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Assignment:
P.S., a 68-year-old retired secretary, comes to the office complaining of feeling "so tired" during the day. She has had trouble sleeping off and on for years, and a few weeks ago received a prescription for the benzodiazepine alprazolam (Xanax) to take "as needed for nerves." Upon closer questioning, the nurse discovers that P.S. has been using alprazolam almost every night for a week to help her get to sleep. She says, "I just could not fall asleep before! I am sleeping very well, but I'm so tired during the day. I don't understand how I can get such good sleep and still feel tired!"
1. Can you explain the reason for her tiredness?
2. P.S. receives a prescription for ramelteon (Rozerem). How is this drug different from alprazolam?
3. What nonpharmacologic measures can P.S. try to improve her sleep?
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