John Robinson, 74 years old, complains of insomnia and of always feeling tired. He has been diagnosed with gastroesophageal reflux disease (GERD) and congestive heart failure. What would you suggest to help him sleep better?
a. Take a long-lasting analgesic before bed
b. Take antacids before bed to relieve acid reflux
c. Raise the head of the bed so that the upper body is elevated
d. Tell him to lie only on his side
C
Patients with acid reflux (GERD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) should sleep with the head of the bed elevated. The head of the bed can be raised by placing blocks under the head end or by other means. Response A is incorrect; Mr. Robinson did not complain of pain. Response B may be appropriate if prescribed by a physician, but simple measures should always be tried first. Lying on the side may help but is unrealistic as a long-term solution.
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