What is the most effective treatment for insomnia in the elderly?
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Cognitive behavioral therapy (CBT) improves certain sleep parameters and should be considered first-line therapy for elderly patients. (SOR: A, based on a systematic review.) Pharmacologic therapy should aim to match the patient's symptoms with the properties of the drug, with preference given to short- to intermediateacting benzodiazepine receptor agonists or ramelteon. (SOR: C, based on expert opinion.) Over-the-counter and prescription antihistamines are generally inappropriate for use in the elderly due to adverse effects. (SOR: C, based on expert opinion.)
Evidence Based Practice 14(2): 09-10.