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Insomnia in older adult — ABFM Board MCQ

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HardGeriatricsInsomnia in older adultABFM Board

A 68-year-old man has insomnia and asks for a sleeping pill. He has mild cognitive impairment, a fall last month, and takes oxybutynin. He drinks one glass of wine nightly. Which of the following would you advise this patient?

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

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Correct answer: A — Use cognitive behavioral therapy for insomnia and reduce fall-risk medications

CBT-I is first-line for chronic insomnia. Sedative-hypnotics, benzodiazepines, antipsychotics, and anticholinergics increase fall and cognitive risks in older adults and should be avoided when possible.

Reference: AASM Insomnia Guideline; AGS Beers Criteria