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Insomnia

What is Insomnia?

Insomnia is a sleep disorder where falling asleep, staying asleep, or getting restful sleep becomes difficult—despite having the opportunity to sleep. It is more than occasional restless nights. Insomnia can impact energy, mood, concentration, memory, work performance, and emotional well-being.


Biologically, insomnia may involve heightened stress hormones (like cortisol), disruptions in circadian rhythm, medical issues, pain, or changes in brain chemicals that regulate sleep and wakefulness. Anxiety, depression, trauma, pregnancy/postpartum changes, menopause, and medications can all interfere with sleep.


Psychologically, insomnia often turns into a cycle: worrying about sleep leads to frustration, which makes sleep even harder. Many people lie awake replaying thoughts, planning, or feeling unable to “turn the brain off.” Over time, this creates sleep anxiety and conditioned wakefulness.


Insomnia is common and treatable, often with a combination of behavioral strategies, therapy, and sometimes medication.

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What Are the Symptoms?

  • Trouble falling asleep

  • Waking up throughout the night

  • Waking up too early and not falling back asleep

  • Feeling unrefreshed despite hours in bed

  • Daytime fatigue, irritability, or fogginess

  • Anxiety or dread around bedtime

  • Difficulty concentrating or remembering

  • Reliance on caffeine or naps to function

Chronic insomnia can affect mood, relationships, productivity, and health but treatment can lead to significant improvement.

How Are Insomnia Treated?

Insomnia is highly treatable, and the most effective care is personalized to each individual. Treatment may include:

Therapy

  • Cognitive Behavioral Therapy for Insomnia (CBT-I)

  • Sleep hygiene and routine building

  • Relaxation training, grounding, and mindfulness

  • Addressing anxiety, trauma, or racing thoughts​

CBT-I is one of the most effective treatments for chronic insomnia and can work as well as medication.

Medication

  • Melatonin and sleep supplements (for circadian rhythm support)

  • Non-benzodiazepine sedatives (Ambien, Lunesta)

  • Sedating antidepressants (trazodone, mirtazapine, doxepin)

  • Hydroxyzine for nighttime anxiety

  • Gabapentin for sleep, pain, or anxiety

  • Benzodiazepines (used cautiously and short-term only)

Lifestyle & Support

  • Evening wind-down routines

  • Limiting screens, caffeine, nicotine, and alcohol

  • Consistent sleep/wake times

  • Exercise and light exposure regulation

  • Treating sleep apnea or pain conditions if needed
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Advanced Treatment Options

  • Combination therapy + medication

  • Ketamine or esketamine if insomnia is tied to severe depression

  • Collaboration with sleep specialists when appropriate
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How We Can Help at Better Balance Mental Health

We understand that insomnia can feel frustrating, lonely, and exhausting. Many patients feel like they are “trying everything” and nothing works. We take time to understand your sleep patterns, lifestyle, medical history, mood, and anxiety level because insomnia is rarely just one issue.


We move at a pace that feels safe and supportive. We never judge, and we never push medication. Treatment is collaborative and tailored to your comfort level. Our goal is to help you feel rested, restored, and in control again—so sleep becomes something peaceful, not a nightly battle.


You don’t have to spend another night struggling alone. We’re here to help.

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