Chronic insomnia is its own condition, not just a symptom of stress. It has a first-line treatment that is not a sleeping pill, and it is treated seriously here.
Book a Telehealth Appointment →Sleep trouble usually starts with a reason: a stressful stretch, a new baby, a night shift, a loss. What makes it chronic is what happens afterward. You start going to bed earlier to make up for it, lying awake longer, watching the clock, dreading the night, and the bed itself quietly becomes a place your brain associates with being awake and anxious. At that point the original cause is gone and the insomnia keeps running on its own.
The most important thing to know is that the first-line treatment for chronic insomnia is not medication. It is cognitive behavioral therapy for insomnia, and every major guideline says so. It outperforms sleeping pills over the long run and the benefit lasts after treatment stops. That is not a way of withholding medication, it is simply what the evidence shows.
A proper evaluation also looks for what else might be driving it. Sleep apnea, restless legs, thyroid problems, depression, anxiety, alcohol, and medication side effects all disturb sleep, and treating the insomnia alone while missing one of those is how people stay stuck for years.
The first-line treatment for chronic insomnia, more effective than medication over time and without the dependence risk.
Sleep apnea, restless legs, thyroid disease, depression, and alcohol all disrupt sleep and are checked rather than assumed away.
There is a role for it, particularly short term. It is used with clear reasoning and an exit plan rather than indefinitely.
Insomnia both causes and worsens depression and anxiety. Treating them together works better than treating either alone.
Not as a first step. Chronic insomnia responds better and more durably to CBT-I, and starting with a pill often means being on one for years. Medication has a role, usually short term or alongside other treatment, and it is used with a plan.
Not for long-term or daily use. This practice does not manage long-term benzodiazepines and does not offer tapering. There are safer and more effective options for chronic insomnia.
A structured, short-term therapy that resets the association between your bed and being awake. It typically runs six to eight sessions and works for most people who complete it. There are also validated free apps built on it.
Possibly, particularly with snoring, witnessed pauses in breathing, morning headaches, or daytime sleepiness despite adequate time in bed. If the picture suggests it, referral for a sleep study is part of the plan.
Usually within one to two weeks. There is no waitlist and no referral requirement.
By secure video, anywhere in Oregon. The initial evaluation is up to 60 minutes and follow-ups are 30 or 45 minutes. You need to be physically located in Oregon during the visit.
Oregon care is self-pay only. $400 for the initial evaluation, $200 for a 30-minute follow-up, $250 for 45 minutes. Nothing is billed to a health plan.
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