Initial, middle, and terminal insomnia

  1. Discuss the differences in initial, middle, and terminal insomnia. How would you best choose pharmacologic treatment for each one ofthese based on the half-lives of each hypnotic? 2. KL is a 79 yo 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 £10 mg hs, and doxazosin a mg hs. He admits to drinking 2 alcoholic drinks/night and denies smoking. Identify any secondary causes for insomnia. What treatment plan do you recommend for KL's insomnia? Identify any secondary causes for insomnia. What treatment plan do you recommend for KL's insomnia?