Which statement best describes sleep in generalized anxiety disorder as seen on polysomnography?

Which statement best describes sleep in generalized anxiety disorder as seen on polysomnography?

• A. Increased stage 1 non-REM sleep
• B. Increased REM density
• C. Shortened sleep latency
• D. Increased slow-wave sleep

Answer: (A)

The central idea is that generalized anxiety disorder tends to produce lighter, more fragmented sleep, reflected on polysomnography as an increase in the lightest non-REM stage. When a person is highly aroused by anxiety, sleep tends to stay in Stage 1 longer and wake more easily, rather than progressing smoothly into deeper stages. This makes Stage 1 non-REM sleep more prominent on the sleep study. That’s why the statement describing an increase in Stage 1 non-REM sleep fits best. It captures the pattern of hyperarousal and poor sleep maintenance seen in GAD. The other possibilities don’t align as closely: REM density can vary and isn’t a defining feature of GAD on standard sleep studies; shortened sleep latency would imply falling asleep quickly, which is uncommon in anxiety where initiating sleep is often difficult; and increased slow-wave sleep would indicate deeper, more restorative sleep, which is not typically observed in this condition.

The central idea is that generalized anxiety disorder tends to produce lighter, more fragmented sleep, reflected on polysomnography as an increase in the lightest non-REM stage. When a person is highly aroused by anxiety, sleep tends to stay in Stage 1 longer and wake more easily, rather than progressing smoothly into deeper stages. This makes Stage 1 non-REM sleep more prominent on the sleep study.

That’s why the statement describing an increase in Stage 1 non-REM sleep fits best. It captures the pattern of hyperarousal and poor sleep maintenance seen in GAD. The other possibilities don’t align as closely: REM density can vary and isn’t a defining feature of GAD on standard sleep studies; shortened sleep latency would imply falling asleep quickly, which is uncommon in anxiety where initiating sleep is often difficult; and increased slow-wave sleep would indicate deeper, more restorative sleep, which is not typically observed in this condition.