CBT/ sleep hygiene Sleep initiation: Melatonin 3-5mg 1 hour before bed. Ramelteon ( melatonin receptor agonist) low risk of abuse Sleep maintenance: Zolpidem ER, Doxepin 3-6 mg, Gabapentin 100-300 mg QHS, Mirtazapine 7.5 mg. Benadryl not recommended due to anticholinergic effects and adverse effects on cognition. Avoid > 60 Avoid Benzo receptor angoinist: Eszopidon, Zaleplon and Zolpiden ( Ambien) habit forming Caution with Trazodone ( Can amplify mania)