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March 26, 1997

A 96-Year-Old Woman With Insomnia

Author Affiliations


JAMA. 1997;277(12):990-996. doi:10.1001/jama.1997.03540360058032

Dr Delbanco:  Mrs G is a 96-year-old widow who has had trouble sleeping for the past 30 years. She has lived in a long-term care facility for the past 3 years, where she was admitted due to increasing physical disability and falls. She has 1 son with chronic depression with whom she has minimal contact. Her insurance is through Medicare and a supplemental commercial insurance program.Mrs G began to have difficulty falling asleep at the age of 65 years. At that time, and over the next 30 years, she took acetaminophen each evening, which she claims helped her go to sleep. When she developed sciatica 3 years ago, she had more trouble with sleeping and began taking oxazepam irregularly. She started to take it regularly 1 year ago when, in addition to her physical discomfort, she was disturbed by her cognitively impaired roommate in the nursing home.Mrs G