A 50-year-old woman presents with difficulty initiating and maintaining sleep for the past 6 months, occurring at least four nights per week, with daytime fatigue and irritability. She has no other medical or psychiatric illness. According to current guidelines, what is the recommended first-line treatment?

• A Zolpidem 10 mg at bedtime
• B Melatonin 3 mg at bedtime
• C Trazodone 50 mg at bedtime
• D Cognitive behavioural therapy for insomnia (CBT-I) ✓

Explanation

CBT-I is the recommended first-line treatment for chronic insomnia in adults across major guidelines (AASM, APA, Indian sleep society consensus). It produces durable improvements without the risks of hypnotic medications. Pharmacotherapy is considered second-line or adjunctive when CBT-I is unavailable or insufficient.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.