Insomnia

Why insomnia needs its own treatment, and how to find a CBT-I specialist

Part of The ShieldMee Guide: Is This Something Else? →

“I’m exhausted, but the second my head hits the pillow, my brain turns on.”

“I wake up at 3 a.m. every night.”

“My partner sleeps fine. I lie there staring at the ceiling.”

I don’t treat insomnia directly, and here’s why

I don’t treat insomnia directly. A sleep specialist is the right fit. While you work with them, I can still see you, your partner or your family for couples or family therapy, or individual therapy for the anxiety, depression or stress that may be making sleep worse.

What insomnia is

Insomnia means trouble falling asleep, staying asleep, or waking too early, and feeling the effects during the day.

When it happens at least three nights a week for three months or more, it’s called chronic insomnia.

It often starts with stress, then keeps going because of habits and worry about sleep itself.

The treatment that works best: CBT-I

Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first treatment for chronic insomnia in adults, ahead of sleeping pills.

It usually takes a handful of sessions. It works on sleep schedules, habits in bed, and the racing thoughts that keep you up.

When to see a doctor first

• Loud snoring, gasping or choking at night, or a partner noticing you stop breathing (possible sleep apnea)
• Restless or crawling feelings in your legs at night
• Falling asleep during the day without meaning to
• Insomnia that started with a new medicine or health problem

If you’re drowsy while driving, pull over. Drowsy driving is dangerous.

Where to find help in Florida

• Your primary care doctor can check for medical causes and refer you to a sleep specialist.
• A sleep medicine doctor or sleep center can test for sleep apnea and other sleep disorders.
• Behavioral sleep medicine providers specialize in CBT-I. The Society of Behavioral Sleep Medicine has a provider directory, and many offer telehealth.
• Your insurance company can tell you which sleep providers are in-network.

Sleep and your relationship

Insomnia affects couples too. Different bedtimes, snoring, tossing and turning, and irritability can cause tension.

Some couples quietly start sleeping apart and never talk about what it means. That conversation is worth having.

While you work with a sleep specialist, I can still see you, your partner or your family for couples or family therapy, or individual therapy for the anxiety, depression or stress that may be making sleep worse.

If you’re having thoughts of hurting yourself, call or text 988 (press 2 for Spanish).

If conflict at home includes threats, hitting, pushing, or one person controlling another’s money, phone or movements, call the National Domestic Violence Hotline at 1-800-799-7233. It’s free and open 24/7.

Frequently asked questions

Can you treat my insomnia?

Not directly. A sleep specialist is the right fit, such as a provider trained in CBT-I. While you work with them, I can still see you, your partner or your family for couples or family therapy, or individual therapy for the anxiety, depression or stress that may be making sleep worse.

Aren’t sleeping pills easier?

Some people use them short term with a doctor’s guidance. For chronic insomnia, CBT-I is recommended first because its benefits tend to last.

Related reading: High-Functioning Anxiety · Catastrophic Thinking · Perimenopause and Menopause