Insomnia and Sleep Care in Colorado

Falling asleep fine and waking at 2 or 3 in the morning. Lying awake with a mind that will not stop. Sleeping seven hours and still feeling wrung out. These are different problems, and they do not all respond to the same thing.

Sleep is often treated as a symptom of something else and left to fix itself once the anxiety or depression is treated. Sometimes it does. Often it does not, and the sleep problem keeps the rest going. During perimenopause the picture shifts again: 56 percent of women in the transition report sleeping less than seven hours a night, compared with 33 percent before it.

A first visit looks at the whole list rather than assuming one cause. Night sweats and hot flashes, which line up with about three quarters of measured overnight awakenings in women going through the menopause transition. Anxiety and depression, which can push sleep in either direction. Medications and their timing, including stimulants and some antidepressants. Alcohol, which shortens the time it takes to fall asleep and then fragments the second half of the night. Thyroid problems, iron status and pain. Sleep apnea, which is underdiagnosed in women and worth screening for when snoring, morning headaches or unrefreshing sleep are part of the picture.

The point is to find out which of these is actually operating for you, and in what order to address them.

Cognitive behavioral therapy for insomnia, usually shortened to CBT-I, is the first-line treatment for chronic insomnia in adults. It is not sleep hygiene advice. It is a structured approach to the timing of sleep and the thinking that keeps people awake, and its results hold up better over time than medication. I do not provide therapy myself, so when CBT-I is the right fit I will point you to it, including app-based and telehealth options that work well from the Western Slope.

Medication has a place, particularly in the short term or when something else has to be treated first. It is chosen with attention to what else you take and how long you plan to be on it, rather than started indefinitely by default. When night sweats or hormonal change are driving the awakenings, that gets addressed rather than sedated around. When depression or anxiety is in the mix, both get treated, because treating one and ignoring the other tends to leave you stuck.

Care is by telehealth anywhere in Colorado, starting with a 60-minute first visit.