Overview

What is insomnia?

Insomnia is a dissatisfaction with sleep quantity or quality with at least one of the following:

Difficulty falling asleep
Difficulty staying asleep
Early-morning awakening with inability to fall back asleep

These symptoms occur 3 times per week, over at least 3 months, despite adequate opportunity for sleep. This results in a compromise to your ability to function during the daytime.

How to deal with insomnia?

Insomnia should be managed through a multi-disciplinary approach. First, we recommend behavioral modifications and maintaining adequate sleep hygiene (reducing screen time, ensuring you are in an environment conducive to sleep). Second, we recommend therapy to discuss possible causes that could be contributing to your sleeping pattern disruption. There is even a specific kind of therapy, CBT-I (Cognitive Behavioral Therapy for Insomnia), that we typically recommend for our patients. Lastly, initiating pharmacological therapy to help regulate your sleep/wake cycle, if warranted.

How to tell if you have insomnia?

One-third of the population has insomnia and many individuals do not know to speak with their providers about this even though they meet the criteria. This screening questionnaire, the ISI, helps determine if you meet guidelines for insomnia (https://www.ons.org/sites/default/files/InsomniaSeverityIndex_ISI.pdf). Speak with your provider about insomnia to learn more about the diagnosis.

Are there doctors for Insomnia in Austin, TX?

If you’re looking for an insomnia doctor near you in Austin, TX, or surrounding areas, Specialty Clinic in Austin has two locations in north and south Austin for in-person and telehealth appointments. Our team of providers can diagnose and treat insomnia, with decades of experience, we believe in best practice and evidence-based approach to helping you overcome insomnia and get the restful sleep you deserve.

Causes

What causes insomnia?

This varies based on the patient. For example, a person who has restless legs or has stimulant use during the day may have issues with sleep initiation. Others, maybe those dealing with depression or anxiety, may struggle with sleep maintenance. Several things can contribute to sleep, including genetic factors, substances and medications, life circumstances, bedroom environment, daily behaviors and routines, and personality features (1).

How to prevent insomnia?

One of the best non-pharmacological interventions patients can do to help prevent insomnia is trying to stay scheduled in their sleeping patterns. Avoiding light at bedtime, alcohol, caffeine, watching the clock, noise, temperature regulations, eating right before bed, and napping can help promote better sleep.

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Symptoms

What are the symptoms of insomnia?

Some symptoms, besides lack of sleep, that patients can experience include (2):

Fatigue or malaise
Poor attention or concentration
Social or vocational/educational dysfunction
Mood disturbance or irritability
Daytime sleepiness
Reduced motivation or energy
Increased errors or accidents
Behavioral problems such as hyperactivity, impulsivity or aggression
Ongoing worry about sleep

Diagnosis

How to know if you have insomnia?

See “How to tell if you have insomnia?” listed above.

Are there insomnia doctors in Austin?

Yes, we treat insomnia here, at Speciality Clinics of Austin, but we also refer to sleep specialists for more specialized treatment if needed.

Treatment

How to treat insomnia?

We have different neurotransmitters that moderate our sleep. We have some ‘sleep’ receptors (adenosine, GABA, melatonin, for example) and some ‘wake’ receptors (hypocretin/orexin) that work to balance each other out and regulate our sleep cycles. Medications we use to treat insomnia typically affect the above receptors in helping correct the imbalance that is causing the sleeping pattern disruption. We also emphasize the importance of cognitive behavioral therapy working in conjunction with pharmacotherapy to help treat insomnia.

Are there counselors who deal with anxiety and insomnia in Austin?

Yes! CBT-i is the gold standard for behavioral treatment for insomnia. It is extensive, with 6 to 8 in-person visits over 8 weeks. However, there are online options like the unguided CBT-i that you can access using your smartphone (SHUTi, or Sleep Healthy Using the Internet) which have been validated by the FDA (3). We also recommend using psychologytoday.com to find a CBT therapist closest to your zip code and covered by your insurance.

What help can I get for Insomnia in Austin?

Specialty Clinic of Austin is currently accepting new patients to help aid in the treatment of insomnia. Therapy and sleep specialists such as https://www.txsleepmedicine.com are also available to Austinites.

References:

Doghramji, Karl and Doghramji, Paul P., “Clinical Management of Insomnia” (2015). Department of Psychiatry and Human Behavior Faculty Papers. Paper 25
American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed, American Academy of Sleep Medicine, Darien, IL 2014
Vedaa Ø, Hagatun S, Kallestad H, Pallesen S, Smith ORF, Thorndike FP, Ritterband LM, Sivertsen B. Long-Term Effects of an Unguided Online Cognitive Behavioral Therapy for Chronic Insomnia. J Clin Sleep Med. 2019 Jan 15;15(1):101-110. doi: 10.5664/jcsm.7580. PMID: 30621837; PMCID: PMC6329541.

Information

Medically reviewed by:

Charles Sweet, MD, MPH

Dr. Sweet is a native Texan and attended The University of Texas at Austin for undergraduate studies. He earned his Doctor of Medicine and Master of Public Health degrees at the University of Illinois and then did residency training at the prestigious Johns Hopkins Hospital, Dr. Sweet came back to Austin, TX for specialized training in Child and Adolescent Psychiatry and has been in practice since 2009.

Dr. Sweet believes strongly in working with, and training Physician Assistants to treat the behavioral health needs of adults, children and adolescents.

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