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A 46-year-old woman has a 15-year history of difficulty in falling asleep and staying asleep. It takes her two hours to fall asleep most nights, and when she falls asleep rapidly, she wakes at 2 a.m. and cannot go back to sleep. Her bedtime is 11 p.m., and going to bed later does not help her fall asleep more easily. She has no symptoms of sleep-disordered breathing or the restless legs syndrome and is otherwise well. How should her case be managed?
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Michael H. Silber (2005) studied this question.
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