INSOMNIA
When sleep is the thing you came in for.
Telehealth therapy for adults whose main complaint is sleep, and for whom trauma, anxiety, depression or shift work may be what is keeping them awake.
You did not come in to talk about trauma. You came in to sleep.
Plenty of people reach out to a therapist for one reason: they cannot sleep. They are not necessarily looking to talk about their past or their feelings. They want to stop lying awake at 3 a.m., stop dreading bedtime, and stop dragging through every day. That is a completely reasonable place to start, and it is treated here as the goal it is.
If you want the background on why trauma disrupts sleep, the guide on what trauma does to sleep explains it. This page is about what the actual treatment looks like when sleep is the reason you are here.
Sleep problems rarely travel alone
Insomnia often has a driver. A body that stays on guard after trauma will not let you drift off easily. Anxiety fills the quiet with worry and planning. Depression can mean lying in bed for hours without real rest, or waking far too early. Nightmares make sleep itself feel unsafe. When one of these is behind the sleep problem, working on sleep alone only goes so far. Part of the first few sessions is figuring out what is driving it, so both can be addressed together.
What CBT-based sleep work involves
Zandria Hooks, LCSW, uses Cognitive Behavioral Therapy, and sleep strategies are part of how she uses it. To be clear about scope: this is not a claim of specialized CBT-I training. It is CBT applied to sleep as part of broader treatment. In practice, that can include:
- A sleep log. A simple record of when you go to bed, fall asleep and wake, so patterns become visible rather than guessed.
- Reconnecting bed with sleep. Reducing time spent awake and frustrated in bed so your brain stops treating it as a place to worry.
- A steadier rhythm. A consistent wake time and wind-down routine that fit your real life.
- Working with nighttime thoughts. Noticing the catastrophic thinking that shows up at 2 a.m. and learning ways to answer it.
- Calming the body. Practical tools to bring down the physical alertness that keeps you awake.
When to see a physician first
Some sleep problems are medical. Loud snoring, pauses in breathing, gasping awake, restless or jumpy legs, or deep exhaustion despite spending plenty of time in bed can point to conditions a doctor should evaluate. Pain, medication side effects and other health issues can also disrupt sleep. If any of these sound familiar, see a physician to rule out a medical cause. Therapy can still run alongside that. Questions about sleep medication always belong with your prescriber.
Shift work and sleep on an upside-down clock
Nurses, officers, firefighters, medics, dispatchers and service members often sleep in the daytime, on rotating schedules, or in short fragments. Standard sleep advice written for a nine-to-five life can feel useless. The work here adapts strategies to your actual schedule: protecting daytime sleep, planning around rotations and handling the days off without wrecking the next shift. The first responder page covers more of what shift life does to the nervous system.
Where trauma treatment fits in
If nightmares or hypervigilance are keeping you up, trauma-focused treatment may be part of the plan. EMDR and CPT work on the memories and beliefs that keep the alarm system switched on. Zandria is EMDR trained and CPT certified. Sleep work and trauma work often support each other, and the order is decided with you.
Sleep questions before starting
Is this CBT-I?
No. CBT-I is a specific protocol with its own training, and it is not claimed here. Sleep is addressed using CBT-based strategies within broader CBT, alongside treatment for the trauma, anxiety or depression that may be driving the problem.
Should I see a doctor first?
If you snore loudly, stop breathing or gasp at night, have restless legs, or feel exhausted despite enough time in bed, talk with a physician to rule out a medical sleep problem. Therapy can run alongside that.
Can you advise me about sleep medication?
No. Medication questions belong with your prescriber. Therapy focuses on thoughts, habits and the things keeping your system on alert at night.
I work nights. Can sleep still improve?
Shift work makes sleep harder, and there is no perfect answer for it. Strategies can still be adapted to your actual schedule rather than a nine-to-five one.
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