Concierge Medicine
Insomnia & Sleep Issues Treatment by Telehealth
Restore the night, restore the day.
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.
Who We Typically See
Usually a high-functioning adult who falls asleep fine but wakes at 2 or 3 a.m. with a busy mind, or lies awake for an hour every night. Many have tried every supplement and sleep app. Some rely on a sleep aid they want to get off. Most are exhausted but wired.
Treatment Options at a Glance
Restoring sleep that actually restores you.
From retraining the sleep system to targeted medical support and apnea screening.
CBT-I
What it targets
The learned patterns and hyperarousal that keep insomnia going.
The first-line treatment with the strongest long-term results.
Sleep apnea screening
What it targets
Breathing interruptions that fragment sleep.
Frequently missed, especially in women and lean adults.
Non-habit-forming medications
What it targets
Sleep maintenance and nighttime arousal.
Used short-term to break the cycle while behavioral work takes hold.
Progesterone in perimenopause
What it targets
Night waking, hot flashes, and calming GABA activity.
Often transformative for women whose sleep fell apart in their 40s.
Circadian reset
What it targets
Light timing, melatonin rhythm, and wake consistency.
Low-tech changes that make every other treatment work better.
Options are prescribed only when clinically appropriate, after evaluation by a licensed provider.
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
Medically reviewed by
Aileen Macaraeg, DNP, FNP-C, PMHNP-BC
PRX Dual Board Certified · Family Medicine & Psychiatry
Dual board certified in family medicine and psychiatry, treating mental and physical health as one connected system.
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.