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Quiz: Sleep, Exercise, and Therapy

Test your understanding of Chapter 18. Choose the best answer, then click Show Answer to check.

Question 1

How much sleep does the American Academy of Sleep Medicine recommend for teenagers aged 13 to 18?

  1. 6 to 7 hours per night
  2. 8 to 10 hours per 24 hours
  3. 7 or more hours per night, the same as adults
  4. 11 to 13 hours per 24 hours
Show Answer

The correct answer is B. The 2016 AASM consensus recommends 8 to 10 hours per 24 hours for teens 13 to 18. Option C is the adult recommendation; teens need more.

Concept Tested: Teen Sleep Need Bloom's Level: Remember

Question 2

Which part of the brain acts as the body's master clock, receiving light information directly from the eyes?

  1. The pineal gland
  2. The brainstem's vagus nerve nucleus
  3. The enteric nervous system
  4. The suprachiasmatic nucleus of the hypothalamus
Show Answer

The correct answer is D. The suprachiasmatic nucleus (SCN) receives light signals from the eyes and sets the body's circadian rhythm. The pineal gland (A) makes melatonin, but it takes its timing signals from the SCN.

Concept Tested: Circadian Rhythm Bloom's Level: Remember

Question 3

What is heart rate variability (HRV)?

  1. The natural variation in the time between one heartbeat and the next
  2. How fast your heart beats during hard exercise
  3. The difference between your resting heart rate and your maximum heart rate
  4. An irregular heartbeat that always signals heart disease
Show Answer

The correct answer is A. HRV is the beat-to-beat variation in timing, and part of it reflects the vagus nerve's braking effect on the heart. Option D confuses normal, healthy variation with an abnormal heart rhythm.

Concept Tested: Heart Rate Variability Bloom's Level: Remember

Question 4

Why can't most teens solve short sleep simply by going to bed at 9:30 p.m.?

  1. Teens need less sleep than younger children, so they aren't tired
  2. Melatonin stops being made during adolescence
  3. Around puberty, sleep timing shifts later by up to about 2 hours, partly because melatonin is released later
  4. The suprachiasmatic nucleus stops responding to light in teenagers
Show Answer

The correct answer is C. The AAP describes a puberty-related shift in sleep timing of up to 2 hours, with later nighttime melatonin release. Option A is wrong because teens actually need 8 to 10 hours, more than adults.

Concept Tested: Circadian Rhythm Bloom's Level: Understand

Question 5

In the 2013 study of people with inflammatory bowel disease, people with Crohn's disease in remission who slept poorly had about twice the odds of active disease six months later. Which conclusion fits this evidence best?

  1. Poor sleep has been proven to cause Crohn's flares.
  2. Poor sleep is linked to later flares, but the study can't show whether sleep causes them.
  3. Sleep has no connection to Crohn's disease, since the link was not found in ulcerative colitis.
  4. Good sleep cures Crohn's disease.
Show Answer

The correct answer is B. It was an observational study, so it shows an association. Early inflammation, pain, or stress could disturb sleep and also lead to flares. Option A overstates the evidence by turning a link into proof of cause.

Concept Tested: Sleep and Inflammation Bloom's Level: Understand

Question 6

Which statement best describes how brain-gut psychotherapy helps IBS?

  1. It works on the brain's side of the two-way gut-brain loop, changing how gut signals are processed and how stress affects the gut.
  2. It proves the pain was imaginary by making it disappear.
  3. It replaces all medical care for IBS.
  4. It works by changing the gut microbiome directly.
Show Answer

The correct answer is A. Therapies like gut-focused CBT and gut-directed hypnotherapy target the brain end of the gut-brain axis; the pain is real. Option B reflects the common myth that therapy means symptoms are "all in your head."

Concept Tested: Brain-Gut Psychotherapy Bloom's Level: Understand

Question 7

Sam, who has IBS, plans a 3-hour hard training run on a hot afternoon. Based on the 2017 review of exercise-induced gastrointestinal syndrome, what is most likely?

  1. The long, hard run will settle his gut, since exercise always helps IBS.
  2. Exercise has no effect on the gut, so nothing will change.
  3. His gut symptoms will be cured for the week.
  4. Gut disturbances such as slowed transit and symptoms become more likely, especially with heat and running.
Show Answer

The correct answer is D. The review found that exercise of about two hours or more at moderate-to-high effort can disturb the gut, and heat and running made it worse. Option A ignores that intensity and duration matter: moderate activity helped IBS in a trial, but extreme effort is different.

Concept Tested: Exercise and Gut Transit Bloom's Level: Apply

Question 8

Maya's one-week diary shows that her worst stomachache days followed her shortest nights, and that her stress ratings were also highest on those days. What is the best next step for interpreting her data?

  1. Conclude that short sleep causes her stomachaches.
  2. Delete the stress ratings because they make the pattern confusing.
  3. Keep tracking longer, try changing one thing at a time, and treat stress as a possible confounder to discuss with her care team.
  4. Conclude that her stomachaches are caused only by stress.
Show Answer

The correct answer is C. One week is a small sample, and stress could drive both poor sleep and symptoms. Longer tracking and one-change-at-a-time testing get closer to an answer. Options A and D both jump from a correlation to a single cause.

Concept Tested: Self-Monitoring Bloom's Level: Apply

Question 9

In the IBSOS trial, 61.0% of the minimal-contact CBT group and 43.5% of the education group rated their IBS as moderately or substantially improved two weeks after treatment. What does the education group's result tell you?

  1. Education is useless for IBS.
  2. Many people improve with attention, information, and time, so a comparison group is needed to see what CBT adds.
  3. CBT works for everyone with IBS.
  4. The trial was not randomized.
Show Answer

The correct answer is B. Over 40% improved with education alone, which shows why randomized comparison groups matter: CBT's real added benefit is the difference between groups. Option C is wrong because about 4 in 10 people in the CBT group did not report much improvement.

Concept Tested: Brain-Gut Psychotherapy Bloom's Level: Analyze

Question 10

A post says: "Exercise rebuilds your microbiome, and that's why it fixes depression." Which analysis matches this chapter's evidence?

  1. The mood benefit of exercise is strongly supported, but the claim that it works through microbe changes is not supported by human evidence.
  2. Both parts are strongly supported by large human trials.
  3. Neither part has any evidence at all.
  4. The microbe part is strong, but exercise has no effect on mood.
Show Answer

The correct answer is A. A large umbrella review supports exercise for depression and anxiety symptoms, but the key microbiome study had 32 adults, small changes that reversed, and no mood measurements. Option B treats a plausible mechanism as if it were proven.

Concept Tested: Exercise and Mood Bloom's Level: Analyze