Case: An elderly widow who just lost her spouse. Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: • Metformin 500mg BID • Januvia 100mg daily • Losartan 100mg daily • HCTZ 25mg daily • Sertraline 100mg daily Current weight: 88 kg Current height: 64 inches Temp: 98.6 degrees F BP: 132/86 Insomnia is a disorder linked with difficulty in sleep quality, initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. Its prevalence ranges from 10 to 15% among the general population, with higher rates seen among females, divorced or separated individuals, those with loss of loved ones, and older people (Bollu & Kaur, 2019). Insomnia can simply be defined as a sleep disorder where the patient has trouble falling asleep or staying asleep. According to Krystal et al (2019), it is a common condition that is linked with noticeable deterioration in function and quality of life, mental and physical morbidity. The complaints of insomnia are present in 60–90% of patients with major depression, Complaints of disrupted sleep are very common in patients suffering from depression, (Wichniak, etal., 2017). Questions you might ask the patient and rationale The diagnosis and treatment of insomnia rely mainly on a thorough sleep history to address the precipitating factors as well as maladaptive behaviors resulting in poor sleep (Bollu & Kaur, 2019). What is your sleep pattern including how many hours of sleep do you get at night prior to your husband’s demise and what it has been in the 10 months since his death? Does she perform certain rituals or do something special before she sleeps. This assesses if the insomnia started before or after the husband’s death. This provides a clue to insomnia that may be related to bereavement. What time do you go to bed every night and what is your normal routine before going to bed? This is to check if the patient is doing something differently which has disrupted her normal routine and caused insomnia. How often do you wake up to urinate at night? This question is asked to assess for nocturia due to diabetes that may lead to insomnia. Nocturia can prevent the patient from having a good night’s sleep. , changes in blood glucose levels at night causesto hypoglycemic and hyperglycemic episodes, nocturia and associated .