Inpatient Insomnia: What to Order When a Patient Can't Sleep at 2 AM
A patient calls at 2 AM — can't sleep. What do you order?
Most residents reach for the wrong drug. Here's the framework I use after 15 years on the wards.
In this video, I break down every inpatient sleep medication — melatonin, trazodone, zolpidem, temazepam, antihistamines — with exact doses, the drugs to avoid in the elderly, how to prevent delirium and falls, and the one thing you should never write on a discharge prescription.
This is part of the First Week of Residency Tips series — the practical stuff your attendings assume you already know.
👉 Chapters:
00:00 Intro
00:34 Why hospital patients can’t sleep
01:00 Insomnia drug classes
01:11 Melatonin
01:28 Trazodone and Mirtazapine
02:21 Antihistamines
02:40 Zolpidem (Ambien)
03:02 Temazepam
03:40 Which sleeping aid to give
03:59 What dose of sleeping aid to start with
Link to the full playlist: • Essential Tips for First-Week Residents
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