What treatment plan do you recommend for KL’s insomnia?

Posted: June 8th, 2022

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KL is a 79 year man requesting assistance for “something to help with sleep”. His past medical history is significant for coronary artery disease and s/p CABG, hyperlipidemia, hypertension, major depressive disorder, and benign prostatic hypertrophy. He is taking the following medications: Aspirin 81 mg daily, Lisinopril 20 mg daily, Metoprolol succinate 100 mg daily, Simvastatin 20 mg daily, fluoxetine 40 mg hs, and doxazosin 4 mg hs. He admits to drinking 2 alcoholic drinks/night and denies smoking. Include in your discussion:
The differences in initial, middle, and terminal insomnia and how would you best choose pharmacologic treatment for each one of these based on the half-lives of each hypnotic?
Identify any secondary causes for insomnia.
What treatment plan do you recommend for KL’s insomnia? (Be specific with your recommendations-which hypnotic and why)
APA format, scholarly written, articles within the last 5 years.

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