skip to main content

OSA – DVLA Driving Advice — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardSleep DisordersOSA – DVLA Driving AdviceSCE Neurology

A 29-year-old nurse cannot fall asleep before 3 am and struggles to wake for 7 am shifts. On free days she sleeps from 3 am to 11 am and feels refreshed. A two-week diary confirms a stable delayed sleep schedule without depression, substance use or another sleep disorder. What is the most appropriate initial treatment plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Use timed low-dose melatonin before the desired bedtime with morning light exposure and a fixed wake time

The pattern is delayed sleep-wake phase disorder: sleep quality and duration are preserved at the patient’s biologically preferred later schedule. Timed melatonin before the target bedtime, morning light and a consistent wake time advance the circadian phase; sedatives and stimulants do not correct the underlying timing disorder.

Reference: British Association for Psychopharmacology consensus statement on sleep disorders (2019): https://madeinheene.hee.nhs.uk/Portals/19/BAP_Guidelines-Sleep%202019.pdf