A 69-year-old has chronic difficulty initiating sleep, takes several medications and has fallen twice in the past year. Alcohol, restless legs and

Question

A 69-year-old has chronic difficulty initiating sleep, takes several medications and has fallen twice in the past year. Alcohol, restless legs and untreated sleep apnea are not contributing. Which initial treatment is preferred?

Accepted Answer

Provide cognitive behavioral therapy for insomnia

Answer

Begin long-term benzodiazepine therapy with the falls

Answer

Recommend alcohol at bedtime as a behavioral intervention

Answer

Use low-dose quetiapine as routine first-line sleep therapy

Answer

Use diphenhydramine every night because it is available in the absence of prescription

Insomnia — ABIM Board MCQ

A 69-year-old has chronic difficulty initiating sleep, takes several medications and has fallen twice in the past year. Alcohol, restless legs and untreated sleep apnea are not contributing. Which initial treatment is preferred?