Chronic insomnia

A 46-year-old woman has difficulty in falling asleep and staying asleep. The problem started after the birth of her second child 15 years earlier in association with mild post-partum depression. Despite having had no recurrence of depression and no major psychosocial stressors, the patient requires two hours tofall asleep most nights, and on the occasions that she falls asleep rapidly, she wakes at 2 a. m. and cannot reinitiate sleep. Her bedtime is 11 p. m., andshe has found that going to bed later does not allow her to fall asleep more easily. She has no symptoms of sleep-disordered breathing or the restless legssyndrome and is otherwise well. How should her case be managed?