (ipRGCs) expressing melanopsin transduce light directly, providing the non-image-forming pathway to the SCN — explaining how light entrains the circadian system independently of rod/cone vision C) That the SCN is in the brainstem D) That sleep is unrelated to light
12. The Walker and Stickgold framework on sleep and memory describes:
A) Memory as unrelated to sleep B) Sleep as actively supporting memory consolidation — with declarative memory consolidated principally during N3 (slow-wave) sleep and procedural/emotional memory consolidated principally during REM sleep C) Memory consolidation occurring only during waking D) Sleep impairing memory
13. The molecular clock — BMAL1/CLOCK ↔ PER/CRY — is:
A) A bacterial gene network B) The transcription-translation feedback loop producing ~24-hour rhythms in cells across virtually all tissues; positive limb (BMAL1/CLOCK) drives expression of negative limb (PER/CRY), which then inhibits the positive limb; the kinetics produce the period C) An obsolete model D) Specific to the SCN only
14. Konopka and Benzer 1971 PNAS identified:
A) The first sleep-promoting drug B) The period gene in Drosophila — the first circadian gene ever discovered, foundational for the 2017 Nobel Prize awarded to Hall, Rosbash, and Young C) The first neurotransmitter D) The structure of melatonin
15. The glymphatic system's activity during sleep:
A) Is reduced compared to waking B) Is substantially elevated during sleep — particularly N3 — with cerebrospinal fluid flow through perivascular spaces clearing metabolic byproducts including amyloid-β; one mechanism by which sleep loss affects long-term neural health C) Is uniform across the day D) Does not exist in humans
16. Cataplexy in narcolepsy type 1 is:
A) A type of seizure B) Sudden bilateral skeletal muscle weakness triggered by strong emotion (laughter, surprise), typically with preserved consciousness; the cardinal feature distinguishing type 1 narcolepsy and reflecting REM-atonia intrusion into wakefulness C) Sleep paralysis D) Daytime sleepiness only
17. Obstructive sleep apnea is associated with:
A) No cardiovascular risk B) Elevated cardiovascular event risk, hypertension, atrial fibrillation, insulin resistance, and accidents from daytime sleepiness — with continuous positive airway pressure (CPAP) as established first-line treatment when severity warrants C) Only snoring complaints D) Improvement with weight gain
18. The chapter's framing of the Cat's integrator position — consolidation — describes sleep as:
A) Passive rest B) An active temporal pass that closes the daily loops of the other modalities — memory consolidation (Brain), metabolic restoration (Food, Move), glymphatic clearance (Brain), endocrine cycle reset, immune housekeeping — without which the other modalities cannot fully resolve their work C) Equivalent to all other modalities D) The same as the synchronizer position
19. Sleep deprivation's effect on cognition includes:
A) No measurable effect B) Attentional lapses, microsleep intrusions, working memory deficits, mood disturbance, and impaired emotional regulation — with the largest effects on prefrontal-dependent functions and emotional reactivity (amygdala disinhibition documented in fMRI work) C) Improved performance after one night D) Only physical fatigue
20. The chapter's posture on sleep medications:
A) Prescriptive endorsement of any class B) Descriptive — CBT-I is first-line for chronic insomnia per AASM guidelines; benzodiazepines and Z-drugs have a role but with limits including dependency risk, fall risk in older adults, and limited duration of benefit; melatonin is descriptively useful for circadian misalignment but not as a sedative; clinical evaluation belongs with a clinician C) Recommendation against all pharmacotherapy D) Self-prescription guidance
Part C — Application (30 points, 6 points each)
Write 3-5 complete sentences for each question.
21. Describe the two-process model of sleep regulation (Borbély). How do Process S (adenosine-mediated homeostatic pressure) and Process C (circadian alerting signal) interact to determine when sleep occurs and when wakefulness is maintained?
22. Apply the sharp-wave ripples and glymphatic clearance findings to explain why sleep is not merely "rest" but active neural work. Why does the chapter argue that sleep loss imposes cognitive costs that cannot be made up through caffeine or willpower?
23. Safety recognition. A 38-year-old adult in your community reports loud snoring, witnessed breathing pauses during sleep, daytime sleepiness severe enough to nod off at red lights, and a body mass index in the obesity range. Walk through what the chapter teaches about obstructive sleep apnea recognition, why this combination warrants prompt clinical evaluation, and the consequences if it is left untreated.
24. Explain social jet lag per Roenneberg, including the chronotype-schedule mismatch concept. Apply it to a college student with a late chronotype required to start morning classes at 8 AM five days a week. What does the research suggest about the health implications and what realistic interventions are available?
25. Apply the Sleep Associates integrator position — consolidation — to explain how sleep closes the daily loops of at least three other Coach domains. Use lesson-level cross-references.
Continue to Section D — Coach Move.