An otherwise healthy 76-year-old woman presents with 3 months of difficulty initiating sleep following the death of her spouse. She naps in the day an...

Question

An otherwise healthy 76-year-old woman presents with 3 months of difficulty initiating sleep following the death of her spouse. She naps in the day and drinks two cups of coffee in the evening. She requests a benzodiazepine to help her sleep. According to Choosing Wisely Canada, what is the most appropriate management?

Accepted Answer

Recommend sleep hygiene, reduce caffeine and consider referral for cognitive behavioural therapy for insomnia

Answer

Prescribe lorazepam 1 mg at bedtime as needed for up to 3 months

Answer

Prescribe zopiclone 7.5 mg at bedtime as a safer alternative

Answer

Prescribe clonazepam 0.5 mg at bedtime because of its long half-life

Answer

Order polysomnography before making any recommendations

ca-mccqe1 MCQ (SBA): Insomnia in older adults