A 34-year-old man presents to his primary care clinic for evaluation of chronic insomnia. His past medical history

A 34-year-old man presents to his primary care clinic for evaluation of chronic insomnia. His past medical history is significant for a motor vehicle accident that occurred over 1 year ago and led to chronic back pain. He reports that he is currently taking oxycodone 10 mg every four hours as needed for severe pain and ibuprofen 800 mg three times per day as needed for mild-moderate pain. He reports his pain has been gradually decreasing. He states he has been having issues with sleep for the past 3 months. He denies having any nightmares. He denies having any past traumatic experiences. The patient works as a programmer for a local software company, and it requires him to focus for long hours when programming. He currently smokes 1 pack per day of cigarettes and denies using illicit substances. His review of systems is negative except for lower back pain. His vital signs show blood pressure 145/91 mmHg, pulse rate 89/min, respiratory rate 17/min, and temperature 98.7°F. His current BMI is 23.1 kg/m². His physical examination is unremarkable except for dilated pupils and tenderness to palpation on the middle-upper lumbar area. He feels tired in the evening, but he reports feeling energetic during the daytime. He denies feeling depressed, having concentration issues, loss of appetite, or feeling suicidal. He reported that he gets about 5-6 hours of sleep. Which of the following is the best initial step in the management of this patient? A. Electrocardiography (EKG) B. Sleep study C. Psychotherapy D. Urine drug screen