Clinical QuickieBehavioral Health
Insomnia
Treat the cause before the sedative.
Define the sleep problem
Sleep-onset, maintenance, early awakening, schedule, naps, substances, pain, nocturia, mood, medications, and circadian factors point toward different causes.
CBT-I is first-line for chronic insomnia
Stimulus control, sleep compression/restriction, and cognitive strategies outperform generic 'sleep hygiene' alone.
Screen for other sleep disorders
Snoring, witnessed apneas, daytime sleepiness, restless legs, and unusual nocturnal behaviors should redirect evaluation.
Medication risk matters
Benzodiazepines, anticholinergics, Z-drugs, sedating antidepressants, and other agents can worsen falls, cognition, respiratory risk, or dependence.
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