A 45-year-old female patient repos that over the last 3 months she has lost her appetite and interest in her usual activities, and often feels that life is not woh living. Compared with typical sleep, in this patient the percentage of REM sleep, percentage of delta sleep, and REM latency, respectively, are most likely to

**Core Concept**
Major Depressive Disorder (MDD) is characterized by a persistent and profound disturbance in mood, often accompanied by changes in sleep patterns, appetite, and interest in activities. The sleep disturbances in MDD are thought to be related to alterations in the normal sleep-wake cycle, also known as the circadian rhythm.

**Why the Correct Answer is Right**
In patients with MDD, the percentage of REM sleep is typically increased, reflecting an earlier transition from non-rapid eye movement (NREM) sleep to REM sleep. This is often accompanied by a decrease in the percentage of delta sleep (slow-wave sleep), which is essential for physical restoration and memory consolidation. Additionally, REM latency, the time it takes to enter REM sleep, is often shortened in patients with MDD. These changes in sleep architecture are thought to be related to the hyperarousal and increased stress response that is characteristic of MDD.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately reflect the changes in sleep architecture that are typically seen in patients with MDD.
**Option C:** This option is incorrect because it suggests that the percentage of delta sleep is increased in MDD, which is not the case.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that sleep disturbances are a common feature of MDD, and changes in sleep architecture can be used as a diagnostic clue. Additionally, sleep disturbances can also be a side effect of many antidepressant medications, particularly those that affect serotonin and norepinephrine.

**Correct Answer: B. Increased percentage of REM sleep, decreased percentage of delta sleep, and shortened REM latency.**

✓ Correct Answer: A. increase, decrease, decrease