Sleep Problems
When Rest Stops Feeling Restorative
Sleep sits underneath everything else. Poor sleep worsens nearly every psychiatric condition, and nearly every psychiatric condition disrupts sleep. This makes it hard to tell which came first, and easy to treat one problem while ignoring the other.
Some people come to us because sleep is the main problem. Others come for anxiety or depression and mention in passing that they haven’t slept well in years. Either way, sleep is one of the first things we ask about because getting good rest is foundational to wellness.
How Sleep Problems Can Show Up
Lying awake with a mind that won't slow down
Interrupted sleep with difficulty returning to sleep
Waking in the early morning and unable to return to sleep
Sleeping enough hours but never feeling rested
Daytime fatigue, low energy, or difficulty concentrating
Relying on caffeine to function, then on something else to wind down
A sleep schedule that runs later or earlier than your life allows
Shift work that keeps your body out of sync
Sleep that's fine on weekends and impossible on weeknights
Nightmares or distressing
dreams
dreams
Restlessness or difficulty
settling
settling
Snoring, gasping, or being told you stop breathing
What We Address
Ongoing difficulty falling or staying asleep, waking too early, or feeling unrested during the day. Insomnia can begin during a stressful period and persist long after the original trigger has passed.
Sleep disruption can be a symptom of anxiety, depression, trauma, ADHD, or mood instability. Treating the underlying condition often improves sleep, and improving sleep often makes the condition more treatable.
Both psychiatric and non-psychiatric medications can disrupt sleep, sometimes in ways that go unnoticed for years. Reviewing what you're taking is part of the assessment.
Disruptions in your body's natural sleep-wake cycle that make it difficult to fall asleep or wake up at the times you need to. This may involve shift work, irregular sleep schedules, or a tendency to fall asleep much later than intended.
Distressing dreams and disrupted sleep connected to trauma, which sometimes need treatment in their own right.
Some sleep disorders require testing we don't provide and treatment outside the scope of psychiatry. Sleep apnea in particular is common, frequently undiagnosed, and easily mistaken for depression or ADHD. If needed, we will refer you to sleep medicine, and coordinate with your care team from there.
Poor sleep isn’t a minor complaint.
It’s a clinical priority.
Common Questions About Sleep Problems
How much sleep do I actually need?
Most adults need seven to nine hours of sleep within a 24-hour period, though individual needs vary. What's most important is whether you're getting enough restorative sleep to feel rested and function well during your waking hours, regardless of your schedule.
Can nightmares be treated?
Yes. Recurring nightmares, especially those connected to trauma, can be treated with approaches that help reduce their frequency and intensity.
Is it bad to use alcohol or cannabis to fall asleep?
Both alcohol and cannabis make people fall asleep faster and both degrade sleep quality. Alcohol reliably causes waking in the second half of the night, and cannabis affects sleep architecture with regular use. We ask about your use patterns without judgment because the more accurate the picture, the more useful the plan.
Do I need to have a sleep study?
If your history and symptoms point toward a condition that requires specialty testing, sleep apnea being the most common, we'll tell you and refer you to sleep medicine. From there, we coordinate with your care team so that your psychiatric treatment accounts for any findings.