Insomnia

Insomnia is a clinical disorder characterized by difficulty with sleep initiation, maintenance, or quality, despite adequate opportunity for sleep, resulting in daytime functional impairment. It is estimated to affect 10-15% of the adult population chronically, with significantly higher prevalence in those with comorbid psychiatric or chronic pain conditions. Prolonged insomnia is a risk factor for hypertension, type 2 diabetes, burnout, and major depressive disorder.

Are you experiencing...

Sleep onset latency greater than 30 minutes

Frequent nocturnal awakenings with difficulty returning to sleep

Early morning awakening before desired time

Non-restorative sleep despite adequate duration

Daytime fatigue, irritability, or cognitive impairment

Start Your Recovery.

Schedule a clinical assessment with Dr. Connor Anderson to build your personalized roadmap.

get started today with a free consultation

Common Restoration Protocol

As with all patients, my approach is tailored to you, from discovery and diagnostics, to personalized care plan. This is just an informative example of a more common approach to conditions themselves.

01. Functional Analysis

Functional assessment of insomnia prioritizes the identification of physiological, psychological, and environmental disruptors of the sleep-wake cycle. This includes evaluating the hypothalamic-pituitary-adrenal (HPA) axis for nocturnal cortisol elevations, identifying nutritional deficiencies that act as cofactors for neurotransmitter synthesis (such as Magnesium and Iron), and assessing circadian rhythm alignment through melatonin and core body temperature patterns. These are emphasized as first-line and most important. Sleep History Sleep Diary (1–2 weeks) – Used to assess sleep latency, awakenings, total sleep time, and calculate sleep efficiency. Sleep Efficiency (%) – Target ≥ 85%; calculated as total sleep time ÷ total time in bed. Validated Questionnaires - Insomnia Severity Index (ISI) - Pittsburgh Sleep Quality Index (PSQI) - Epworth Sleepiness Scale (ESS)

02. Introduction to Care

The therapeutic approach to insomnia is multi-modal, targeting the neurochemical, behavioral, and metabolic foundations of sleep. The primary pillars include restoring the circadian drive, modulating the HPA axis to reduce hyperarousal, and optimizing the nutritional environment for inhibitory neurotransmitter function. Insomnia is not simply a lack of sleep — it is most often a state of heightened nervous system arousal. Many people with insomnia feel exhausted but “wired,” making it difficult to fall asleep or stay asleep despite adequate opportunity for rest. Understanding this helps shift the focus from forcing sleep to calming and retraining the sleep system. Healthy sleep habits are important, but for many people with long-standing insomnia, they are necessary but not sufficient. When sleep difficulties persist for months or years, the brain can begin to associate the bed with alertness or frustration. In these cases, targeted behavioural and cognitive strategies are needed to restore healthy sleep patterns. Cognitive Behavioural Therapy for Insomnia (CBT-I) through trained healthcare providers (Psychologists, Psychotherapists, Social Workers (RSWs), Occupational Therapists (OTs), and Psychiatrists) is considered the most effective long-term treatment for chronic insomnia. It focuses on improving sleep efficiency, reducing sleep-related anxiety, and re-establishing a healthy relationship with sleep. Unlike medications, the benefits of CBT-I tend to persist after treatment ends.

03. Pillars of Improvement

Sleep Hygiene Basics

Establishing a consistent wake-up time 7 days a week, ensuring the bedroom is kept at 18 degrees Celsius, and using the bed only for sleep and intimacy to strengthen the stimulus control.

Digital and Light Hygiene

Strict avoidance of blue-wavelength light from screens at least 90 minutes before bedtime and ensuring 20 minutes of bright sunlight exposure within 1 hour of waking to anchor the circadian rhythm.

Dietary Strategy

Limiting caffeine intake to before 12:00 PM and avoiding large, high-protein meals or alcohol within 3 hours of sleep to prevent metabolic interference with sleep depth.

Stress Regulation and Wind-Down

Chronic stress is strongly linked to poor sleep quality and insomnia. Creating a predictable wind-down routine—such as reading, breathing exercises, or gentle stretching—helps signal safety and calm to the nervous system. Mental “decompression” is often as important as physical relaxation. Structured mindfulness-based stress reduction or progressive muscle relaxation techniques to lower sympathetic nervous system arousal before bed.

Sleep Environment

A cool, dark, and quiet bedroom supports the natural drop in body temperature and alertness needed for sleep. Keeping the bedroom reserved for sleep and intimacy helps retrain the brain to associate the space with rest rather than stimulation. Small environmental changes can meaningfully improve sleep quality.

Caffeine, Alcohol & Nicotine Awareness

Caffeine can interfere with sleep even when consumed earlier in the day, particularly in sensitive individuals. Alcohol may help with sleep onset but commonly disrupts sleep later in the night. Nicotine is stimulating and can worsen both sleep onset and maintenance.

Physical Activity

Regular physical activity improves sleep quality, sleep depth, and overall mental health. Exercise appears most effective when performed consistently and earlier in the day, though benefits can still occur regardless of timing. Movement supports sleep through stress reduction and circadian regulation.

Mindfulness & Relaxation

Mindfulness-based practices help reduce hyperarousal and pre-sleep anxiety. Studies show improvements in sleep quality and mental health when mindfulness is practiced consistently. These techniques support sleep by calming the stress response rather than forcing sleep.

Consistent Sleep-Wake Timing

Going to bed and waking up at roughly the same time each day helps anchor your internal body clock. A consistent wake time is especially important, even after a poor night of sleep, as it strengthens circadian rhythm and improves sleep drive over time. This is one of the most impactful changes for chronic insomnia.

Frequently Asked Questions About Insomnia

Should I take melatonin every night if I can't sleep?

While melatonin can be effective for circadian rhythm disorders (like jet lag), and dosing is important. It is not always the first-line treatment for primary insomnia. We focus on optimizing your body's endogenous production through light hygiene and targeted precursors first.

Can insomnia be cured without relying on supplements or medication?

Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the gold standard and can often resolve chronic insomnia without long-term dependence on any substances, natural or pharmaceutical.

Does a glass of wine before bed help with sleep quality?

Alcohol is a sedative that may decrease sleep latency (time to fall asleep) but typically significantly disrupts sleep architecture, particularly reducing REM sleep and causing mid-night awakenings as it is metabolized.

Why are you checking my iron levels for a sleep problem?

Low iron stores (ferritin) can cause Restless Leg Syndrome or periodic limb movements that wake you up, even if you do not feel 'anemic' during the day.