Focus Area
Integrative treatment for insomnia.
Sleep is one of the most underutilized interventions in mental health care. When sleep improves, anxiety, mood, and cognitive function often improve with it. Treating insomnia is a core component of treating mental health.
What this actually is
Insomnia is defined as difficulty falling asleep, staying asleep, or waking earlier than intended, occurring at least three nights per week for three months or longer.
Common presentations include:
- Sleep-onset insomnia
- Sleep-maintenance insomnia
- Early-morning awakening
Insomnia often coexists with or reflects underlying conditions such as sleep apnea, restless legs syndrome, depression, anxiety, hormonal changes, or medication side effects.
Why the standard approach often falls short
Treatment is often limited to sleep medications. While medications can be helpful short-term, they do not address underlying drivers and may carry risks with long-term use.
The first-line treatment for chronic insomnia is CBT-I (Cognitive Behavioral Therapy for Insomnia), which targets the behavioral and cognitive patterns that sustain sleep disruption.
The Elevae approach
Treatment is structured across five domains:
Mind
Evaluation for anxiety, depression, PTSD, ADHD, or other conditions contributing to sleep disruption.
Biology
Targeted labs when indicated (e.g., thyroid function, iron/ferritin, vitamin D, hormonal factors). Screening for sleep apnea and other sleep disorders.
Lifestyle
Sleep timing, light exposure, caffeine and alcohol use, screen habits, and sleep environment are addressed as primary drivers of sleep quality.
Relationships
External factors — co-sleeping dynamics, caregiving demands, work schedules, and bedroom environment — are assessed and addressed where possible.
Meaning
For some individuals, insomnia is maintained by conditioned arousal or anxiety about sleep itself, creating a self-reinforcing cycle.
What treatment typically looks like
Care begins with a detailed sleep evaluation. This may include:
- Sleep history and pattern assessment
- A 1–2 week sleep diary
- Targeted lab work when indicated
Treatment combines CBT-I principles with medical evaluation and, when appropriate, time-limited medication support.
Most patients experience meaningful improvement within 4–8 weeks.
Frequently asked questions
Do I need a sleep study?
Sometimes. If there's any indication of sleep apnea — snoring, observed pauses, unrefreshed sleep — or restless legs, we recommend a study. Often done at home.
How long does CBT-I take to work?
Most people see real improvement within 4–8 weeks of consistent application.
Can I do CBT-I without a therapist?
Yes, via structured apps (CBT-i Coach, Somryst). We often combine app-based CBT-I with clinical support.
Is chronic insomnia linked to depression and anxiety?
Very strongly. Treating sleep often improves mood and anxiety — sometimes dramatically.
Start here
A free 15-minute consultation. We'll tell you honestly if we're the right fit.
We'll listen, answer questions, and either welcome you in or point you somewhere better.
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