Specialties

Chronic insomnia involves ongoing difficulty falling asleep, staying asleep, or waking too early, typically occurring several nights per week for several months or longer. Over time, sleep can become something people feel increasingly worried about, which often leads to more effort to control it and, paradoxically, more disruption.

Many people develop patterns like spending extra time in bed and irregular sleep schedules that unintentionally maintain the problem. CBT-I targets these patterns directly by adjusting sleep timing, reducing sleep-related anxiety, and strengthening the body’s natural sleep drive.

The goal is not to “force sleep,” but to restore your body’s natural ability to sleep resotratively.

Sleep changes are common during perimenopause and menopause and can include trouble falling asleep, frequent night awakenings, or earlier-than-desired morning waking. Hormonal shifts can contribute to changes in temperature regulation, mood, and overall sleep stability, which can make sleep feel lighter and more fragmented.

CBT-I can be used alongside hormonal therapy or on its own. Hormonal treatment can be helpful for some people, but it does not fully resolve sleep disruption for everyone, and some individuals prefer to avoid or cannot use it for medical or personal reasons.

Treatment focuses on improving sleep continuity and supporting the ability to fall back asleep even after hot flushes or other sleep disruptions.

Stress and anxiety-related insomnia involves difficulty sleeping that is often tied to worry or racing thoughts. People describe feeling “tired but wired,” where the body feels exhausted but the mind remains alert and over-active.

Common patterns include rumination, replaying events from the day, anticipating future concerns, or difficulty disengaging from problem-solving at bedtime. Over time, the bed can become associated with wakefulness and stress rather than rest.

CBT-I helps by working with the habits, thoughts, and sleep patterns that keep the problem going. The focus is on reducing the link between the sleep environment and stress, so that you stop “trying to sleep” and let sleep come to you.