Question

A 71-year-old woman in a long-term care facility has chronic insomnia. She asks for a "sleeping pill". She has a history of falls and mild cognitive impairment. According to Choosing Wisely Canada and geriatric recommendations, what is the most appropriate initial approach?

Accepted Answer

Recommend non-pharmacologic sleep hygiene and cognitive-behavioural strategies and avoid benzodiazepines as first-line

Answer

Start a benzodiazepine, as older adults tolerate them well

Answer

Start a zopiclone prescription for nightly use

Answer

Prescribe long-acting benzodiazepines but only on alternate nights

Answer

Combine a benzodiazepine and an antipsychotic for synergy

Practice question

A 71-year-old woman in a long-term care facility has chronic insomnia. She asks for a "sleeping pill". She has a history of falls and mild cognitive impairment. According to Choosing Wisely Canada and geriatric recommendations, what is the most appropriate initial approach?