Insomnia

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or waking too early and being unable to return to sleep. It leads to daytime fatigue, impaired functioning, and diminished quality of life. Insomnia is one of the most common health complaints, yet it often goes untreated or is managed ineffectively, leaving many people struggling night after night with poor sleep.

What is Insomnia?

Insomnia involves persistent difficulty with sleep despite having adequate opportunity to sleep. It's not just about the number of hours you sleep—it's about the quality of your sleep and how you feel during the day as a result. While occasional sleepless nights are normal, insomnia becomes clinically significant when sleep difficulties occur at least three nights per week for three months or longer and cause distress or impairment in daily functioning.

Insomnia can manifest in different ways. Some people struggle primarily with falling asleep, lying awake for hours while their mind races. Others fall asleep easily but wake frequently throughout the night or wake too early in the morning and cannot get back to sleep. Many experience a combination of these patterns.

Insomnia often develops in response to stress, life changes, or medical conditions, but it can persist long after the initial trigger has resolved. This happens because the anxiety and behaviors that develop around sleep—worrying about not sleeping, trying too hard to fall asleep, irregular sleep schedules—create a self-perpetuating cycle. The bedroom becomes associated with wakefulness and frustration rather than rest.

Signs and Symptoms

Nighttime symptoms may include:

• Difficulty falling asleep, often taking 30 minutes or longer

• Waking up multiple times during the night

• Waking too early and being unable to return to sleep

• Feeling like your sleep is light or unrefreshing

• Racing thoughts or anxiety when trying to sleep

• Heightened awareness of being awake and not sleeping

• Watching the clock and calculating hours of potential sleep

Daytime symptoms may include:

• Fatigue or low energy throughout the day

• Difficulty concentrating, remembering, or making decisions

• Irritability, mood changes, or emotional reactivity

• Decreased motivation or productivity at work

• Anxiety or worry about sleep

• Physical tension, headaches, or other discomfort

• Using caffeine excessively to stay alert

• Feeling tired but unable to nap

Common contributing factors:

• Stress related to work, relationships, or life changes

• Anxiety or depression

• Irregular sleep schedule or shift work

• Poor sleep environment (noise, light, temperature)

• Stimulant use (caffeine, nicotine) or alcohol

• Medical conditions or pain

• Medications that interfere with sleep

• Excessive screen time before bed

My Approach to Treatment

I take a comprehensive approach to treating insomnia, addressing both the immediate need for better sleep and the underlying factors that may be contributing to sleep difficulties.

Comprehensive Assessment: I provide thorough psychiatric evaluations that explore your sleep patterns and history, factors contributing to insomnia, co-occurring mental health or medical conditions, current sleep habits and environment, and medications or substances that may affect sleep. Understanding the full picture allows us to develop the most effective treatment plan.

Behavioral and Therapeutic Approaches: I work with you to address the thoughts, behaviors, and patterns that may be maintaining insomnia. This includes exploring strategies to strengthen the association between bed and sleep, cognitive approaches to address anxiety and unhelpful beliefs about sleep, relaxation techniques to reduce arousal, and guidance on optimizing your sleep environment and habits.

Medication Management: When appropriate, I may prescribe medication to help restore sleep, particularly during acute periods of severe insomnia or when insomnia is connected to another condition like depression or anxiety. I carefully consider the risks and benefits of sleep medications, preferring short-term use while behavioral strategies are being implemented, and work collaboratively with you to find the safest and most effective approach.

Addressing Underlying Conditions: Insomnia frequently occurs alongside anxiety, depression, PTSD, or other mental health conditions. It can also be a symptom of medical conditions, chronic pain, or medication side effects. Effective treatment often requires addressing these co-occurring issues. I work closely with you to treat the whole picture, not just the sleep symptoms in isolation.

Holistic Care: Sleep doesn't exist in isolation from the rest of your life. Treatment may involve attention to stress management and work-life balance, exercise and physical activity, caffeine and alcohol use, schedule regularity and daily routines, and relationship or environmental factors affecting sleep. I collaborate with other providers involved in your care when helpful, including therapists, primary care physicians, or sleep specialists.

Long-Term Sleep Health: Beyond resolving the current episode of insomnia, my goal is to help you develop sustainable sleep practices and resilience against future sleep difficulties. This includes building confidence in your ability to sleep, reducing anxiety around sleep, and maintaining healthy sleep habits over time.

Getting Started

If you're struggling with insomnia and it's affecting your daily functioning and quality of life, I offer comprehensive psychiatric evaluations and evidence-based treatment to help you sleep better and feel more rested.

To schedule an appointment, please call or email my practice. I look forward to helping you restore healthy, restorative sleep.