14- High Cortisol Wakes You Up at 3AM (Do This to Fall Back Asleep)

Source: https://www.youtube.com/watch?v=MFh-JOXoM4c

What is the biggest mistake people make when they wake up in the middle of the night?

A. Drinking water immediately
B. Forcing themselves to sleep
C. Opening the window
D. Sleeping on the couch

Answer: B. Forcing themselves to sleep

Explanation: The speaker explains that trying to force sleep increases stress and arousal, making it harder to fall asleep again.

According to the information, what are the two major systems involved in sleep and wakefulness?

A. Digestive system and immune system
B. Memory system and motor system
C. Sleep system and arousal system
D. Respiratory system and muscular system

Answer: C. Sleep system and arousal system

Explanation: The text explains that sleep is controlled by the sleep system (circadian rhythm and sleep drive) and the arousal system.

What is the circadian rhythm?

A. A breathing exercise
B. The body’s internal clock
C. A type of medication
D. A stage of dreaming

Answer: B. The body’s internal clock

Explanation: Circadian rhythm is described as the body’s internal clock that regulates the sleep-wake schedule.

What happens when the arousal system stays active at night?

A. Sleep becomes deeper
B. The body enters REM sleep immediately
C. It overrides the sleep drive
D. The muscles become stronger

Answer: C. It overrides the sleep drive

Explanation: The speaker explains that an active arousal system can keep a person awake even when tired.

Why should people avoid looking at the clock during the night?

A. The clock produces loud sounds
B. It can increase stress and anxiety
C. Clocks reduce melatonin directly
D. Clocks cause nightmares

Answer: B. It can increase stress and anxiety

Explanation: Looking at the clock may trigger mental calculations about remaining sleep time, increasing stress.

Why is looking at the phone discouraged during nighttime awakenings?

A. Phones make the room colder
B. Phones increase hunger
C. Screen light and content stimulate the brain
D. Phones slow down breathing

Answer: C. Screen light and content stimulate the brain

Explanation: The text explains that screen light may signal daytime to the brain and the content may keep the mind active.

Which nervous system is associated with “fight or flight”?

A. Parasympathetic nervous system
B. Digestive nervous system
C. Sympathetic nervous system
D. Sensory nervous system

Answer: C. Sympathetic nervous system

Explanation: The speaker explains that the sympathetic nervous system is connected to fight-or-flight responses.

Which nervous system is linked to “rest and digest” functions?

A. Sympathetic nervous system
B. Parasympathetic nervous system
C. Central nervous system
D. Skeletal nervous system

Answer: B. Parasympathetic nervous system

Explanation: The parasympathetic nervous system helps the body relax and prepare for rest.

What breathing technique is recommended in the information?

A. Box breathing
B. Alternate nostril breathing
C. 4-7-8 breathing
D. Rapid breathing

Answer: C. 4-7-8 breathing

Explanation: The speaker specifically recommends the 4-7-8 breathing technique to reduce arousal.

During the 4-7-8 breathing technique, how long should the inhale last?

A. 2 seconds
B. 4 seconds
C. 7 seconds
D. 8 seconds

Answer: B. 4 seconds

Explanation: The breathing pattern includes inhaling for 4 seconds, holding for 7, and exhaling for 8.

What is stimulated when breathing deeply into the belly?

A. Optic nerve
B. Spinal cord
C. Vagus nerve
D. Facial nerve

Answer: C. Vagus nerve

Explanation: Deep diaphragmatic breathing helps stimulate the vagus nerve, promoting relaxation.

What can activation of the vagus nerve help reduce?

A. Muscle growth
B. Stress hormones
C. Bone density
D. Blood sugar immediately

Answer: B. Stress hormones

Explanation: The speaker mentions that activation of the vagus nerve may reduce stress hormones like cortisol and adrenaline.

What does PMR stand for?

A. Passive Memory Recall
B. Progressive Muscle Relaxation
C. Physical Movement Recovery
D. Parasympathetic Muscle Response

Answer: B. Progressive Muscle Relaxation

Explanation: PMR is the relaxation technique involving tensing and relaxing muscle groups.

Which body part does the PMR exercise begin with?

A. Neck
B. Hands
C. Feet
D. Shoulders

Answer: C. Feet

Explanation: The instructions say to start at the feet and move upward through the body.

What is the purpose of Progressive Muscle Relaxation?

A. To increase muscle strength
B. To improve eyesight
C. To reduce physical tension and promote relaxation
D. To improve appetite

Answer: C. To reduce physical tension and promote relaxation

Explanation: PMR helps identify and release hidden muscle tension, helping the body relax.

What term describes the dreamlike visuals that occur as a person falls asleep?

A. Lucid dreaming
B. Hypnogogic imagery
C. Sleep paralysis
D. Night terror

Answer: B. Hypnogogic imagery

Explanation: The text explains that hypnogogic imagery refers to brief dreamlike mental images during the transition to sleep.

What technique is used to quiet the mind with neutral imagery?

A. Sleep restriction
B. Cognitive shuffling
C. Exposure therapy
D. Guided hypnosis

Answer: B. Cognitive shuffling

Explanation: Cognitive shuffling involves visualizing neutral words and images to gently occupy the mind.

In cognitive shuffling, what should a person do after choosing a word like “blanket”?

A. Repeat the word continuously
B. Count backward from 100
C. Think of words beginning with each letter
D. Spell the word aloud repeatedly

Answer: C. Think of words beginning with each letter

Explanation: The method involves visualizing words connected to each letter of the chosen word.

What is the goal of the sleep techniques described?

A. To force sleep immediately
B. To stay awake calmly
C. To create conditions that allow natural sleep
D. To memorize numbers better

Answer: C. To create conditions that allow natural sleep

Explanation: The speaker repeatedly emphasizes that the goal is not to force sleep, but to let it happen naturally.

What does CBT-I stand for?

A. Cognitive Behavioral Therapy for Insomnia
B. Clinical Behavioral Treatment for Insomnia
C. Cognitive Brain Training Intervention
D. Controlled Bedtime Therapy Instruction

Answer: A. Cognitive Behavioral Therapy for Insomnia

Explanation: CBT-I is identified as Cognitive Behavioral Therapy for Insomnia, a major treatment for chronic insomnia.

According to the information, CBT-I is considered:

A. An outdated treatment
B. The gold standard treatment for insomnia
C. A treatment only for children
D. A medication-based therapy

Answer: B. The gold standard treatment for insomnia

Explanation: The speaker describes CBT-I as the gold standard treatment for most people with insomnia.

What percentage of people with chronic insomnia reportedly improve with CBT-I?

A. About 20%
B. About 40%
C. Over 70%
D. Nearly 100%

Answer: C. Over 70%

Explanation: The text states that over 70% of people with chronic insomnia experience significant improvement after CBT-I.

Which statement is a clarification rather than a fully accurate scientific fact?

A. Circadian rhythm affects sleep timing
B. PMR can help relaxation
C. The body is “checking if you are safe” during awakenings
D. Bright phone light can increase alertness

Answer: C. The body is “checking if you are safe” during awakenings

Explanation: This statement is more metaphorical and motivational than a precise scientific mechanism.

Which clarification about nighttime awakenings is important?

A. They always indicate a serious disorder
B. They only happen in older adults
C. They can occur naturally during sleep cycles
D. They are caused only by stress hormones

Answer: C. They can occur naturally during sleep cycles

Explanation: Brief awakenings during the night are normal and can occur during transitions between sleep cycles.

Which clarification about staying in bed is accurate?

A. People should always stay in bed no matter how long they are awake
B. CBT-I may recommend leaving bed after prolonged wakefulness
C. Getting out of bed always worsens insomnia
D. Sleeping on the floor is recommended

Answer: B. CBT-I may recommend leaving bed after prolonged wakefulness

Explanation: CBT-I often suggests getting out of bed after about 15–20 minutes of wakefulness to avoid associating the bed with being awake.

What happens to sleep pressure the longer a person stays awake?

A. It disappears completely
B. It decreases rapidly
C. It builds up gradually
D. It turns into REM sleep

Answer: C. It builds up gradually

Explanation: Sleep pressure increases the longer a person remains awake, helping promote sleep later.

What is one function of the arousal system during the day?

A. Causing dreams
B. Keeping people alert and responsive
C. Slowing breathing permanently
D. Preventing muscle movement

Answer: B. Keeping people alert and responsive

Explanation: The arousal system helps maintain alertness and responsiveness during waking hours.

What can happen when a person tries too hard to force sleep?

A. Stress hormones may increase
B. Sleep becomes instantly deeper
C. The circadian rhythm stops
D. The muscles become numb

Answer: A. Stress hormones may increase

Explanation: Forcing sleep can increase stress and arousal, making sleep more difficult.

Which analogy was used to describe forcing sleep?

A. Running in circles
B. Driving without brakes
C. Pressing the gas pedal while trying to park
D. Climbing a mountain in the dark

Answer: C. Pressing the gas pedal while trying to park

Explanation: The speaker compares forcing sleep to pressing the gas pedal while trying to park, meaning the effort works against relaxation.

How many times is the 4-7-8 breathing cycle recommended to be repeated?

A. 1–2 times
B. 3–4 times
C. 7–10 times
D. 20–30 times

Answer: C. 7–10 times

Explanation: The technique recommends repeating the breathing cycle several times to promote relaxation.

What may a person notice after a few rounds of 4-7-8 breathing?

A. Increased hunger
B. Warmth or heaviness in the body
C. Muscle cramps
D. Sharp pain in the chest

Answer: B. Warmth or heaviness in the body

Explanation: These sensations are described as signs that the body is relaxing.

During PMR, what should a person notice after releasing muscle tension?

A. The contrast between tension and relaxation
B. Their heart stopping briefly
C. Complete muscle weakness
D. Faster thinking

Answer: A. The contrast between tension and relaxation

Explanation: PMR encourages awareness of how relaxation feels compared to tension.

Which sequence correctly follows the PMR muscle order described?

A. Face → shoulders → arms → feet
B. Feet → calves → thighs → stomach → hands → arms → shoulders → face
C. Hands → feet → shoulders → stomach
D. Stomach → face → calves → thighs

Answer: B. Feet → calves → thighs → stomach → hands → arms → shoulders → face

Explanation: The speaker describes gradually moving upward through the body.

Approximately how long does the PMR exercise usually take?

A. 30 seconds
B. 1 minute
C. 3–5 minutes
D. 20 minutes

Answer: C. 3–5 minutes

Explanation: The speaker states that the full PMR process generally takes about 3–5 minutes.

According to the information, what kind of mind is considered a wakeful mind?

A. A creative mind
B. A busy structured mind
C. A relaxed mind
D. A sleepy mind

Answer: B. A busy structured mind

Explanation: Logical and highly structured thinking is associated with wakefulness.

As people begin falling asleep, their thoughts usually become:

A. Faster and more mathematical
B. Completely absent
C. Less logical and more image-based
D. More focused on problem-solving

Answer: C. Less logical and more image-based

Explanation: Sleep onset is associated with more dreamlike and image-based thinking.

What type of word is recommended for cognitive shuffling?

A. Emotional words
B. Long scientific words
C. Neutral simple words
D. Difficult vocabulary words

Answer: C. Neutral simple words

Explanation: Neutral words help occupy the mind without increasing emotional stimulation.

What should a person do if they finish one word during cognitive shuffling and are still awake?

A. Stop the exercise immediately
B. Open their phone
C. Choose another word and continue
D. Turn on bright lights

Answer: C. Choose another word and continue

Explanation: The exercise can continue with another neutral word if sleep has not occurred yet.

According to the information, waking up during the night:

A. Always means something is seriously wrong
B. Means sleep is permanently damaged
C. Does not automatically mean sleep is broken
D. Only happens in insomnia

Answer: C. Does not automatically mean sleep is broken

Explanation: Brief awakenings can occur naturally and do not necessarily indicate a disorder.

Preparing the mind and body before bedtime may help:

A. Eliminate all dreams
B. Reduce nighttime arousal later
C. Prevent all awakenings forever
D. Increase stress hormones

Answer: B. Reduce nighttime arousal later

Explanation: Relaxation before bedtime may decrease the chance of nighttime hyperarousal.

Which clarification about nighttime awakenings is accurate?

A. Hyperarousal is the only possible cause
B. Night awakenings always indicate severe illness
C. Night awakenings can have multiple causes
D. They occur only because of phone use

Answer: C. Night awakenings can have multiple causes

Explanation: Nighttime awakenings may occur because of stress, normal sleep cycles, sleep disorders, noise, temperature, and many other factors.