Understanding Insomnia & Sleep Issues
Trouble falling asleep, staying asleep, or waking unrefreshed.
Sleep is the foundation everything else rests on. We assess sleep architecture, screen for apnea and circadian disruption, and combine CBT-I, medical support when needed, and lifestyle protocols to restore restorative sleep.
What's actually happening
Insomnia is trouble falling asleep, staying asleep, or waking unrefreshed — and it's a condition in its own right, not just a symptom. It reshapes the day that follows it.
How it progresses
Over time, the bed itself becomes a cue for wakefulness and worry, and the body's circadian rhythm flattens. Sleep aids can stop working and the cycle becomes self-sustaining.
When lifestyle isn't enough
Sleep hygiene is the floor, not the fix. When insomnia persists, CBT-I (the first-line, best-evidenced treatment), medical support when needed, and screening for apnea are what actually restore restorative sleep.
Treatment Options
A plan built around your biology, not a protocol.
CBT-I
The first-line, best-evidenced therapy for chronic insomnia — retraining the sleep system rather than sedating it.
Sleep architecture assessment
Screening for apnea, circadian disruption, and the physiology that blocks deep sleep.
Medical support when needed
Short-term, targeted medication used to break the cycle, not as a permanent fix.
Hormone & stress optimization
Cortisol rhythm, melatonin, and hormonal shifts that quietly drive wakefulness.
The Roadmap
What working with us actually looks like.
01 — Deep diagnostics
Sleep history, screens for apnea, and review of what’s actually disrupting the night.
02 — Reprogram
CBT-I to rebuild the bed-sleep association and the circadian rhythm.
03 — Support
Targeted medical or hormonal support to break the loop.
04 — Sustain
Tools and habits that hold the gain without ongoing medication.
Why PracticeRx
Conventional care vs. the PracticeRx approach.
Conventional care
- 10-minute visits and TSH-only labs
- “Your levels are normal” — even when you don’t feel normal
- Treats the symptom: a prescription or “lose weight”
- One specialist per system, none talking to each other
- Reactive — wait until something breaks
- Generic protocols based on demographics
PracticeRx
- 100+ biomarker bloodwork and full hormone & thyroid panels
- Hormones, peptides, and metabolic medicine guided by your data
- Integrated mental and physical care in one practice
- Preventative — full-body MRI screening and early detection
- 7-day access to your care team — no waiting until Monday
- A plan built around your biology, not a protocol
The evidence
Chronic insomnia affects 10–30% of adults; the AASM names CBT-I the first-line treatment, ahead of medication.
Source: AASM; Qaseem et al., 2016
Insomnia & Sleep Issues — Frequently Asked
Common questions about Insomnia & Sleep Issues.
What is the best treatment for chronic insomnia?
CBT for insomnia (CBT-I) is the first-line, best-evidenced treatment, recommended ahead of sleep medication by major sleep medicine guidelines.
Could my insomnia be caused by something else?
Often. Anxiety, depression, sleep apnea, hormonal shifts, and circadian disruption are common drivers, so we screen for them before building a plan.
Do I have to take sleep medication?
No. Many patients improve with CBT-I and targeted lifestyle changes alone. Medication is used selectively when it genuinely helps.
Medically reviewed by
Jacob Johns, NP, MSN, PMHNP
PRX Psychiatric Nurse Practitioner
Psychiatric nurse practitioner with a background in crisis care and inpatient psychiatry; trained in CBT and motivational interviewing.
Stop guessing. Start with the labs.
You don't have to keep guessing what's wrong. We'll run the deep labs, find what's actually driving this, and build a plan around your biology.
100+ biomarker bloodwork
The labs conventional care usually skips.
Integrated care, one team
Mental and physical health under one roof.
7-day access
Your care team, when you actually need them.