Sleep that finally feels restorative.

Sleep isn't a switch you simply flip off at night. It's a system, and like any system it can get stuck. When it does, the effects spill into everything, your mood, your focus, your patience, your body. The good news is that insomnia is treatable, and treating it well usually means more than reaching for a pill.

We start by understanding your sleep the way it actually happens, not the way it's supposed to look in a textbook. Trouble falling asleep, waking repeatedly through the night, waking too early and not getting back down, and sleep that leaves you unrefreshed are all different problems, and they often point to different causes. Sorting that out is the first real step.

Sleep also runs in both directions with mental health. Anxiety and depression disrupt sleep, and poor sleep makes anxiety, low mood, and attention worse. When sleep and another condition feed each other, we treat the whole loop rather than one piece of it.

Signs we look for

• Trouble falling asleep even when you're tired
• Waking through the night and struggling to fall back asleep
• Waking far earlier than you want and not getting back down
• Sleep that leaves you unrefreshed no matter how many hours you log
• Dread or tension as bedtime approaches, or watching the clock
• Daytime fatigue, irritability, brain fog, or trouble concentrating
• Loud snoring, gasping, or being told you stop breathing in your sleep

How we evaluate

A careful sleep evaluation looks past the surface complaint. We take a detailed history of your sleep pattern, your schedule, your routines around bed, caffeine and alcohol, screens, and the medications and supplements you already take, since some quietly fragment sleep. We look for the psychiatric drivers that frequently sit underneath insomnia, such as anxiety, depression, and racing thoughts at night, and we screen for medical causes that need a different kind of care. Loud snoring, gasping, or pauses in breathing can point to sleep apnea, and restless legs and circadian rhythm problems each call for their own approach. When something belongs with a sleep specialist or a sleep study, we say so and help you get there, rather than treating around it.

How we treat

For ongoing insomnia, the most effective and durable first-line treatment isn't a medication. It's cognitive behavioral therapy for insomnia, known as CBT-I, a structured, evidence-based approach that retrains the patterns keeping you awake. Sigma provides the psychiatric side of your care and helps coordinate CBT-I, connecting you with a therapist or program that delivers it. Alongside that, we treat the conditions driving poor sleep, anxiety, depression, or attention problems, and we review your current medications to remove what may be working against your sleep. Medication for sleep is one option, not the first resort. When it's appropriate, we choose it carefully, often favor non-controlled options, and use it for the shortest sensible time. Some sleep and sedative medications are controlled and carry state and telehealth rules, so we explain honestly what fits your situation before anything is prescribed.