Home · Conditions · Insomia
Medically reviewed by Jay Borrego, DNP, PMHNP-BC, CRNA · Updated September 2026
Common signs
Sound familiar?
✓ 30+ minutes to fall asleep, most nights
✓ 3 a.m. wakings with a busy mind
✓ Sleep that doesn't restore
✓ Dread of bedtime; clock-watching
✓ Daytime fog, irritability, caffeine dependence
✓ It's lasted three months or more
Not a fit: A checklist is not a diagnosis — an evaluation is. If several of these fit, it's worth a conversation.
How we evaluate it
Insomnia is a symptom until proven otherwise: we screen for apnea, restless legs, circadian misalignment, anxiety, depression, medications and substances before treating 'insomnia' itself. Sleep diaries and, when indicated, home testing referrals.
How we evaluate it
CBT-I principles are first-line and durable — built into the Sleep & Restore track. Medication has a real but bounded role: short courses, the right agent for your pattern, and an exit plan from day one. Chronic sedative dependence is a thing we help people leave, not enter.
Cost & insurance
Evaluations and follow-ups bill to our participating plans or transparent self-pay. Benefits verified and your expected cost reviewed before your first visit.
What measured care looks like
ISI tracked at every visit
The Insomnia Severity Index is scored before each appointment, so improvement — or its absence — is visible early and the plan changes when the data says to. Illustrative course shown; individual results vary.
What's different here
CBT-I versus a sleeping pill
Cognitive behavioral therapy for insomnia retrains the sleep system — stimulus control, sleep-window scheduling, and dismantling the dread of bedtime. It takes four to six weeks and the gains last. Medication works tonight and stops working the night you stop. We use both, in that order of importance: CBT-I carries the load; a short, bounded course of the right agent bridges the gap and is tapered on a date we set together.
If you're already on nightly Ambien or a benzodiazepine, tapering is part of the plan, not a condition of it.
Researching, not ready to book? Text us a question — a real person answers, no appointment, no pressure.
-Questions
Insomnia questions
Yes — with a gradual, humane taper and CBT-I doing the load-bearing. It's one of the most satisfying things we treat.
When appropriate, yes — with the exit plan attached. The goal is your sleep system working again, not a refill relationship.
At the right (low) dose and time, for the right pattern — often yes. Timing matters more than milligrams; we'll set both.